Gender Inequalities in Aortic and Mitral Valve Replacement and Repair Procedures in Germany
Author(s)
Jana Boleckova, PhD1, Rachele Busca, MBA, MSc, PharmD2, Or Shimoni, M.D.3.
1Senior Manager HTA and RWE, Edwards Lifesciences Sàrl, Prague, Czech Republic, 2Edwards Lifesciences Sàrl, Nyon, Switzerland, 3Edwards Lifesciences, Caeseria, Israel.
1Senior Manager HTA and RWE, Edwards Lifesciences Sàrl, Prague, Czech Republic, 2Edwards Lifesciences Sàrl, Nyon, Switzerland, 3Edwards Lifesciences, Caeseria, Israel.
OBJECTIVES: Gender disparities in cardiovascular interventions persist, but few studies have examined long-term trends in procedural access. We evaluated gender differences in aortic valve replacement (AVR) and mitral valve replacement or repair (MVR) procedures in Germany from 2006 to 2023.
METHODS: We used publicly available data from the Federal Statistical Office in Germany. MVR and AVR procedures were identified for patients aged 60 +. AVRs were further stratified as surgical (SAVR) or transcatheter (TAVR). MVR was stratified as Surgical (SMVR) and mitral valve transcatheter edge-to-edge repair (MTEER). TAVR was first reported in 2008 and MTEER in 2011. Data were stratified by gender. We calculated annual gender proportions for each procedure and analyzed trends.
RESULTS: The trend of TAVR procedures is increasing, while SAVR is slightly decreasing. In 2023, TAVR represented 73.9% of all AVR procedures in Germany. From 2006 to 2023, the proportion of male SAVR recipients increased from 55.3% to 72.3%, and TAVR male distribution increased from 40.2% (in 2008) to 54.1% (in 2023). The proportion of women in AVR slightly decreased from 44.7% to 41.2%. The number of SMVRs increased from 3,262 in 2006 to 3,841 in 2023 and MTEER grew rapidly from 2011 to 8,918 in 2023, representing 69.9% of all MVR procedures. The gender gap in SMVR changed over time, male recipients of SMVR grew from 45.4% in 2006 to 54.7% in 2023 and decreased in MTEER from 58.4% in 2011 to 51.3% in 2023. Overall, female representation in MVR decreased from 54.6% to 47.7%.
CONCLUSIONS: Between 2006 and 2023, the proportion of males in both AVR and MVR in Germany increased. TAVR had more female recipients initially, but more males were treated at the end. The only procedure with an increasing proportion of females was MTEER. Reasons for these gender disparities deserve additional insights.
METHODS: We used publicly available data from the Federal Statistical Office in Germany. MVR and AVR procedures were identified for patients aged 60 +. AVRs were further stratified as surgical (SAVR) or transcatheter (TAVR). MVR was stratified as Surgical (SMVR) and mitral valve transcatheter edge-to-edge repair (MTEER). TAVR was first reported in 2008 and MTEER in 2011. Data were stratified by gender. We calculated annual gender proportions for each procedure and analyzed trends.
RESULTS: The trend of TAVR procedures is increasing, while SAVR is slightly decreasing. In 2023, TAVR represented 73.9% of all AVR procedures in Germany. From 2006 to 2023, the proportion of male SAVR recipients increased from 55.3% to 72.3%, and TAVR male distribution increased from 40.2% (in 2008) to 54.1% (in 2023). The proportion of women in AVR slightly decreased from 44.7% to 41.2%. The number of SMVRs increased from 3,262 in 2006 to 3,841 in 2023 and MTEER grew rapidly from 2011 to 8,918 in 2023, representing 69.9% of all MVR procedures. The gender gap in SMVR changed over time, male recipients of SMVR grew from 45.4% in 2006 to 54.7% in 2023 and decreased in MTEER from 58.4% in 2011 to 51.3% in 2023. Overall, female representation in MVR decreased from 54.6% to 47.7%.
CONCLUSIONS: Between 2006 and 2023, the proportion of males in both AVR and MVR in Germany increased. TAVR had more female recipients initially, but more males were treated at the end. The only procedure with an increasing proportion of females was MTEER. Reasons for these gender disparities deserve additional insights.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MT20
Topic
Medical Technologies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)