INTRODUCTION
Several sex-based differences in the pathophysiology of aortic diseases have been established, such as later presentation of women with acute type A aortic dissection (ATAAD) [1] and faster growth rate of thoracic aortic aneurysms in women when compared to men [2]. In light of these differences, studies have also been conducted to investigate potential differences in sex-based outcomes after ATAAD repair. Some data have suggested worse outcomes in women, though there have been conflicting findings and inconclusive results among these studies over time [3,4,5]. Moreover, it is unclear whether findings of worse outcomes in women were actually attributable to sex-based differences in pathophysiology and initial presentation. Some hypothesize that women have had worse outcomes and higher mortality because of more frequent atypical clinical presentations, leading to considerable delays in diagnosis and management [6]. Over the past decade, outcomes of ATAAD repair have improved significantly, due to advancements in diagnostic methods, cerebral perfusion strategies, spinal cord protection, surgical techniques, and endovascular technologies [7]. Whether sex-related disparities in outcomes of ATAAD repair persist in the modern era is not yet well-established.
To help clarify these questions, we present sex-based outcomes from our experience of ATAAD repair, with additional propensity score matched analysis to eliminate the effects of age, type of repair, and other confounding variables on outcomes.