Sex Differences in Aortopathy and Valve Diseases Among Patients Undergoing Cardiac Surgical Procedure.

Abstract

BACKGROUND:

We aimed to study sex differences in aortopathy and valve disease among patients undergoing aortic valve replacement and/or surgical procedure for ascending aortic aneurysm and assess whether differences are specific for patients with bicuspid aortic valve (BAV) compared with patients with tricuspid aortic valve.

METHODS:

We used a single-center and observational cohort including 1045 patients undergoing elective open heart surgical procedure for aortic valve disease and/or ascending aortic aneurysm at the Karolinska Hospital (Stockholm, Sweden).

RESULTS:

Women (33.0%) were older than men (mean [SD]; 67.9 [11] years vs 62.5 [13] years for men; P < .001). No significant sex difference in prevalence of ascending aortic aneurysm was found according to absolute measures (P = .19); however, women had a greater dilation of the ascending aorta when normalized for body surface area (mean, 21.8 [SD, 6.3] mm/m2 vs 19.3 [SD, 4.4] mm/m2 for men; P < .001). Among the 560 patients with BAV, women had significantly more aortic stenosis (adjusted odds ratio, 2.23; 95% CI, 1.19-4.20; P = .013) and less aortic insufficiency (adjusted odds ratio, 0.42; 95% CI, 0.23-0.78; P < .01); whereas no sex difference was found among patients with tricuspid aortic valve.

CONCLUSIONS:

In this large study of patients undergoing cardiac surgical procedure, we found a greater degree of aortic dilation in women compared with men, suggesting a need for earlier monitoring of women. Moreover, women with BAV had a significantly higher prevalence of aortic stenosis compared with men. These results describe the aorta and valvular characteristics of patients by sex and provide guidance regarding which patients might benefit from closer surveillance.

• Authors: Maxime Vignac, Hanna M Björck, Christian Olsson, Maria J Eriksson, Xavier Jouven, Erin D Michos, Anders Franco-Cereceda, Per Eriksson, Bamba Gaye
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 114 Issue 5 Pg. 1665-1670 (11 2022) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 35271843 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Humans
• Female
• Male
• Heart Valve Diseases (complications, epidemiology, surgery)
• Retrospective Studies
• Bicuspid Aortic Valve Disease
• Aortic Valve (surgery)
• Aortic Aneurysm (epidemiology, surgery)
• Aortic Valve Stenosis (epidemiology, surgery)
• Endocarditis
• Cardiac Surgical Procedures