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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...

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Autores principales: Benk, Julia, Berger, Tim, Kondov, Stoyan, D’Inka, Matthias, Bork, Magdalena, Walter, Tim, Discher, Philipp, Rylski, Bartosz, Czerny, Martin, Kreibich, Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573986/
https://www.ncbi.nlm.nih.gov/pubmed/37834975
http://dx.doi.org/10.3390/jcm12196327
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author Benk, Julia
Berger, Tim
Kondov, Stoyan
D’Inka, Matthias
Bork, Magdalena
Walter, Tim
Discher, Philipp
Rylski, Bartosz
Czerny, Martin
Kreibich, Maximilian
author_facet Benk, Julia
Berger, Tim
Kondov, Stoyan
D’Inka, Matthias
Bork, Magdalena
Walter, Tim
Discher, Philipp
Rylski, Bartosz
Czerny, Martin
Kreibich, Maximilian
author_sort Benk, Julia
collection PubMed
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 (p = 0.012) but revealed a higher incidence of coronary artery disease (p = 0.008) and preoperative dialysis (p = 0.017). More male patients presented with type A aortic dissections (p = 0.042) while more female patients had aortic aneurysms (p = 0.025). The aortic root was replaced in significantly more male patients (p = 0.013), resulting in significantly longer cardiopulmonary bypass duration (p < 0.001) and operative times (p < 0.001). There were no statistically significant differences in postoperative outcome parameters including in-hospital mortality (p = 0.346). However, new in-stent thrombus formation was significantly more frequent in female patients (p = 0.002). Age in years (odds ratio (OR): 1.026, p = 0.049), an acute pathology (OR: 1.941, p = 0.031) and preoperative dialyses (OR: 3.499, p = 0.010) were predictive for long-term mortality in our Cox regression model, sex (p = 0.466) was not. There was no statistical difference in overall survival (log rank: p = 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.
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spelling pubmed-105739862023-10-14 Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement Benk, Julia Berger, Tim Kondov, Stoyan D’Inka, Matthias Bork, Magdalena Walter, Tim Discher, Philipp Rylski, Bartosz Czerny, Martin Kreibich, Maximilian J Clin Med Article 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 (p = 0.012) but revealed a higher incidence of coronary artery disease (p = 0.008) and preoperative dialysis (p = 0.017). More male patients presented with type A aortic dissections (p = 0.042) while more female patients had aortic aneurysms (p = 0.025). The aortic root was replaced in significantly more male patients (p = 0.013), resulting in significantly longer cardiopulmonary bypass duration (p < 0.001) and operative times (p < 0.001). There were no statistically significant differences in postoperative outcome parameters including in-hospital mortality (p = 0.346). However, new in-stent thrombus formation was significantly more frequent in female patients (p = 0.002). Age in years (odds ratio (OR): 1.026, p = 0.049), an acute pathology (OR: 1.941, p = 0.031) and preoperative dialyses (OR: 3.499, p = 0.010) were predictive for long-term mortality in our Cox regression model, sex (p = 0.466) was not. There was no statistical difference in overall survival (log rank: p = 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. MDPI 2023-10-01 /pmc/articles/PMC10573986/ /pubmed/37834975 http://dx.doi.org/10.3390/jcm12196327 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Benk, Julia
Berger, Tim
Kondov, Stoyan
D’Inka, Matthias
Bork, Magdalena
Walter, Tim
Discher, Philipp
Rylski, Bartosz
Czerny, Martin
Kreibich, Maximilian
Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573986/
https://www.ncbi.nlm.nih.gov/pubmed/37834975
http://dx.doi.org/10.3390/jcm12196327
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