Differences Among Sexes in Presentation and Outcomes in Acute Type A Aortic Dissection Repair

ABSTRACT Objective Female sex is a known risk factor in most cardiac surgery, including coronary and valve surgery, but unknown in acute type A aortic dissection (ATAAD) repair. Methods From 1996-2018, 650 patients underwent ATAAD repair, 206 (32%) female and 444 (68%) male. Data were collected through the Cardiac Surgery Data Warehouse, medical record review, and National Death Index database. Results Compared to men, women were significantly older (65 vs. 57 years, p > 80-years-old being female. Women had significantly less chronic renal failure (CRF, 2.0% vs. 5.4%, p=0.04), acute myocardial infarction (1.0% vs. 3.8%, p=0.04), and severe aortic insufficiency (AI). Women underwent significantly fewer aortic root replacements with similar aortic arch procedures, shorter cardiopulmonary bypass (211 vs. 229 minutes, p=0.0001) and aortic cross-clamp times (132 vs. 164 minutes, p Conclusions Physicians and women should be cognizant of the risk of acute type A aortic dissection later in life in women. Surgeons should strongly consider operations for ATAAD in women, especially in patients ≥70 years old.