Sex Difference in Aortic Root Replacement With a Stentless Bioprosthesis

There is an established difference in presentation, pattern of disease progression, and long-term outcomes in males and females presenting with cardiovascular disease. It is also known that aortic insufficiency (AI) severity and left ventricular dilatation are closely associated in males, but not in females. This article found that females who underwent aortic valve replacement with stentless bioprothesis for aortic insufficiency had worse outcomes compared to males, even after accounting for differences in age. This article raises an important question about whether risk stratification models and current guidelines for intervention in AI need to be revised due to the growing evidence of the contribution of sex to cardiovascular illness.