Gender-Related Differences in Patients with Acute Aortic Dissection Type A

The impact of age and sex on in-hospital outcomes in acute type A aortic dissection surgery

“…In a recent analysis from the German Registry for Acute Aortic Dissection Type A (GERAADA), Rylski et al (22) reported a comparable operative mortality in both sexes, despite a more complicated clinical presentation in males. Compared to the IRAD data, the authors of this analysis believed that a better understanding of aortic pathology, together with advances in surgical therapy underlie a decrease in surgical mortality in AAAD and consequently an improvement in survival in females as well.…”

Age, sex, and contemporary outcomes in surgical repair of type A aortic dissection: Insights from the National Inpatient Sample

“…Overall surgical mortality of 15.3% in this study is consistent with the majority of existing literature in ATAAD, which reports operative mortality ranging from 15% to 30%. [3][4][5][6][7][8][9][10][11][12][13] At IRAD-participating institutions from 1996 to 2001, Trimarchi and colleagues 25 identified an overall in-hospital mortality rate of 25.1% in 526 patients with ATAAD undergoing surgical repair. 25 In contrast, in a more contemporary IRAD analysis, Pape and colleagues 3 found that surgical mortality has declined from 25% in 2003 to 18% in 2013.…”

“…Although there is evidence of temporally improving surgical outcomes of ATAAD repair in recent decades, [1][2][3] short-term mortality in surgical patients remains substantial at approximately 15% to 30%. [3][4][5][6][7][8][9][10][11][12][13] In addition to hemodynamic compromise, degree of malperfusion, and burden of comorbidities, age has been consistently identified as a risk factor for intra-and postoperative mortality for patients undergoing surgical repair for ATAAD. 1,2,6,9,11,12,[14][15][16][17][18][19][20][21][22][23][24][25] Given the aging population of the United States and the rising prevalence of thoracic aortic disease in older patients, 24,26 it is becoming increasingly important to understand contemporary outcomes in this patient population.…”

“…1,2,6,9,11,12,[14][15][16][17][18][19][20][21][22][23][24][25] Given the aging population of the United States and the rising prevalence of thoracic aortic disease in older patients, 24,26 it is becoming increasingly important to understand contemporary outcomes in this patient population. Furthermore, as women have prolonged life expectancies relative to men and tend to develop aortic disease later in life, 5,13,27 the relationship between sex, age, and outcomes is of particular interest in ATAAD. In contrast to the well-recognized discrepancy in outcomes for women undergoing other cardiac surgical procedures, 28,29 the impact of sex on outcomes in ATAAD is limited and conflicting.…”

“…In contrast to the well-recognized discrepancy in outcomes for women undergoing other cardiac surgical procedures, 28,29 the impact of sex on outcomes in ATAAD is limited and conflicting. 5,13,27,30 Much of our understanding of current outcomes of patients with ATAAD, as well as the impact of age and sex, is limited to single-center reviews and studies of voluntary registries such as the International Registry of Acute Aortic Dissection (IRAD) and the German Registry for Acute Aortic Dissection Type A (GERAADA). As such, a true perspective of the outcomes of ATAAD is lacking, as there is known center variability in ATAAD outcomes 1 and participation in voluntary registries inevitably presents significant selection bias.…”