Women more likely to experience bad outcomes from aortic surgery: study

CTV National News: Medical imbalance for females Scientists have discovered that women are more likely to face complications after surgery to fix aortic disease. Avis Favaro explains.

A new Canadian study reveals a shocking trend for women undergoing a certain type of heart surgery: they are much more likely than men to develop severe complications or even die. Doctors, moreover, do not even know why.

“We can’t just accept the status quo and we need to investigate further,” said Dr. Michael Chu, one of the study’s co-authors.

Chu is a scientist with the Lawson Health Research Institute and a cardiac surgeon at the London Health Sciences Centre, both of which are in London, Ont.  Other studies, he says, have shown a similar gender bias in medicine.

“We haven’t addressed the differences and issues between women and men, and in this day and age, that’s just unacceptable.”

80 per cent more likely to die

In the study, which was published earlier this week, scientists compared what happened to nearly 1,700 Canadian men and women who underwent surgery to fix aortic disease.

The aorta -- the main blood vessel that connects the heart to the lower body -- can sometimes bulge (an aneurysm) or tear (dissection), causing massive and often fatal internal bleeding.

The study found that even when men and women got the exact same procedure to fix their aortas, women were 40 per cent more likely to have complications, 90 per cent more likely to suffer a stroke and 80 per cent more likely to die than men.

Dr. Jennifer Chung is a surgeon and scientist with the University Health Network's Peter Munk Cardiac Centre in Toronto and another of the study’s co-authors.

“This is not five per cent more, not 10 per cent more,” she told CTV News of that higher mortality rate. “This is 80 per cent more.”

Researchers are now trying to figure out why this is happening. They think that women could have more fragile heart and blood vessel tissues than men, and thus need surgeries that are better tailored to their bodies, or that women don’t get diagnosed with aortic disease as quickly as men.

‘KNOW YOUR OWN BODY’

Canadian opera singer Measha Brueggergosman was in her early 30s when she had a devastating aortic dissection -- a tear in the wall of the aorta -- that was initially misdiagnosed as high blood pressure. Only when she went to her family doctor, convinced there was something else amiss, did she get more testing and the emergency surgery that likely saved her life.

Until scientists figure out why there is this difference in outcome between men and women, Brueggergosman urges women to put their health first.

“If there is a message for women out there, it’s to know your own body,” she told CTV News. “And when there’s something wrong, advocate for yourself because clearly studies like this show us that nobody is doing it for us.”

Doctors say there should be absolutely no difference in complication rates between women and men. The study will help researchers understand how to personalize aortic disease therapy for women.

“We need to be more aggressive in terms of diagnosis,” Chu said.

“Surgically we need to employ different techniques, we need to use some newer techniques, some innovative new technologies to try to narrow that gap."

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What to look for

Aortic disease has no symptoms. Aneurysms are usually found incidentally during chest X-rays or CT scans for other conditions.

Aortic dissections or tears may have symptoms that can include:

You can learn more about the causes, symptoms, diagnosis and treatment of aortic diseases on the University of Ottawa’s Heart Institute website.