[Comparison of the early results of coronary artery bypass grafting in women and men].
Aim of the study was comparing the early results of coronary artery bypass grafting (CABG) in women (W) and in men (M). This study comprises 1640 consecutive patients (1390 male and 250 female) at the age from 29 to 78 years (mean 57.2 +/- 8.9 years) operated on between January 1995 and June 2001 because of coronary artery disease. At least one myocardial infarction in history was noted in 156 W (62.4%) and 848 M (61.0%) (NS). Prior to surgery, coronary angioplasty (PTCA) was performed in 10 W (4.0%) and 63 M (4.5%) (NS). Left main stenosis in the preoperative angiocardiography was seen more often in W (26.3%) than in M (20.4%) (p < 0.05). All patients were operated on from median sternotomy with the use of cardiopulmonary bypass. Less grafts per patient were implanted in W (2.3 +/- 0.5) than in M. (3.0 +/- 0.4) (p < 0.05). In-hospital mortality in W (6.8%--17 W) was higher than in M (3.2%--44 M) (p < 0.05). Low cardiac output syndrome (LCOS) (11 W--4.4% vs 34 M--2.4%; p < 0.05), followed by respiratory failure (1 W--0.4% vs 5 M--0.4%; NS) and mediastinitis with sternal instability (3 W--1.2% vs 4 M--0.2%; p < 0.001) were the main reasons of death. Eight W (3.2%) and 41 M (2.9%) were reoperated, 5 W (2.0%) and 20 M (1.4%) (p < 0.05) because of mediastinitis and 3 W (1.2%) and 21 M. (1.5%) (NS) because of bleeding. Perioperative myocardial infarction confirmed in ECG and in the laboratory tests had 16 W (6.4%) and 90 M (6.5%) (NS). After operation, 20 W (8.0%) and 107 M (7.7%) developed LCOS. Efficacy of intraaortic balloon pump (IABP) in the treatment of LCOS was lower in W (45.0%) than in M. (65.7%) (p < 0.05). Infectious complications including mediastinitis and superficial wound infections were more frequent in W (9.2%) than in M (6.6%) (p < 0.05). The rate of other surgical complications (cardiac tamponade, pneumothorax or postoperative bleeding) and organ dysfunctions (respiratory, renal, neurological) was similar in W and M. Female patients are at higher mortality risk of coronary artery bypass grafting. Efficacy of IABP in the treatment of LCOS is lower in W. Infectious complications are more frequent in females.
D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000453:epidemiology / Q000209:etiology; D002305:Cardiac Tamponade / Q000453:epidemiology / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D011044:Poland / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
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