Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement

Mauro Gitto; Won-Keun Kim; Andrea Buono; Tommaso Fabris; Chiara De Biase; Giuliano Costa; Nicholas Montarello; Pier Pasquale Leone; Andrea Scotti; Michele Bellamoli; Mesfer Alfadhel; Ofir Koren; Simone Fezzi; Barbara Bellini; Mauro Massussi; Giulia Costa; Chiara Fraccaro; Alessandro Mazzapicchi; Enrico Giacomin; Francesco Burzotta; Andrea Zito; Carlo Trani; Riccardo Gorla; Karsten Hug; Carlo Briguori; Francesco Tartaglia; Luca Bettari; Michele Colucci; Emmanuel Villa; Damiano Regazzoli; Ciro Pollio Benvenuto; Mauro Boiago; Gianmaria Calamita; Matthias Renker; Mario Garcia Gomez; Alfonso Ielasi; Uri Landes; Tobias Rheude; Michael Joner; Luca Testa; Ignacio Amat Santos; Francesco Saia; Luca Favero; Lin Bai; Mao Chen; Marianna Adamo; Marco De Carlo; Matteo Montorfano; Raj R Makkar; Darren Mylotte; Dan Blackman; Marco Barbanti; Ole De Backer; Didier Tchetche; Giuseppe Tarantini; Azeem Latib; Diego Maffeo; Antonio Mangieri; Roxana Mehran

doi:10.1016/j.ijcard.2025.133792

Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement

Mauro Gitto
, Won-Keun Kim
, Andrea Buono
, Tommaso Fabris
, Chiara De Biase
, Giuliano Costa
, Nicholas Montarello
, Pier Pasquale Leone
, Andrea Scotti
, Michele Bellamoli
, Mesfer Alfadhel
, Ofir Koren
, Simone Fezzi
, Barbara Bellini
, Mauro Massussi
, Giulia Costa
, Chiara Fraccaro
, Alessandro Mazzapicchi
, Enrico Giacomin
, Francesco Burzotta

Andrea Zito, Carlo Trani, Riccardo Gorla, Karsten Hug, Carlo Briguori, Francesco Tartaglia, Luca Bettari, Michele Colucci, Emmanuel Villa, Damiano Regazzoli, Ciro Pollio Benvenuto, Mauro Boiago, Gianmaria Calamita, Matthias Renker, Mario Garcia Gomez, Alfonso Ielasi, Uri Landes, Tobias Rheude, Michael Joner, Luca Testa, Ignacio Amat Santos, Francesco Saia, Luca Favero, Lin Bai, Mao Chen, Marianna Adamo, Marco De Carlo, Matteo Montorfano, Raj R Makkar, Darren Mylotte, Dan Blackman, Marco Barbanti, Ole De Backer, Didier Tchetche, Giuseppe Tarantini, Azeem Latib, Diego Maffeo, Antonio Mangieri^*, Roxana Mehran

^*Autore corrispondente per questo lavoro

Humanitas University
Icahn School of Medicine at Mount Sinai
Fondazione Poliambulanza Istituto Ospedaliero
University of Padua
Clinique Pasteur Toulouse
University of Catania
University of Copenhagen
Albert Einstein College of Medicine
Leeds Teaching Hospitals NHS Trust
Cedars-Sinai Medical Center
University of Verona
IRCCS San Raffaele Scientific Institute
University of Brescia
University Hospital of Pisa
University of Bologna
IRCCS Policlinico San Donato
Technical University of Munich
Kerckhoff Heart Center
Hospital Clínico Universitario de Valladolid
Istituto di Ricovero e Cura a Carattere Scientifico Hospital Galeazzi-Sant'Ambrogio
Tel Aviv University
Edith Wolfson Medical Center Israel
Sichuan University
Vita-Salute San Raffaele University
University of Galway

