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Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

291
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
291
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Sex-related difference in outcomes after aortic root replacement.

Hannah McMullen1, Tsuyoshi Yamabe2,3, Yanling Zhao2

  • 1Columbia University Vagelos College of Physicians and Surgeons, New York, NY.

Journal of Cardiac Surgery
|April 3, 2020
PubMed
Summary

Female patients undergoing aortic root replacement (ARR) do not face higher risks of in-hospital death or stroke. However, women show an increased need for permanent pacemakers after this cardiovascular surgery.

Keywords:
aorta and great vesselsaortic root replacementaortic surgerycardiac surgery

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Previous studies suggest poorer short-term outcomes for females post-cardiovascular surgery.
  • Aortic root replacement (ARR) is a critical procedure for aortic diseases.

Purpose of the Study:

  • To investigate the influence of sex on patient outcomes following aortic root replacement (ARR).
  • To compare in-hospital mortality, stroke, and long-term survival between male and female patients undergoing ARR.

Main Methods:

  • Retrospective review of 848 patients who underwent ARR between 2005 and 2018.
  • Analysis of sex differences in primary (in-hospital mortality or stroke) and secondary (permanent pacemaker requirement) endpoints.
  • Long-term survival assessment with a median follow-up of 21.4 months.

Main Results:

  • Females were older with higher rates of cerebrovascular disease and prior valve intervention, but less myocardial infarction.
  • No significant sex difference was observed in in-hospital mortality or stroke rates.
  • Females had a higher incidence of permanent pacemaker requirement (11% vs 6%, P=.03).
  • Female sex was an independent predictor of permanent pacemaker requirement (OR, 2.01; 95% CI, 1.085-3.724).

Conclusions:

  • Female patients undergoing ARR do not have increased risks of in-hospital mortality or stroke.
  • Despite different baseline characteristics, outcomes regarding mortality and stroke are similar between sexes.
  • Females exhibit a significantly higher incidence of requiring a permanent pacemaker post-ARR.