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To provide a review of current transcatheter structural heart interventions in women, with a focus on sex-specific considerations in diagnosis, treatment and outcomes.

Transcatheter interventions have transformed structural heart disease treatment, including valvular heart disease and left atrial appendage closure. Historically, low female enrollment in cardiovascular trials has limited sex-specific data integration into clinical guidelines. Recently, the changing landscape of female representation has provided insight into distinct pathophysiology, high-risk features, clinical characteristics, disease surveillance, referral barriers, and treatment responses. The success of transcatheter structural heart interventions relies on judicious patient selection and timely intervention. This review evaluates contemporary female representation in transcatheter studies, highlighting sex-specific prevalence, anatomic and physiologic variations, clinical presentations and both short- and long-term outcomes. Knowledge gaps and future research directions are identified to address diagnostic and therapeutic disparities, ultimately improving individualized lifetime care in women with structural heart disease.