Risultato della ricerca: Contributo in rivista › Articolo

Abstract

Background: There is paucity of data regarding sex-related differences among patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR). Methods: The AD-HOC was an observational, retrospective, investigator-initiated registry enrolling consecutive patients with Sievers type 1 BAV stenosis who underwent TAVR at 24 international centers from 2016 to 2023. The primary endpoint was major adverse events (MAEs), including death, neurologic events and heart failure hospitalization. Results: Of 980 included patients, 364 (37 %) were women. As compared to men, women had lower prevalence of associated comorbidities, smaller aortic dimensions and lower calcific burden on the raphe. After propensity score adjustment, Valve Academic Research Consortium-3 (VARC-3) defined technical success (93.7 % vs. 95.8 %, adjusted odds ratio [adj. OR]: 0.37, 95 % confidence intervals [CI]: 0.17–0.81) and device success (83.5 % vs. 86.6 %, adj, OR: 0.61, 95 % CI: 0.38–0.98) were lower in women, who also had more major periprocedural bleedings. There were no sex-differences in 3-year MAEs (19.7 % in women vs. 25.6 % in men, adjusted hazard ratio [adj. HR]: 0.75, 95 % CI: 0.47–1.20). Predictors of MAEs in men included diabetes, chronic obstructive pulmonary disease and severe aortic valve calcifications. Conversely, in women, chronic kidney disease was an independent predictor of MAEs and hemodynamic valve performance and higher baseline mean aortic gradients had a protective effect. Conclusions: Women undergoing TAVR for raphe-type BAV stenosis had lower technical and device success, but similar long-term clinical outcomes compared to men. Prognostic determinants differed between sexes, including clinical comorbidities in men and poor hemodynamic valve performance in women.

Lingua originale	Inglese
pagine (da-a)	N/A-N/A
Rivista	International Journal of Cardiology
Volume	441
Numero di pubblicazione	Aug 18
DOI	https://doi.org/10.1016/j.ijcard.2025.133792
Stato di pubblicazione	Pubblicato - 2025

OSS delle Nazioni Unite

Questo processo contribuisce al raggiungimento dei seguenti obiettivi di sviluppo sostenibile

SDG 3 Salute e benessere

All Science Journal Classification (ASJC) codes

Cardiologia e Medicina Cardiovascolare

Keywords

Bicuspid aortic valve
Sievers type 1
Transcatheter aortic valve replacement
VARC-3
Women

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10.1016/j.ijcard.2025.133792

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Gitto, M., Kim, W.-K., Buono, A., Fabris, T., De Biase, C., Costa, G., Montarello, N., Leone, P. P., Scotti, A., Bellamoli, M., Alfadhel, M., Koren, O., Fezzi, S., Bellini, B., Massussi, M., Costa, G., Fraccaro, C., Mazzapicchi, A., Giacomin, E., ... Mehran, R. (2025). Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement. International Journal of Cardiology, 441(Aug 18), N/A-N/A. https://doi.org/10.1016/j.ijcard.2025.133792

@article{c8dc54e57f53421aad17f968bd8f1d32,

title = "Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement",

abstract = "Background: There is paucity of data regarding sex-related differences among patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR). Methods: The AD-HOC was an observational, retrospective, investigator-initiated registry enrolling consecutive patients with Sievers type 1 BAV stenosis who underwent TAVR at 24 international centers from 2016 to 2023. The primary endpoint was major adverse events (MAEs), including death, neurologic events and heart failure hospitalization. Results: Of 980 included patients, 364 (37 \%) were women. As compared to men, women had lower prevalence of associated comorbidities, smaller aortic dimensions and lower calcific burden on the raphe. After propensity score adjustment, Valve Academic Research Consortium-3 (VARC-3) defined technical success (93.7 \% vs. 95.8 \%, adjusted odds ratio [adj. OR]: 0.37, 95 \% confidence intervals [CI]: 0.17–0.81) and device success (83.5 \% vs. 86.6 \%, adj, OR: 0.61, 95 \% CI: 0.38–0.98) were lower in women, who also had more major periprocedural bleedings. There were no sex-differences in 3-year MAEs (19.7 \% in women vs. 25.6 \% in men, adjusted hazard ratio [adj. HR]: 0.75, 95 \% CI: 0.47–1.20). Predictors of MAEs in men included diabetes, chronic obstructive pulmonary disease and severe aortic valve calcifications. Conversely, in women, chronic kidney disease was an independent predictor of MAEs and hemodynamic valve performance and higher baseline mean aortic gradients had a protective effect. Conclusions: Women undergoing TAVR for raphe-type BAV stenosis had lower technical and device success, but similar long-term clinical outcomes compared to men. Prognostic determinants differed between sexes, including clinical comorbidities in men and poor hemodynamic valve performance in women.",

keywords = "Bicuspid aortic valve, Sievers type 1, Transcatheter aortic valve replacement, VARC-3, Women, Bicuspid aortic valve, Sievers type 1, Transcatheter aortic valve replacement, VARC-3, Women",

