Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement
Background: Our aim was to investigate outcomes and long-term survival in male and female patients after frozen elephant trunk (FET) total arch replacement. Methods: Between March 2013 and January 2023, 362 patients underwent aortic arch replacement via the FET technique. We compared patient charact...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/19/6327 |
| _version_ | 1797575666699337728 |
|---|---|
| author | Julia Benk Tim Berger Stoyan Kondov Matthias D’Inka Magdalena Bork Tim Walter Philipp Discher Bartosz Rylski Martin Czerny Maximilian Kreibich |
| author_facet | Julia Benk Tim Berger Stoyan Kondov Matthias D’Inka Magdalena Bork Tim Walter Philipp Discher Bartosz Rylski Martin Czerny Maximilian Kreibich |
| author_sort | Julia Benk |
| collection | DOAJ |
| description | Background: Our aim was to investigate outcomes and long-term survival in male and female patients after frozen elephant trunk (FET) total arch replacement. Methods: Between March 2013 and January 2023, 362 patients underwent aortic arch replacement via the FET technique. We compared patient characteristics and intra- and postoperative data between male and female patients. Results: Male patients were significantly younger (<i>p</i> = 0.012) but revealed a higher incidence of coronary artery disease (<i>p</i> = 0.008) and preoperative dialysis (<i>p</i> = 0.017). More male patients presented with type A aortic dissections (<i>p</i> = 0.042) while more female patients had aortic aneurysms (<i>p</i> = 0.025). The aortic root was replaced in significantly more male patients (<i>p</i> = 0.013), resulting in significantly longer cardiopulmonary bypass duration (<i>p</i> < 0.001) and operative times (<i>p</i> < 0.001). There were no statistically significant differences in postoperative outcome parameters including in-hospital mortality (<i>p</i> = 0.346). However, new in-stent thrombus formation was significantly more frequent in female patients (<i>p</i> = 0.002). Age in years (odds ratio (OR): 1.026, <i>p</i> = 0.049), an acute pathology (OR: 1.941, <i>p</i> = 0.031) and preoperative dialyses (OR: 3.499, <i>p</i> = 0.010) were predictive for long-term mortality in our Cox regression model, sex (<i>p</i> = 0.466) was not. There was no statistical difference in overall survival (log rank: <i>p</i> = 0.425). Conclusions: Female patients are older but reveal fewer cardiovascular risk factors; aneurysms are more common in female than male patients. As female patients undergo concomitant surgical procedures less often, their operative times are shorter. While survival and outcomes were similar, female patients suffered from postoperative new in-stent thrombus formation significantly more often. |
| first_indexed | 2024-03-10T21:41:28Z |
| format | Article |
| id | doaj.art-20e14bf6c7a74441a6cdefa4ba308f63 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:41:28Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-20e14bf6c7a74441a6cdefa4ba308f632023-11-19T14:37:19ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011219632710.3390/jcm12196327Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch ReplacementJulia Benk0Tim Berger1Stoyan Kondov2Matthias D’Inka3Magdalena Bork4Tim Walter5Philipp Discher6Bartosz Rylski7Martin Czerny8Maximilian Kreibich9Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyDepartment of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, University of Freiburg, 79106 Freiburg, GermanyBackground: Our aim was to investigate outcomes and long-term survival in male and female patients after frozen elephant trunk (FET) total arch replacement. Methods: Between March 2013 and January 2023, 362 patients underwent aortic arch replacement via the FET technique. We compared patient characteristics and intra- and postoperative data between male and female patients. Results: Male patients were significantly younger (<i>p</i> = 0.012) but revealed a higher incidence of coronary artery disease (<i>p</i> = 0.008) and preoperative dialysis (<i>p</i> = 0.017). More male patients presented with type A aortic dissections (<i>p</i> = 0.042) while more female patients had aortic aneurysms (<i>p</i> = 0.025). The aortic root was replaced in significantly more male patients (<i>p</i> = 0.013), resulting in significantly longer cardiopulmonary bypass duration (<i>p</i> < 0.001) and operative times (<i>p</i> < 0.001). There were no statistically significant differences in postoperative outcome parameters including in-hospital mortality (<i>p</i> = 0.346). However, new in-stent thrombus formation was significantly more frequent in female patients (<i>p</i> = 0.002). Age in years (odds ratio (OR): 1.026, <i>p</i> = 0.049), an acute pathology (OR: 1.941, <i>p</i> = 0.031) and preoperative dialyses (OR: 3.499, <i>p</i> = 0.010) were predictive for long-term mortality in our Cox regression model, sex (<i>p</i> = 0.466) was not. There was no statistical difference in overall survival (log rank: <i>p</i> = 0.425). Conclusions: Female patients are older but reveal fewer cardiovascular risk factors; aneurysms are more common in female than male patients. As female patients undergo concomitant surgical procedures less often, their operative times are shorter. While survival and outcomes were similar, female patients suffered from postoperative new in-stent thrombus formation significantly more often.https://www.mdpi.com/2077-0383/12/19/6327frozen elephant trunk (FET)sex differenceaortic dissectionaortic aneurysmarch surgery |
| spellingShingle | Julia Benk Tim Berger Stoyan Kondov Matthias D’Inka Magdalena Bork Tim Walter Philipp Discher Bartosz Rylski Martin Czerny Maximilian Kreibich Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement Journal of Clinical Medicine frozen elephant trunk (FET) sex difference aortic dissection aortic aneurysm arch surgery |
| title | Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement |
| title_full | Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement |
| title_fullStr | Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement |
| title_full_unstemmed | Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement |
| title_short | Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement |
| title_sort | comparative study of male and female patients undergoing frozen elephant trunk total arch replacement |
| topic | frozen elephant trunk (FET) sex difference aortic dissection aortic aneurysm arch surgery |
| url | https://www.mdpi.com/2077-0383/12/19/6327 |
| work_keys_str_mv | AT juliabenk comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT timberger comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT stoyankondov comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT matthiasdinka comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT magdalenabork comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT timwalter comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT philippdischer comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT bartoszrylski comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT martinczerny comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement AT maximiliankreibich comparativestudyofmaleandfemalepatientsundergoingfrozenelephanttrunktotalarchreplacement |