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Marfan syndrome is a connective tissue disorder that affects multiple organs, with the most serious complications occurring in the cardiovascular system. Aortic root dilatation and dissection are particularly concerning. While the prevalence of Marfan syndrome is equal between genders, male patients have a higher risk of developing thoracic aortic aneurysm and dissection compared to females. A recent study using a mouse model of severe Marfan syndrome found that male mice had poorer survival rates and exhibited lower elastin content and more fragmented elastic fibers compared to female mice. The study suggests that material properties, aortic size, and wall integrity may be connected to dissection risk. Further research is needed to understand how age and sex contribute to dissection risk in Marfan syndrome. [Extracted from the article]

Pericytes are essential components of small blood vessels and are found in human aortic vasa vasorum. Prior work uncovered lower vasa vasorum density and decreased levels of pro‐angiogenic growth factors in adventitial specimens of human ascending thoracic aortic aneurysm. We hypothesized that adventitial extracellular matrix (ECM) from normal aorta promotes pericyte function by increasing pericyte contractile function through mechanisms deficient in ECM derived from aneurysmal aortic adventitia. ECM biomaterials were prepared as lyophilized particulates from decellularized adventitial specimens of human and porcine aorta. Immortalized human aortic adventitia‐derived pericytes were cultured within Type I collagen gels in the presence or absence of human or porcine adventitial ECMs. Cell contractility index was quantified by measuring the gel area immediately following gelation and after 48 h of culture. Normal human and porcine adventitial ECM increased contractility of pericytes when compared with pericytes cultured in absence of adventitial ECM. In contrast, aneurysm‐derived human adventitial ECM failed to promote pericyte contractility. Pharmacological inhibition of TGFβR1 and antibody blockade of α2β1 integrin independently decreased porcine adventitial ECM‐induced pericyte contractility. By increasing pericyte contractility, adventitial ECM may improve microvascular function and thus represents a candidate biomaterial for less invasive and preventative treatment of human ascending aortic disease. [ABSTRACT FROM AUTHOR]

Elderly patients are less likely to undergo surgery for an acute type A aortic dissection (ATAAD). This study aims to understand the risks of surgical treatment in patients 75 and older.This was a retrospective study using an institutional database of patients who underwent ATAAD repair from 2007 to 2021. Outcomes were compared between patients <75 and patients ≥ 75. Logistic regression was performed for operative mortality, and Cox regression was performed for long-term mortality.A total of 601 patients underwent surgery for ATAAD, 112 (18.6%) of whom were ≥75. Patients ≥75 were significantly more likely to undergo hemiarch replacement (vs total arch replacement) and concomitant CABG. Operative mortality was 16.1% in patients ≥75 versus 10.2% in those <75 (p = 0.078). On multivariable logistic regression, age ≥75 was not significantly associated with operative mortality (p = 0.068). Effect of age on long-term mortality was time-dependent: on Cox regression, being 75 or older and within one-year post-discharge was significantly associated with an increased hazard of death (time-dependent HR 4.56; 95% CI, 2.31–9.06; p < 0.001), while age was not associated with an increased hazard of death after the first postoperative year (p = 0.779).Despite reduced survival during the first postoperative year among patients 75 years and older, operative mortality and late survival were similar across each group. By implication, age alone should not be a deterrent to operative intervention in ATAAD patients, even though further investigation is needed to determine opportunities for improving survival during the first postoperative year after ATAAD repair. [ABSTRACT FROM AUTHOR]