Cardiovascular Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation.
Cardiac Imaging Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation.
Braz J Cardiovasc Surg. 2023 Oct 27;39(1):e20220179. doi: 10.21470/1678-9741-2022-0179.
According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes.
Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR).
From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females.
Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404).
Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women.
根据最新数据，胸主动脉手术降低了发病率和死亡率，包括升主动脉瘤的治疗；然而，女性在术后出现不良结局的风险增加。
我们旨在评估接受预防性升主动脉置换术（AAR）的男性和女性患者的早期和晚期结果。
从 2013 年 1 月至 2021 年 9 月，91 名患者（56 名[61.5%]男性和 35 名[38.5%]女性）因小（范围为 5.0 至 5.5 厘米）非综合征性动脉瘤接受 AAR。对两组进行了基于倾向评分的调整。我们比较了男性和女性之间的临床结果。
女性的术前标准化主动脉直径明显大于男性（2.9 [2.7；3.2] cm/m2）（2.5 [2.3；2.6] cm/m2，P<0.001），但绝对值无差异（51 [49；53] mm 与 52 [50；53] mm，P=0.356）。两组患者在匹配前后均无明显的神经、心脏、肺部和肾脏并发症。未匹配组中男性和女性患者的院内死亡率分别为 1（1.8%）和 2（5.7%）（P=0.307），匹配组中分别为 1（2.9%）和 2（5.7%）（P=0.553）。单变量逻辑回归分析表明，院内死亡的唯一危险因素是年龄（比值比 1.117，95%置信区间 1.003-1.244；P=0.04）。男性的总体生存率为 36 个月时为 83.5±0.06%，女性为 94.3±0.04%（P=0.404）。
升主动脉手术治疗直径为 5.0 至 5.5 厘米的动脉瘤，在男性和女性中似乎具有可接受的早期和晚期结果。
