Gender-Specific Disparities in Outcomes of Transcatheter Aortic Valve Implantation/Repair in Patients With Aortic Stenosis: A Systematic Review.

Aortic stenosis caused by calcification and sclerosis of the left ventricular outflow tract is a life-threatening condition associated with a high risk of heart failure. Transcatheter aortic valve replacement (TAVR) is the definitive treatment for this condition. Gender-specific disparities influence post-procedural recovery, as women, despite generally having better long-term survival, have higher risks of short-term mortality, vascular complications, and major bleeding. Understanding these differences is essential for better post-operative care. We performed a comprehensive literature search of PubMed, Google Scholar, and the Cochrane Library using the keywords "Gender Disparities," "TAVR," "Aortic Stenosis," and "TAVI." Studies published between 2015 and 2025 were screened, yielding 25 eligible studies. Quality assessment was conducted using the Newcastle-Ottawa Scale for cohorts and the Cochrane risk-of-bias tool for randomized controlled trials. Overall, the included studies demonstrated moderate to high methodological quality, ensuring reliability of the findings. Female patients undergoing TAVR showed better long-term survival, with seven studies reporting higher all-cause mortality in females (p <0.05) and six reporting a significantly higher mortality in males (p<0.05). Stroke and MACE outcomes were mixed; some studies reported a higher incidence in females (p<0.05), whereas others found no significant difference (p > 0.05). Females had significantly higher rates of vascular complications, major or life-threatening bleeding (p<0.05), and a smaller aortic valve annulus. Secondary outcomes, including new pacemakers and non-home discharge, showed variable significance between genders. Women undergoing TAVR demonstrate better long-term survival despite higher rates of vascular complications and bleeding. Further research is needed to confirm these gender-related differences and guide post-procedural management.