title: Robotic totally endoscopic coronary artery bypass grafting in men and women: are there sex differences in outcome?
abstract: BACKGROUND
  According to several studies, women are at higher risk for mortality and experience less relief of angina after coronary artery bypass graft surgery (CABG) than men. Sex-related differences in patients undergoing totally endoscopic coronary bypass grafting (TECABG) have not been investigated thus far. The aim of the present study was to evaluate the impact of sex on the outcome of patients undergoing TECABG.
  
  
  METHODS
  The data of 500 consecutive patients (364 male, 136 female) undergoing TECABG using the da Vinci telemanipulation system (Intuitive Surgical, Sunnyvale, CA) from 2001 to 2011 at two institutions were investigated regarding sex-related differences in short-term and long-term outcome.
  
  
  RESULTS
  In all, 334 single, 150 double, 15 triple, and 1 quadruple TECABG procedures were carried out. Female patients were significantly older (63 years [range, 26 to 90] versus 59 years [range, 31 to 85], p = 0.001) and had higher European System for Cardiac Operative Risk Evaluation score levels (3 [range, 0 to 11] versus 2 [range, 0 to 13], p < 0.001). Male patients received slightly more grafts (1 [range, 1 to 4] versus 1 [range, 1 to 3], p = 0.028), female patients were more likely to undergo beating heart surgery (20% versus 28%, p = 0.042). In-hospital mortality was 3 of 364 men (0.8%) and 2 of 136 women (1.5%; p = 0.513). Comparison of long-term-survival revealed 1-, 3- and 5-year survival rates of 96%, 96%, and 95% in men and 96%, 96%, and 96% in women, respectively, without any significant difference. Analysis of freedom from major adverse cardiac and cerebrovascular events revealed 1-, 3-, and 5-year rates of 86%, 84%, and 82% in men and 85%, 81%, and 81% in women, respectively, without any significant difference.
  
  
  CONCLUSIONS
  Our data show that women undergoing TECABG have outcomes similar to those of men.
authors.affiliation: University Clinic of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria. Electronic address: dominik.wiedemann@meduniwien.ac.at.
authors.forename: Dominik
authors.initials: D
authors.lastname: Wiedemann
authors.forename: Thomas
authors.initials: T
authors.lastname: Schachner
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Bonaros
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lehr
authors.forename: Brody
authors.initials: B
authors.lastname: Wehman
authors.forename: Patricia
authors.initials: P
authors.lastname: Hong
authors.forename: Marc
authors.initials: M
authors.lastname: Gibber
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lee
authors.forename: Johannes
authors.initials: J
authors.lastname: Bonatti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D012737:Sex Factors; D016896:Treatment Outcome
keywords: 23