Paquin A, Annabi MS, Bienjonetti-Boudreau D, et al. - Given that elevated mortality post-aortic valve replacement (AVR) is seen in women suffering from severe aortic stenosis (AS) and also they tend to be managed surgically at a more advanced stage of their valvular disease, therefore, researchers performed this retrospective analysis to examine this gender disparity in surgical referral as well as its influence on mortality in patients with low ejection fraction (LVEF). Consecutive patients experiencing severe AS and decreased LVEF (≤ 50%) on echocardiogram, seen between 2004-2015 (n = 460 patients, 243 eliminated for missing data or endocarditis), were included. This analysis involved 139 females, 321 males, with a mean age of 75.5 ± 11.6 years. In the female group, more deaths and less AVRs were found. Less referrals for AVR were reported in women despite comparable AS severity and adjustment for comorbidities, and those who were not operated experienced an elevated mortality. This observation underlies a potential gender gap in the care of valvular heart diseases in females.