†These authors contributed equally.
Background: To assess whether there are differences in common
postoperative complications and survival between men and women after
transcatheter aortic valve implantation. Methods: We searched the
Cochrane Library, PubMed, Embase, and the Web of Science from January 2000 to
August 2022. Gender-related articles reporting complications and mortality after
transcatheter aortic valve implantation were identified. The primary outcomes
were the thirty-day mortality, one-year mortality and perivalvular leakage. The
secondary outcomes were conversion to open heart surgery during operation,
ejection fraction after operation, reintervention and other common postoperative
complications. Data were pooled using the risk ratio or standardized mean
difference with 95% confidence interval. Subgroup analysis, meta-regression,
sensitivity analysis, egger’s test and begg’s test were performed. The original
study protocol was registered prospectively with PROSPERO (CRD42021245858).
Results: There were 24 studies, a total of 92,499 patients, enrolled in
our systematic review and meta-analysis, including 43,948 men and 48,551 women.
Comprehensive analysis showed significant differences in gender in postoperative
complications and survival after transcatheter aortic valve implantation. Men had
a significantly higher risk of perivalvular leakage (risk ratio
(RR) = 1.42; 95% CI: 1.15 to 1.75; p = 0.001; I