No sex-based differences exist in clinical outcomes of extended aortic arch repair for acute type A aortic dissection.

Abstract

Reports regarding the association between sex and clinical outcomes following surgical repair of acute type A aortic dissection (ATAAD) are not exhaustive and in part even conflicting. A total of 786 eligible adult patients with ATAAD undergoing extended arch repair between January 2015 and December 2021 were included. They were entered into a female group (n=161) or a male group (n=625). In-hospital outcomes (surgical mortality and major postoperative morbidity) and midterm outcomes (survival and aortic reintervention) between the two groups were compared before and after propensity score (PS) matching (1:1). Compared with male subjects, female patients were more likely to be older (median [interquartile range], 57 [46-67] vs. 50 [42-59] years, p<0.001) and to have a lower body mass index, but were less likely to be current smokers. Operative death occurred in 66 patients (6.8% for female vs. 8.8% for male), without significant differences between groups before and after matching (p=0.422 and p>0.999, respectively). Major postoperative morbidity was observed in 313 (39.8%) patients, including 57 (35.4%) female and 256 (41.0%) male patients (p=0.199). Sex-based grouping was not significantly associated with operative mortality or major postoperative morbidity. The 5-year cumulative survival and incidence of aortic reintervention among females were 90.6% and 6.0%, respectively, which were not statistically different from those observed in males before and after matching. No sex-based differences were found in terms of in-hospital and midterm outcomes of extended arch repair for ATAAD.