Impact of gender on long-term outcomes after surgical repair for acute Stanford A aortic dissection: a propensity score matched analysis†

Abstract

Considering patients with similar risk profiles, female gender per se is not associated with worse long-term survival and freedom from stroke after surgical aortic repair. Moreover, female patients might even benefit from a smoother early postoperative course and lower incidence of early postoperative complications.

Sex-specific risk factors for early mortality and survival after surgery of acute aortic dissection type a: a retrospective observational study

“…Several studies indicated a poor outcome after surgery for AADA in women [5,11] and Nienaber et al [5] found a higher in-hospital mortality in women (32% vs. 22%), more in-hospital complications and a worse surgical outcome despite similar time from symptom onset to diagnosis, surgical technique and hemodynamics. In contrast female gender was not associated with worse early and long-term outcomes in several recent studies [3,4,12], which was confirmed by our results.…”

“…Men presented with a higher creatinine level and tended to have a higher rate of chronic renal insufficiency, however, this difference was not significant. Consistent with our findings Fukui et al [4], Conway et al [3] and Sabashnikov et al [12] reported increased creatinine levels in men despite no substantial disparities in GFR and rate of chronic renal failure, concluding that creatinine is of lower clinical relevance [12]. Moreover, creatinine levels are physiologically higher in men, as indicated by sex-specific standard values.…”

“…Kaplan-Meier analyses showed no significant differences in survival between women and men in our study as in recent studies [3,4,12,23]. Cumulative survival of women and men in our study was similar to the results of a matched cohort of 71 female and male patients in the study of Sabashnikov et al [12] after 1 year. After 5 years it was lower in their matched cohort (62.9% vs. 62.8%), which may be due to the older age compared to that of our patients.…”

“…As in coronary disease, delayed presentation and diagnosis in women due to less typical pain, older age and different comorbidities were described as potential risk factors for a worse outcome in female patients after surgery for AADA [2,5]. In contrast to these findings, female gender was not associated with a worse outcome in recent studies [3,4,12,13]. Several studies on the risk factors for mortality after surgery for AADA included gender as risk factor [4,14], but information about sex-specific risk factors of women and men is rare.…”

Impact of Different Aortic Entry Tear Sites on Early Outcomes and Long-Term Survival in Patients with Stanford A Acute Aortic Dissection

“…Sabashnikov et al described surgical procedure for Stanford A AAD. 8,9 Depending on the identification of the location of the aortic entry tear in the CT scan before surgery extent of surgery was planned. Moreover, if the exact location of the primary aortic entry tear was unclear, extent of aortic repair and the very entry tear site were in detail reevaluated during surgery due to proper intraoperative visual inspection to exclude a possible communication between lumina.…”