The role of gender in coronary surgery

Abstract

Gender-based outcome data in coronary artery bypass graft (CABG) surgery has been the focus of extensive research over the last two decades. Increased awareness in gender-specific health and advancements in scientific research have produced evidence that risk profiles vary between genders and alter operative mortality after CABG. Some of these data remain controversial, emphasizing the complexity of gender as an independent variable and questioning processes of care that are intimately associated with outcome. Although patient gender cannot be changed, understanding gender-specific risks and modifying surgical practice may be helpful in improving patient outcomes.

Gender’s impact on outcome in coronary surgery with minimized extracorporeal circulation

“…Despite the proposed advantages of MECC, gender-related disparity on outcome is still present in our study and unadjusted mortalities in men and women are not significantly lower compared to recent studies conducted with the use of conventional extracorporeal circuits (for review see [9]). After adjusting for comorbidity and inclusion of female gender in the regression model, female gender itself was not identified as an independent risk factor for adverse outcome.…”

“…Even after risk adjustment, female gender remains associated with worse outcome [8]. A recent review by Blasberg et al [9] emphasizes the role of gender as an independent variable in cardiac surgery.…”

Acute Kidney Injury Following Coronary Artery Bypass Surgery and Long-term Risk of Heart Failure

“…The evidence of differences in postoperative risks between men and women is not uniform. A recent study showed that female sex is an independent risk factor for mortality and morbidity after cardiac surgery, 36 although another study found that the difference in mortality was largely explained by preoperative risk factors. 37 The main strength of our study was the size of the study population and length of follow-up.…”

Uterine artery as an arterial conduit for coronary artery bypass graft (CABG) surgery in women: A role for estrogen-receptor alpha (ER-α) in the prevention of post-CABG accelerated atherosclerosis and graft disease

“…The evidence clearly establishes that amongst women, associated risk factors for recurrent angina and graft failure include fewer bypass grafts used and decreased use of the LITA as a conduit [11]. Therefore, the selection of certain types of grafts for a CABG procedure has been theorized to benefit female patients.…”