New Research Indicates Catheter Procedure is Superior for Women with Aortic Stenosis

Recent findings from an international research team, including contributions from Austrian experts, reveal that women suffering from severe aortic valve stenosis benefit more from catheter-based interventions than traditional surgical procedures.

Aortic stenosis, a condition that increasingly affects individuals with age, traditionally required a major surgical operation involving the implantation of an artificial heart valve. This approach often necessitated the temporary cessation of heart function and the use of a heart-lung machine to maintain oxygen supply, making it a high-risk procedure. However, advancements in cardiology and medical technology have paved the way for less invasive catheter systems that allow for the installation of a new aortic valve through blood vessels, significantly mitigating risks associated with open-heart surgery.

The researchers aimed to evaluate the outcomes of surgical and catheter-based strategies specifically for women, who have been historically underrepresented in clinical studies despite experiencing more complications than men when undergoing surgical treatment for severe aortic stenosis.

The study, known as RHEIA, involved 48 treatment centers across Europe and included 443 female participants. Of these, 420 were randomly assigned to one of two groups: one receiving surgical treatment and the other undergoing a catheter-based intervention known as transcatheter aortic valve implantation (TAVI) through the femoral artery. The average age of the participants was 73 years.

Researchers monitored the overall mortality rates, incidence of strokes, and the need for hospital readmissions related to heart valve issues or other complications for a duration of one year. The results demonstrated a clear advantage for the catheter intervention.

Among the women treated via catheter, 8.9% experienced complications, compared to 15.6% of those who underwent surgery. This difference was statistically significant. Specifically, the total mortality rate in the surgical group was 2%, more than double the 0.9% observed in the catheter group. While stroke rates were comparable between both groups, at 3.3% for TAVI and 3% for surgery, the need for readmission within one year was notably higher among surgical patients, with 11.4% requiring further hospitalization compared to just 5.8% in the catheter group.

These findings underscore the potential for catheter-based procedures to provide safer and more effective treatment options for women with aortic valve stenosis, offering a promising alternative to traditional surgical methods.