Sex-Specific Differences in Clinical Outcomes After Transcatheter Aortic Valve Replacement: A Meta-Analysis of Reconstructed Individual Patient Survival Data

Background: Females with severe aortic stenosis present with distinct anatomical and clinical characteristics compared to males, which may influence outcomes following transcatheter aortic valve replacement (TAVR). We sought to investigate the prognostic impact of sex-specific differences on short- and long-term outcomes following TAVR. Methods: PubMed, Embase, Scopus, and Web of Science were searched through August 2025 for randomized and observational studies reporting sex-specific outcomes after TAVR. Reconstructed individual patient data from published Kaplan-Meier (KM) curves were used to estimate long-term survival outcomes. Results: < 0.001) during follow-up extending to 10 years, whereas risks of stroke/transient ischemic attack and myocardial infarction were comparable between sexes. Conclusions: Females undergoing TAVR experience higher early risks of mortality, stroke, bleeding, and vascular complications, but exhibit a sustained long-term survival advantage compared with males, highlighting the need for sex-centered periprocedural management strategies.