TY - JOUR AU - Friedrich, Christine; Freundt, Miriam; Salem, Mohamed Ahmed; Panholzer, Bernd; Huenges, Katharina; Puehler, Thomas; Cremer, Jochen; Haneya, Assad TI - Sex-Specific Outcome after Ascending Aortic Surgery in Moderate Hypothermic Circulatory Arrest SN - 0171-6425 SN - 1439-1902 PY - 2019 JO - Thorac Cardiovasc Surg JF - The Thoracic and Cardiovascular Surgeon LA - EN VL - 69 IS - 04 SP - 314 EP - 321 DA - 2019/10/11 KW - aortic valve KW - aortic root KW - cardiopulmonary bypass KW - CPB KW - hypothermia KW - circulatory arrest AB - Background Historically, female patients had worse outcome undergoing heart surgery. No recent data exist on gender-specific outcome after moderate hypothermic circulatory arrest (MHCA). The aim of this large retrospective analysis was to investigate gender disparity in patients undergoing elective surgery of ascending aorta in MHCA at 24°C.Methods We conducted a retrospective review of 905 (33.3% female) cases of elective heart surgery in MHCA for ascending aortic aneurysm (90.9%) or severely calcified aorta (12.5%) between 2001 and 2015. Furthermore, 299 female and 299 male patients matched by propensity score were compared. Patients with dissection of the aorta were excluded.Results Women were older (68.4 ± 9.9 vs. 65.8 ± 11.6 years; p = 0.002), had higher logistic EuroSCORE I (18.4 [11.7; 29.2] vs. 12.3% [7.4; 22.6]; p < 0.001), and significantly shorter cardiopulmonary bypass (CPB) time (132 [105; 175] vs. 150 [118; 192] minutes; p < 0.001), while mean MHCA time was longer (15 [13; 19] vs. 14 [12; 17] minutes; p = 0.003). Surgical procedures were less complex in women and they were treated more frequently by isolated supracoronary ascending aorta replacement (61 vs. 54%; p = 0.046). Postoperatively, men showed a higher incidence of neurologic complications (7.0 vs. 3.3%; p = 0.03). The 30-day mortality (women 4.9% vs. men 3.9%; p = 0.48) did not differ significantly, likewise after statistical matching (4.7 vs. 2.3%; p = 0.120). Age, CPB time, and blood transfusion, but not female gender, were risk factors for mortality in multivariable regression analysis.Conclusion This study supports the hypothesis that female gender is not associated with increased short-term mortality or perioperative adverse events in elective aortic surgery in MHCA. PB - Georg Thieme Verlag KG DO - 10.1055/s-0039-1698409 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0039-1698409 ER -