Presentation and Outcomes of Women and Men After Elective Proximal Aortic Surgery: Retrospective Institutional Analysis.

BACKGROUND: An increasing number of studies are demonstrating how outcomes in women are different from those in men after cardiac surgery. Current research lacks data on the outcomes in elective proximal aortic surgery. METHODS: We retrospectively reviewed 1299 patients undergoing elective aortic surgery between 2010 and 2023; 347 (27.7%) were women. We examined preoperative and postoperative characteristics and analyzed the data with respect to morbidity and mortality in men compared with women. RESULTS: Demographic data of these cases showed that women had lower body mass index (27.4 kg/m2 vs 28.7 kg/m2; P = .001) and creatinine level (0.882 vs 1.03 mg/dL; P < .001), less hypertension (64.8% vs 74.2%; P = .001), and more chronic obstructive pulmonary disease (8.6% vs 5.1%; P = .028) but similar prevalence of diabetes and smoking. Despite that men had greater procedure length (336 minutes vs 313 minutes; P = .003) and cross-clamp time (134 minutes vs 120 minutes; P < .001), women spent more time in the intensive care unit (83.4 hours vs 55.9 hours; P = .009) and on the ventilator (40.7 hours vs 18.2 hours; P = .021), experienced more postoperative complications (54.8% vs 46.2%; P = .007), and had longer stays (9.73 days vs 7.97 days; P = .002). In-hospital mortality was similar. CONCLUSIONS: These results emphasize the need for sex-specific strategies in aortic surgery and further work on identifying the factors that differ between men and women that result in variable outcomes after elective aortic surgery.