PMID- 38090337
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231213
IS  - 2225-319X (Print)
IS  - 2304-1021 (Electronic)
IS  - 2225-319X (Linking)
VI  - 12
IP  - 6
DP  - 2023 Nov 27
TI  - Male-female differences in contemporary elective ascending aortic surgery: 
      insights from the Netherlands Heart Registration.
PG  - 577-587
LID - 10.21037/acs-2022-adw-fs-0139 [doi]
AB  - BACKGROUND: Scientific research regarding male-female differences in ascending 
      aortic surgery is scarce. The objective of this study was to identify male-female 
      differences in presentation, treatment and peri-operative outcome in elective 
      ascending aortic surgery. METHODS: Elective ascending aortic surgery procedures 
      that took place in the Netherlands between 01/01/2013-31/12/2017 were identified 
      from the Netherlands Heart Registration. Male-female differences in presentation, 
      treatment characteristics, and in-hospital mortality and morbidity were explored. 
      RESULTS: The study population consisted of 887 females (31%) and 1,972 males 
      (69%). Females were older (median age 67 versus 62 years, P<0.001), more often 
      had chronic lung disease (12.3% versus 9.1%, P=0.011), New York Heart Association 
      (NYHA) class III-IV (21.5% versus 15.5%, P=0.003), and less often a history of 
      percutaneous coronary intervention (PCI) (3.2% versus 5.0%, P=0.033). Isolated 
      supracoronary aortic replacement was performed in 47.7% of females versus 30.6% 
      of males (P<0.001), and ascending aorta with root replacement in 40.6% of females 
      versus 56.7% of males (P<0.001). Females more often underwent concomitant 
      interventions of the aortic arch (33.1% versus 20.2%, P<0.001) and the mitral 
      valve (8.2% versus 5.2%, P=0.002), and less often concomitant coronary artery 
      bypass grafting (CABG) (14.4% versus 19.1%, P=0.002). Overall, in-hospital 
      mortality was significantly higher in females (5.1% versus 2.7%, P=0.003). In 
      multivariable regression analysis, being female was an independent risk factor 
      for in-hospital mortality [odds ratio (OR) 1.55, 95% confidence interval (CI): 
      1.02-2.37]. CONCLUSIONS: This nation-wide cohort shows clear differences between 
      females and males in patient presentation, procedural characteristics, 
      in-hospital outcomes, and risk factors for in-hospital mortality in elective 
      ascending aortic surgery. Further exploration of these differences, and of 
      modifiable within-male and within-female risk factors, may offer great 
      opportunities in improving treatment and thereby outcomes for both males and 
      females.
CI  - 2023 Annals of Cardiothoracic Surgery. All rights reserved.
FAU - Gokalp, Arjen L
AU  - Gokalp AL
AD  - Department of Cardiothoracic Surgery, Erasmus University Medical Center, 
      Rotterdam, The Netherlands.
FAU - Thijssen, Carlijn G E
AU  - Thijssen CGE
AD  - Department of Cardiology, Erasmus University Medical Center, Rotterdam, The 
      Netherlands.
FAU - Bekkers, Jos A
AU  - Bekkers JA
AD  - Department of Cardiothoracic Surgery, Erasmus University Medical Center, 
      Rotterdam, The Netherlands.
FAU - Roos-Hesselink, Jolien W
AU  - Roos-Hesselink JW
AD  - Department of Cardiology, Erasmus University Medical Center, Rotterdam, The 
      Netherlands.
FAU - Bogers, Ad J J C
AU  - Bogers AJJC
AD  - Department of Cardiothoracic Surgery, Erasmus University Medical Center, 
      Rotterdam, The Netherlands.
FAU - Geuzebroek, Guillaume S C
AU  - Geuzebroek GSC
AD  - Department of Cardiothoracic Surgery, Radboud University Medical Center, 
      Nijmegen, The Netherlands.
FAU - Houterman, Saskia
AU  - Houterman S
AD  - Netherlands Heart Registration, Utrecht, The Netherlands.
FAU - Takkenberg, Johanna J M
AU  - Takkenberg JJM
AD  - Department of Cardiothoracic Surgery, Erasmus University Medical Center, 
      Rotterdam, The Netherlands.
FAU - Mokhles, Mostafa M
AU  - Mokhles MM
AD  - Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, 
      The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20230627
PL  - China
TA  - Ann Cardiothorac Surg
JT  - Annals of cardiothoracic surgery
JID - 101605877
PMC - PMC10711412
OTO - NOTNLM
OT  - Sex
OT  - aortic aneurysm
OT  - aortic surgery
OT  - gender
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2023/12/13 18:42
MHDA- 2023/12/13 18:43
PMCR- 2023/11/27
CRDT- 2023/12/13 13:07
PHST- 2022/10/10 00:00 [received]
PHST- 2023/05/24 00:00 [accepted]
PHST- 2023/12/13 18:43 [medline]
PHST- 2023/12/13 18:42 [pubmed]
PHST- 2023/12/13 13:07 [entrez]
PHST- 2023/11/27 00:00 [pmc-release]
AID - acs-12-06-577 [pii]
AID - 10.21037/acs-2022-adw-fs-0139 [doi]
PST - ppublish
SO  - Ann Cardiothorac Surg. 2023 Nov 27;12(6):577-587. doi: 
      10.21037/acs-2022-adw-fs-0139. Epub 2023 Jun 27.