Do women carry higher operative risk compared to men while undergoing coronary artery bypass grafting? AK Srivastava, MCh, JV Kothari, MS, AK Agarwal, MS, SK Agarwal, MCh, NK Gupta, MCh Department of Cardiovascular and Thoracic Surgery, SGPGI, Lucknow 226014, India Abstract Background. This study was aimed to determine influence of gender on result of coronary artery bypass grafting. It is a retrospective analysis. Methods. Ninety six patients, 48 men and 48 women of similar body surface area operated between 1991 to 1997 were compared. Associated comorbid conditions were identical in both the groups, except that none of the women smoked. Results. One patient (2.08%) died in each group. (p=NS). Although left anterior descending artery was smaller in diameter in women as compared to men, it did not express higher operative risk in women. No statistically significant difference was observed in perioperative and post operative morbidity including hospital stay. Conclusion. This study does not support the view that women carry higher surgical risk in comparison to men of similar body surface area. (Ind J Thorac Cardiovasc Surg, 2001; 17: 146-150) Key words. Coronary artery bypass grafting, Left anterior descending artery, Female sex. Introduction Coronary artery bypass grafting (CABG) remains the most accepted form of myocardial revascularization in multi-vessel coronary artery disease. Although, substantial data reflect the long-term survival of men and women after bypass surgery, little is known about the reasons for the reported higher operative mortality in women as compared to men. The various causes attributed to higher operative mortality in -women include smaller body size and smaller coronary artery diameter,~ 3 older age, 2'4 late presentation of disease at more acute stage 5, higher incidence of diabetes" and hypertension, under utilization of internal mammary artery and distinct referral biasL The purpose of this study, is to examine the various clinical characteristics Address for correspondence: AK Srivastava, MCh,MNAMS Professor and Head Department of Cardiovascular& ThoracicSurgery SanjayGandhi PostgraduateInstituteof MedicalSciences Raebareli Road, Lucknow226014, India Tel: 91-522-440963 Fax: 91-522-4400017/440963 email: ashok@sgpgi.ac.in 9 IJTCVS 097091341730901/011 Paper presented in the Annual Conferenceof Indian Associationof Cardiovascular and Thoracic Surgeons at Mumbai, India on 8th March, 2000. of patients undergoing CABG and to determine the influence of these changes on the result of CABG in men and women of similar body surface area. Patients and Methods Between Feb 1991 and Dec 1997, 688 patients (640 males and 48 females) underwent coronary artery bypass surgery at our center. Patients with coexisting valvular heart disease and primary myocardial disease were excluded from this study. The clinical characteristics of 48 female and 48 male patients of similar body surface were reviewed retrospectively. Satistacally it is not possible to compare 48 female with 500 male patients. Preoperative, operative and postoperative variables including hospital mortality and morbidity were compared between the two groups. (Table 1). Coronary angiography was performed in all patients in multiple right and left anterior oblique projections. All angiograms were interpreted to assess the extent of coronary artery disease by two experienced angiographers. Coronary artery narrowing of more than 50% was considered significant. Contrast left ventriculography was performed to assess regional wall motion abnormality, ejection fraction and presence or absence of mitral insufficiency. Society for thoracic