The Relationship of Sex and Aortic Diameter at the Time of Type A Aortic Dissection

P0343 

Abstract Submission 

Christopher Lau (1), Lamia Harik (1), Arnaldo Dimagli (1), Mohamed Rahouma (1), Giovanni Jr Soletti (1), Gianmarco Cancelli (1), Jordan Leith (1), Eilon Ram (1), Charles Mack (1), Mario Gaudino (1), Leonard Girardi (1)

(1) Weill Cornell Medicine, New York, NY

*Christopher Lau    -  Contact Me
Weill Cornell Medicine

Lamia Harik    -  Contact Me
Weill Cornell Medicine

Arnaldo Dimagli    -  Contact Me
Weill Cornell Medicine

Mohamed Rahouma    -  Contact Me
Weill Cornell Medicine

Giovanni Jr Soletti    -  Contact Me
Weill Cornell Medicine

Gianmarco Cancelli    -  Contact Me
Weill Cornell Medicine

Jordan Leith    -  Contact Me
Weill Cornell Medicine

Eilon Ram    -  Contact Me
Weill Cornell Medicine

♦Charles Mack    -  Contact Me
Weill Cornell Medicine

*Mario Gaudino    -  Contact Me
Weill Cornell Medicine

*Leonard Girardi    -  Contact Me
Weill Cornell Medicine

*Christopher Lau    -  Contact Me
New York Presbyterian-Weill Cornell

Objective: To evaluate sex differences in patients undergoing repair of acute type A aortic dissection (ATAAD).
Methods: Retrospective, sex-stratified, single-center cohort study of patients undergoing surgery for ATAAD from 1997-2022. The primary outcome was aortic diameter at time of presentation with ATAAD. Secondary outcomes were mortality, myocardial infraction, stroke, hemodialysis requirement, tracheostomy, re-exploration for bleeding, a composite of said major adverse events (MAE), and long-term survival.
Results: In 390 consecutive patients (150 women), men were younger than women (61.0 [interquartile range (IQR) 50-70] vs 70.5 [IQR 59-78]; p<0.001), had higher body mass index (BMI) (28.6 [IQR 25.1-32.3] vs 25.4 [IQR 21.9-29.2]; p<0.001), more frequent peripheral vascular disease (11.7% vs 4.7%; p=0.03), renal insufficiency (36.7% vs 22%; p=0.003), malperfusion (34.2% vs 18.7%; p=0.007), and smoking history (65% vs 44%; p<0.001). There was no sex difference in median aortic diameter at the time of ATAAD (men: 5.3cm [IQR 4.9-6.1], women: 5.2cm [IQR 4.6-5.9]; p=0.12) even when adjusted for BMI (men: 5.7cm [IQR 5.4-6.1], women: 5.4cm [IQR 5.4-6.1]; p=0.19). There was no sex difference in operative mortality (4.6% vs 6.0%; p=0.7), MAEs, or ten-year survival (61.7% vs 71.0%; p=0.11). On multivariable analysis, there was no interaction between aneurysm size and sex (p of interaction=0.62); and sex was not associated with MAEs (odds ratio 0.75, 95% confidence interval 0.07-7.39; p=0.806).
Conclusions: There was no difference in aneurysm size at the time of presentation of ATAAD between men and women, even after adjustment for BMI, and no interaction between aneurysm size and sex.

Dissection