Management of patients with severe aortic stenosis (AS) may differ according to the patient sex. This study aimed to describe patterns of aortic valve replacement (AVR) for severe AS across Europe, including stratification by sex. Procedure volume data for surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) for six years (2015–2020) were extracted from national databases for Austria, Czech Republic, Denmark, England, Finland, France, Germany, Norway, Poland, Spain, Sweden, and Switzerland and stratified by sex. Patients per million population (PPM) undergoing AVR per year were calculated using population estimates from Eurostat. Between 2015 and 2019, AVR procedures grew at an average annual rate of 3.9%. In 2020, the average total PPM undergoing AVR across all countries was 339, with 51% of procedures being TAVI and 49% SAVR. AVR PPM varied widely between countries, with the highest and lowest in Germany and Poland, respectively. The average total PPM was higher for men than women (423 vs. 258), but a higher proportion of women (62%) than men (44%) received TAVI. The proportion of TAVI among total AVR procedures increased with age, with an overall average of 96% of men and 98% of women aged ≥85 years receiving TAVI; however, adoption of TAVI varied by country. The analysis of temporal trends in the adoption of TAVI vs. SAVR across Europe showed significant variations. Despite the higher use of TAVI vs. SAVR in women, overall rates of AV intervention in women were lower compared to men.

中文翻译：

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欧洲主动脉瓣置换术的模式和性别采用情况

严重主动脉瓣狭窄 (AS) 患者的治疗可能因患者性别而异。本研究旨在描述整个欧洲严重主动脉瓣置换术 (AVR) 的模式，包括按性别分层。六年（2015-2020）的主动脉瓣置换术（SAVR）和经导管主动脉瓣植入术（TAVI）的手术量数据是从奥地利、捷克共和国、丹麦、英国、芬兰、法国、德国、挪威、波兰、西班牙、瑞典和瑞士，并按性别分层。每年接受 AVR 的每百万人口 (PPM) 患者是根据欧盟统计局的人口估计值计算的。 2015 年至 2019 年间，AVR 手术年均增长率为 3.9%。 2020 年，所有国家接受 AVR 的平均 PPM 总数为 339，其中 51% 的手术为 TAVI，49% 为 SAVR。各国之间的 AVR PPM 差异很大，德国和波兰分别最高和最低。男性的平均总 PPM 高于女性（423 比 258），但接受 TAVI 的女性比例（62%）高于男性（44%）。 TAVI 在总 AVR 手术中的比例随着年龄的增长而增加，总体平均 96% 的男性和 98% 的女性年龄≥85 岁接受 TAVI；然而，TAVI 的采用情况因国家而异。对整个欧洲采用 TAVI 与 SAVR 的时间趋势的分析显示出显着的差异。尽管女性中 TAVI 的使用率高于 SAVR，但女性 AV 干预的总体比率低于男性。