Sex differences in outcomes after transcatheter pulmonary valve implantation: No impact on endocarditis but increased reintervention risk in males - 27/08/26
, Aleksander Kempny 2, Ali Houeijeh 3, Maria Jesus Del-Cerro-Marin 4, James R. Bentham 5, Nicolas Combes 6, Clement Karsenty 7, Sophie-Guiti Malekzadeh Milani 8, Hélène Bouvaist 9, Zakaria Jalal 10, Patrice Guérin 11, Julie Lourtet-Hascoet 12, Philippe Aldebert 13, Anja Tengler 14, Stephane Morisset 15, Alain Fraisse 16Résumé |
Introduction |
Sex-related differences in outcomes after transcatheter pulmonary valve implantation (TPVI) remain incompletely understood, particularly regarding infective endocarditis (IE), valve durability, and survival.
Methods |
This study is a sub-analysis of the ENDOCPULM international registry including 1200 patients undergoing TPVI between 2007 and 2021. The cohort comprised 486 females (40.5%) and 714 males (59.5%). Outcomes included IE, pulmonary valve reintervention (PVR), and overall survival.
Results |
Males underwent TPVI at a younger age and exhibited higher post-procedural RVOT gradients. During a median follow-up of 2.3 years (3714 patient-years), 65 patients (5.4%) developed IE. Sex was not associated with IE risk in the overall cohort, and subgroup analyses showed limited and inconsistent signals without robust effect.
In contrast, male sex was associated with a higher risk of valve reintervention in specific subgroups ( Fig. 1 ), particularly in patients with conotruncal defects and in those aged > 40 years. These findings are consistent with a less favorable hemodynamic profile in males, combining earlier intervention and higher residual gradients.
No significant association between sex and overall survival was observed.
Conclusion |
In this large TPVI cohort, sex has no consistent impact on IE risk. However, male sex is associated with increased risk of valve reintervention in selected subgroups, likely driven by timing of intervention and residual hemodynamic burden. No effect on overall survival was observed, although follow-up duration remains insufficient to assess long-term mortality.
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Vol 119 - N° 8-9S
P. S243 - août 2026 Retour au numéro
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