Eur J Cardiothorac Surg. 2024 Jun 26:ezae242. doi: 10.1093/ejcts/ezae242. Online ahead of print.
ABSTRACT
OBJECTIVES: Gender difference in the outcome after type A aortic dissection surgery remains an issue of ongoing debate. In this study we aimed to evaluate the impact of gender on the short- and long-term outcome after surgery for type A aortic dissection.
METHODS: A multicentre European registry retrospectively included all consecutive type A aortic dissection surgery patients between 2005 and 2021 from 18 hospitals across eight European countries. Early and late mortality, and cumulative incidence of aortic reoperation were compared between genders.
RESULTS: A total of 3902 patients underwent type A aortic dissection surgery, with 1185 (30.4%) being females. After propensity score matching, 766 pairs of males and females were compared. No statistical differences were detected in the early postoperative outcome between genders. Ten-year survival was comparable between genders (47.8% vs 47.1%; Log-rank test, p = 0.679), as well as cumulative incidences of distal or proximal aortic reoperations. Ten-year relative survival compared to country-, year-, age-, and sex-matched general population was higher among males (0.65) compared to females (0.58). The time-period subanalysis revealed advancements in surgical techniques in both genders over the years. However, an increase of stroke was observed over time for both populations, particularly among females.
CONCLUSIONS: The past sixteen years have witnessed marked advancements in surgical techniques for TAAD in both males and females, achieving comparable early and late mortality rates. Despite these findings, late relative survival was still in favour of males.
PMID:38924518 | DOI:10.1093/ejcts/ezae242