author = "Mauro Gitto and Won-Keun Kim and Andrea Buono and Tommaso Fabris and \{De Biase\}, Chiara and Giuliano Costa and Nicholas Montarello and Leone, \{Pier Pasquale\} and Andrea Scotti and Michele Bellamoli and Mesfer Alfadhel and Ofir Koren and Simone Fezzi and Barbara Bellini and Mauro Massussi and Giulia Costa and Chiara Fraccaro and Alessandro Mazzapicchi and Enrico Giacomin and Francesco Burzotta and Andrea Zito and Carlo Trani and Riccardo Gorla and Karsten Hug and Carlo Briguori and Francesco Tartaglia and Luca Bettari and Michele Colucci and Emmanuel Villa and Damiano Regazzoli and Benvenuto, \{Ciro Pollio\} and Mauro Boiago and Gianmaria Calamita and Matthias Renker and Gomez, \{Mario Garcia\} and Alfonso Ielasi and Uri Landes and Tobias Rheude and Michael Joner and Luca Testa and Santos, \{Ignacio Amat\} and Francesco Saia and Luca Favero and Lin Bai and Mao Chen and Marianna Adamo and \{De Carlo\}, Marco and Matteo Montorfano and Makkar, \{Raj R\} and Darren Mylotte and Dan Blackman and Marco Barbanti and \{De Backer\}, Ole and Didier Tchetche and Giuseppe Tarantini and Azeem Latib and Diego Maffeo and Antonio Mangieri and Roxana Mehran",

year = "2025",

doi = "10.1016/j.ijcard.2025.133792",

language = "English",

volume = "441",

pages = "N/A--N/A",

journal = "International Journal of Cardiology",

issn = "0167-5273",

number = "Aug 18",

}

Gitto, M, Kim, W-K, Buono, A, Fabris, T, De Biase, C, Costa, G, Montarello, N, Leone, PP, Scotti, A, Bellamoli, M, Alfadhel, M, Koren, O, Fezzi, S, Bellini, B, Massussi, M, Costa, G, Fraccaro, C, Mazzapicchi, A, Giacomin, E, Burzotta, F, Zito, A, Trani, C, Gorla, R, Hug, K, Briguori, C, Tartaglia, F, Bettari, L, Colucci, M, Villa, E, Regazzoli, D, Benvenuto, CP, Boiago, M, Calamita, G, Renker, M, Gomez, MG, Ielasi, A, Landes, U, Rheude, T, Joner, M, Testa, L, Santos, IA, Saia, F, Favero, L, Bai, L, Chen, M, Adamo, M, De Carlo, M, Montorfano, M, Makkar, RR, Mylotte, D, Blackman, D, Barbanti, M, De Backer, O, Tchetche, D, Tarantini, G, Latib, A, Maffeo, D, Mangieri, A & Mehran, R 2025, 'Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement', International Journal of Cardiology, vol. 441, n. Aug 18, pagg. N/A-N/A. https://doi.org/10.1016/j.ijcard.2025.133792

