The influence of gender on mortality in patients after thoracic endovascular aortic repair

Objectives: The aim of this study was to determine if gender affects mortality in patients after thoracic endovascular aortic repair (TEVAR). Methods: We retrospectively analyzed 286 consecutive patients undergoing TEVAR at our institution during a 12-year period (female 29%, median age 69 years). Chronic health conditions, risk factors, as well as early and long-term outcome were assessed. Follow-up data were available in all patients. Results: For female gender, 1-year survival and 5-year survival was 84% and 56% versus 83% and 60% for male gender. No significant gender influence was observed (odds ratio (OR) 0.96, 95% confidence interval (CI) 0.59-1.56). Furthermore, no significant gender influence could be observed according to the individual indication - atherosclerotic aneurysms (OR 0.78 95% CI 0.41-1.47), acute type B dissections (OR 0.78 95% CI 0.21-2.83), penetrating atherosclerotic ulcers/intramural hematoma (OR 1.48 95% CI 0.53-4.19), and traumatic aortic lesions (OR 1.48 95% CI 0.53-4.19). Age (OR 3.6 95% CI 1.24-10.45) and chronic obstructive pulmonary disease (COPD; OR 3.09 95% CI 0.98-9.73) were independent predictors of mortality in females. Conclusions: Gender does not affect mortality in patients after TEVAR irrespective of the underlying indication, atherosclerotic aneurysms, acute type B dissections, penetrating ulcers/ intramural hematoma, and traumatic aortic lesions. Classical risk factors such as age and the presence of COPD at the time of TEVAR remain the most important risk factors in females. (C) 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B. V. All rights reserved.