P343. The Relationship of Sex and Aortic Diameter at the Time of Type A Aortic Dissection
Weill Cornell Medicine
New York, NY
United States - Contact Me
Dr. Christopher Lau is an Associate Professor of Cardiothoracic Surgery at Weill Cornell Medical Center and the Director of Endovascular Surgery for the Department of Cardiothoracic Surgery. He completed his undergraduate studies at New York University where he obtained a degree in Psychology and Philosophy. He then earned his medical degree at Downstate Medical Center, where he was recruited to complete his General Surgery residency. During this time, he received numerous awards including the Thomas W. Pollock Award for professionalism, compassion and dedication. Subsequently, he completed his Cardiothoracic Surgery Fellowship at Weill Cornell Medical College, New York Presbyterian Hospital, and Memorial Sloan Kettering Cancer Center. He remained at Weill Cornell for an Advanced Cardiovascular/Aortic Aneurysm Surgery Fellowship and was recruited to stay on staff as faculty. Dr. Lau takes a particular interest in surgery of the aorta and aortic aneurysms. He manages the aortic surgery center and is skilled in performing both open aortic repair and endovascular stent-grafting of the aorta. He and his team have published extensively on aortic root reconstruction, valve sparing aortic root replacement, aortic valve repair, aortic arch repair, cerebral protection techniques, and techniques for repair of descending thoracic and thoracoabdominal aortic aneurysm.
Description
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.
Authors
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)
Institutions
(1) Weill Cornell Medicine, New York, NY