TY - JOUR

T1 - Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement

AU - Gitto, Mauro

AU - Kim, Won-Keun

AU - Buono, Andrea

AU - Fabris, Tommaso

AU - De Biase, Chiara

AU - Costa, Giuliano

AU - Montarello, Nicholas

AU - Leone, Pier Pasquale

AU - Scotti, Andrea

AU - Bellamoli, Michele

AU - Alfadhel, Mesfer

AU - Koren, Ofir

AU - Fezzi, Simone

AU - Bellini, Barbara

AU - Massussi, Mauro

AU - Costa, Giulia

AU - Fraccaro, Chiara

AU - Mazzapicchi, Alessandro

AU - Giacomin, Enrico

AU - Burzotta, Francesco

AU - Zito, Andrea

AU - Trani, Carlo

AU - Gorla, Riccardo

AU - Hug, Karsten

AU - Briguori, Carlo

AU - Tartaglia, Francesco

AU - Bettari, Luca

AU - Colucci, Michele

AU - Villa, Emmanuel

AU - Regazzoli, Damiano

AU - Benvenuto, Ciro Pollio

AU - Boiago, Mauro

AU - Calamita, Gianmaria

AU - Renker, Matthias

AU - Gomez, Mario Garcia

AU - Ielasi, Alfonso

AU - Landes, Uri

AU - Rheude, Tobias

AU - Joner, Michael

AU - Testa, Luca

AU - Santos, Ignacio Amat

AU - Saia, Francesco

AU - Favero, Luca

AU - Bai, Lin

AU - Chen, Mao

AU - Adamo, Marianna

AU - De Carlo, Marco

AU - Montorfano, Matteo

AU - Makkar, Raj R

AU - Mylotte, Darren

AU - Blackman, Dan

AU - Barbanti, Marco

AU - De Backer, Ole

AU - Tchetche, Didier

AU - Tarantini, Giuseppe

AU - Latib, Azeem

AU - Maffeo, Diego

AU - Mangieri, Antonio

AU - Mehran, Roxana

PY - 2025

Y1 - 2025

N2 - Background: There is paucity of data regarding sex-related differences among patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR). Methods: The AD-HOC was an observational, retrospective, investigator-initiated registry enrolling consecutive patients with Sievers type 1 BAV stenosis who underwent TAVR at 24 international centers from 2016 to 2023. The primary endpoint was major adverse events (MAEs), including death, neurologic events and heart failure hospitalization. Results: Of 980 included patients, 364 (37 %) were women. As compared to men, women had lower prevalence of associated comorbidities, smaller aortic dimensions and lower calcific burden on the raphe. After propensity score adjustment, Valve Academic Research Consortium-3 (VARC-3) defined technical success (93.7 % vs. 95.8 %, adjusted odds ratio [adj. OR]: 0.37, 95 % confidence intervals [CI]: 0.17–0.81) and device success (83.5 % vs. 86.6 %, adj, OR: 0.61, 95 % CI: 0.38–0.98) were lower in women, who also had more major periprocedural bleedings. There were no sex-differences in 3-year MAEs (19.7 % in women vs. 25.6 % in men, adjusted hazard ratio [adj. HR]: 0.75, 95 % CI: 0.47–1.20). Predictors of MAEs in men included diabetes, chronic obstructive pulmonary disease and severe aortic valve calcifications. Conversely, in women, chronic kidney disease was an independent predictor of MAEs and hemodynamic valve performance and higher baseline mean aortic gradients had a protective effect. Conclusions: Women undergoing TAVR for raphe-type BAV stenosis had lower technical and device success, but similar long-term clinical outcomes compared to men. Prognostic determinants differed between sexes, including clinical comorbidities in men and poor hemodynamic valve performance in women.

AB - Background: There is paucity of data regarding sex-related differences among patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR). Methods: The AD-HOC was an observational, retrospective, investigator-initiated registry enrolling consecutive patients with Sievers type 1 BAV stenosis who underwent TAVR at 24 international centers from 2016 to 2023. The primary endpoint was major adverse events (MAEs), including death, neurologic events and heart failure hospitalization. Results: Of 980 included patients, 364 (37 %) were women. As compared to men, women had lower prevalence of associated comorbidities, smaller aortic dimensions and lower calcific burden on the raphe. After propensity score adjustment, Valve Academic Research Consortium-3 (VARC-3) defined technical success (93.7 % vs. 95.8 %, adjusted odds ratio [adj. OR]: 0.37, 95 % confidence intervals [CI]: 0.17–0.81) and device success (83.5 % vs. 86.6 %, adj, OR: 0.61, 95 % CI: 0.38–0.98) were lower in women, who also had more major periprocedural bleedings. There were no sex-differences in 3-year MAEs (19.7 % in women vs. 25.6 % in men, adjusted hazard ratio [adj. HR]: 0.75, 95 % CI: 0.47–1.20). Predictors of MAEs in men included diabetes, chronic obstructive pulmonary disease and severe aortic valve calcifications. Conversely, in women, chronic kidney disease was an independent predictor of MAEs and hemodynamic valve performance and higher baseline mean aortic gradients had a protective effect. Conclusions: Women undergoing TAVR for raphe-type BAV stenosis had lower technical and device success, but similar long-term clinical outcomes compared to men. Prognostic determinants differed between sexes, including clinical comorbidities in men and poor hemodynamic valve performance in women.

KW - Bicuspid aortic valve

KW - Sievers type 1

KW - Transcatheter aortic valve replacement

KW - VARC-3

KW - Women

KW - Bicuspid aortic valve

KW - Sievers type 1

KW - Transcatheter aortic valve replacement

KW - VARC-3

KW - Women

UR - https://publicatt.unicatt.it/handle/10807/320776

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U2 - 10.1016/j.ijcard.2025.133792

DO - 10.1016/j.ijcard.2025.133792

M3 - Article

SN - 0167-5273

VL - 441

SP - N/A-N/A

JO - International Journal of Cardiology

JF - International Journal of Cardiology

IS - Aug 18

ER -

Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement

Abstract

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All Science Journal Classification (ASJC) codes

Keywords

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