Compared with CR patients , RR patients were younger ( 56.9 versus 62.3 years ; p = 0.023 ) and more likely to present with larger root diameter ( 4.7 cm versus 4.0 cm ; p < 0.001 ) , Marfan syndrome ( 8.7 % versus 2.5 % ; p < 0.001 ) , aortic insufficiency ( 64.0 % versus 50.3 % ; p < 0.001 ) , and hypotension , shock , or tamponade ( 33.0 % versus 26.5 % ; p = 0.003 ) .