Sex-Related Differences Between Patients Undergoing Surgery for Acute Type A Aortic Dissection

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Dissection Research

Background:

• Acute type A aortic dissection (ATAAD) is a life-threatening condition requiring urgent surgical intervention.
• Understanding sex-specific differences in ATAAD is crucial for optimizing patient management and outcomes.

Purpose of the Study:

• To evaluate sex-specific characteristics of patients diagnosed with ATAAD.
• To compare surgical outcomes between male and female patients undergoing ATAAD repair.

Main Methods:

• Retrospective review of 213 patients who underwent ATAAD repair between 2004 and 2020.
• Analysis of demographic data, clinical presentation, surgical procedures, in-hospital mortality, and long-term survival rates.
• Multivariable logistic regression to identify predictors of operative mortality.

Main Results:

• Females were older, presented with more nonspecific symptoms, and had a longer time from onset to surgery compared to males.
• Ascending aorta replacement was more frequent in females.
• No significant difference in in-hospital mortality between sexes; male sex was not an independent predictor of early death.
• Males demonstrated significantly better unadjusted 10-year survival rates than females.

Conclusions:

• While male sex is not an independent predictor of early mortality in ATAAD, significant sex-based differences exist in patient characteristics and surgical approaches.
• These disparities highlight the importance of considering sex-specific factors in the management of ATAAD.
• A tailored, sex-based management strategy may improve long-term outcomes for ATAAD patients.