Abstract 14008: Female Gender is Associated With Increased Risk of Stroke After Hemiarch Surgery

• Published in: Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A14008-A14008
• Main Authors: Ghincea, Christian V, Aftab, Muhammad, Ikeno, Yuki, Eldeiry, Mohamed, Anderson, Devon A, Roda, Gavriel F, Rove, Jessica, Pal, Jay D, Cleveland, Joseph C, Fullerton, David A, Reece, T B
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.14008

IntroductionFemale gender is associated with worse outcomes after cardiac surgery. The purpose of this study was to compare morbidity and mortality after hemiarch surgery between females and males.HypothesisWe hypothesized women would have poorer outcomes compared to males following hemiarch surgery.MethodsOver 8 years at our institution, 276 patients underwent hemiarch surgery with hypothermic circulatory arrest. We evaluated sex-based differences in postoperative outcomes including stroke, death, mediastinitis, and a composite endpoint of stroke, dialysis at discharge, prolonged ventilation requiring tracheostomy, mediastinitis, myocardial infarction, and death.ResultsMean age was 58.6 ±14.1 years (range 20-89) and 23.9% (66/276) were female. Non-elective procedures were performed in 31.5% (87/276) of cases. There were no significant differences between the sexes in preoperative characteristics, except women had significantly fewer redo sternotomies and were less likely to undergo concomitant aortic root surgery. Outcomes in females vs. males were the followingstroke 13.6% (9/66) vs 2.4% (5/210), p=0.001; death 6.1% (4/66) vs. 2.4% (5/210), p=0.170; composite outcome 16.7% (11/66) vs. 8.6% (18/210), p=0.074. Female sex remained a significant predictor of stroke after 1:1 propensity matching. Patient characteristics and outcomes before and after matching are summarized in Table 1.ConclusionsIn conclusion, despite undergoing less complex operations than their male counterparts, women were at increased risk of stroke after hemiarch surgery. There is a growing body of evidence demonstrating differential outcomes between the sexes following cardiac surgery and warrants further study.