OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching. METHODS: A total of 240 patients operated for Stanford A AAD were included in this study. To control for selection bias and other confounders, propensity score matching was applied to gender groups. RESULTS: After propensity score matching, the gender groups were well balanced in terms of risk profiles. There were no statistically significant differences regarding duration of cardiopulmonary bypass ( P = 0.165) and duration of aortic cross-clamp time ( P = 0.111). Female patients received less fresh frozen plasma ( P = 0.021), had shorter stays in the intensive care unit ( P = 0.031), lower incidence of temporary neurological dysfunction ( P < 0.001) and lower incidence of dialysis ( P = 0.008). There were no significant differences regarding intraoperative mortality ( P = 1.000), 30-day mortality ( P = 0.271), long-term overall cumulative survival ( P = 0.954) and long-term freedom from cerebrovascular events ( P = 0.235) with up to a 9-year follow-up. CONCLUSIONS: 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.
OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching. METHODS: A total of 240 patients operated for Stanford A AAD were included in this study. To control for selection bias and other confounders, propensity score matching was applied to gender groups. RESULTS: After propensity score matching, the gender groups were well balanced in terms of risk profiles. There were no statistically significant differences regarding duration of cardiopulmonary bypass ( P = 0.165) and duration of aortic cross-clamp time ( P = 0.111). Female patients received less fresh frozen plasma ( P = 0.021), had shorter stays in the intensive care unit ( P = 0.031), lower incidence of temporary neurological dysfunction ( P < 0.001) and lower incidence of dialysis ( P = 0.008). There were no significant differences regarding intraoperative mortality ( P = 1.000), 30-day mortality ( P = 0.271), long-term overall cumulative survival ( P = 0.954) and long-term freedom from cerebrovascular events ( P = 0.235) with up to a 9-year follow-up. CONCLUSIONS: 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.
Authors: Julia Merkle; Anton Sabashnikov; Antje-Christin Deppe; Mohamed Zeriouh; Johanna Maier; Carolyn Weber; Kaveh Eghbalzadeh; Georg Schlachtenberger; Olga Shostak; Ilija Djordjevic; Elmar Kuhn; Parwis B Rahmanian; Navid Madershahian; Christian Rustenbach; Oliver Liakopoulos; Yeong-Hoon Choi; Ferdinand Kuhn-Régnier; Thorsten Wahlers Journal: Ther Adv Cardiovasc Dis Date: 2018-10-08
Authors: Frederike Meccanici; Arjen L Gökalp; Carlijn G E Thijssen; Mostafa M Mokhles; Jos A Bekkers; Roland van Kimmenade; Hence J Verhagen; Jolien W Roos-Hesselink; Johanna J M Takkenberg Journal: Interact Cardiovasc Thorac Surg Date: 2022-03-31
Authors: Lauren V Huckaby; Ibrahim Sultan; Santi Trimarchi; Bradley Leshnower; Edward P Chen; Derek R Brinster; Truls Myrmel; Anthony L Estrera; Daniel G Montgomery; Amit Korach; Hans-Henning Eckstein; Joseph S Coselli; Takeyoshi Ota; Clayton A Kaiser; Kim A Eagle; Himanshu J Patel; Thomas G Gleason Journal: Ann Thorac Surg Date: 2021-06-02 Impact factor: 5.102