Sex and gender in thoracic aortic aneurysms and dissection

Disease of the aorta affects more than 40,000 Americans annually, with a portion of these presentations involving the thoracic aorta. Studies have revealed gender differences in the presentation, management, and outcome of patients with aortic disease. However, most of this work focuses on the abdominal aorta; the data are then extrapolated to the thorax. It is currently established that women with abdominal aortic disease have worse outcomes, are less likely to undergo surgical treatment, and have higher morbidity and mortality. Similar results are seen in the management of women with thoracic aortic dissection. Herein we review the issue of sex and gender differences in thoracic aortic disease.