[Transcatheter aortic valve implantation in women: Sex-specific features].

Abstract

Women remain underrepresented in major TAVI studies, despite notable anatomical, pathophysiological, and clinical characteristics. These differences impact diagnosis, technical decisions, outcomes, and post-TAVI complications. Women typically present with a smaller aortic annulus, lower calcific burden but increased fibrosis, and a specific hemodynamic profile: paradoxical low-flow, low-gradient aortic stenosis. In the short term, they are at higher risk of annular rupture, coronary obstruction, and vascular complications, but experience less paravalvular regurgitation. In the long term, women benefit from better survival and a quality of life comparable to that of men. In light of these findings and the RHEIA study, a sex-specific, personalized approach is essential in the management of aortic stenosis.