Our Summary

This research paper looks at data from the United States related to coronary artery bypass grafting (CABG), a type of heart surgery. In 2019, more than half of all adult heart surgeries were CABG, with around 301,077 procedures performed. About 25% of these operations were performed on women.

The study found that women who undergo this surgery are usually older and have more health problems like diabetes and high blood pressure. They’re also more likely to have the surgery in a more critical health state, for example, after a heart attack.

Despite these factors, the research found that just being female is an independent risk factor for worse outcomes from the surgery. This means that even if women were the same age as men and had the same health problems, they’re still more likely to fare worse.

Evidence has shown that women are at a significantly higher risk of negative outcomes after the surgery and in the long term. However, the overall trends for patients undergoing this surgery have improved over the years.

But a recent study from Gaudino et al. showed that the outcome gap between men and women hasn’t gotten better. They looked at over 1.2 million patients who had the surgery between 2011 and 2020 and found that women had a higher risk of complications and death within 30 days of the surgery. This hasn’t improved over the period of their study.

The researchers conclude that we need to understand this discrepancy better and pay more attention to the differences in outcomes between men and women in CABG surgeries. This could help improve outcomes for women undergoing this procedure.

FAQs

  1. How many coronary artery bypass grafting (CABG) procedures were performed in the United States in 2019?
  2. Are women at a higher risk of adverse outcomes from CABG surgeries compared to men?
  3. Has there been any improvement in the outcomes gap between men and women undergoing CABG surgeries over the past decade?

Doctor’s Tip

One helpful tip a doctor might tell a patient about coronary artery bypass is to follow a healthy lifestyle after surgery, including maintaining a balanced diet, regular exercise, and quitting smoking. This can help improve long-term outcomes and reduce the risk of future cardiovascular issues.

Suitable For

Patients who are typically recommended for coronary artery bypass grafting (CABG) include those with severe coronary artery disease, significant blockages in the coronary arteries that cannot be managed with medications or other interventions, and those who have had a heart attack or are at high risk for a heart attack. Other factors that may indicate the need for CABG include:

  • Severe angina (chest pain) that is not controlled with medications
  • Left main coronary artery disease
  • Multiple blockages in the coronary arteries
  • Diabetes
  • Heart failure
  • Previous coronary artery stenting that has failed
  • High-risk anatomy for percutaneous coronary intervention (PCI)
  • Presence of other comorbidities that increase the risk of complications from PCI

It is important for patients to undergo a thorough evaluation by a cardiac surgeon and cardiologist to determine if CABG is the best treatment option for their specific condition. Additionally, factors such as age, sex, and overall health status will also play a role in determining if CABG is appropriate for a particular patient.

Timeline

Before coronary artery bypass surgery:

  • Patient undergoes diagnostic tests such as a stress test, coronary angiography, and echocardiogram to determine the extent of coronary artery disease.
  • Patient may undergo medical management with medications to control symptoms and improve heart function.
  • Patient may undergo lifestyle changes such as diet and exercise to improve heart health.

After coronary artery bypass surgery:

  • Patient is monitored closely in the intensive care unit (ICU) immediately after surgery.
  • Patient may experience pain, swelling, and discomfort at the incision site.
  • Patient undergoes physical therapy to regain strength and mobility.
  • Patient is prescribed medications to prevent blood clots, control cholesterol, and manage pain.
  • Patient follows up with their healthcare provider regularly for monitoring and ongoing care.
  • Patient may need to make further lifestyle changes such as quitting smoking, managing stress, and maintaining a healthy diet and exercise routine to prevent future heart problems.

What to Ask Your Doctor

Some questions a patient should ask their doctor about coronary artery bypass include:

  1. What are the risks and benefits of coronary artery bypass surgery for my specific condition?
  2. What are the expected outcomes and recovery timeline after the surgery?
  3. Are there alternative treatments or procedures that could be considered instead of coronary artery bypass?
  4. What is the surgeon’s experience and success rate with performing coronary artery bypass surgeries?
  5. How will my existing health conditions, such as diabetes or hypertension, affect the surgery and recovery process?
  6. What lifestyle changes will I need to make after the surgery to improve my long-term outcomes?
  7. How often will I need to follow up with my doctor after the surgery and what ongoing care will be required?
  8. Are there any specific considerations or differences in outcomes for women compared to men undergoing coronary artery bypass surgery?
  9. What are the potential complications or risks associated with the surgery and how are these managed?
  10. Are there any specific questions or concerns I should discuss with my healthcare team before undergoing coronary artery bypass surgery?

Reference

Authors: Esmaeilzadeh S, Vinzant N, Ramakrishna H. Journal: J Cardiothorac Vasc Anesth. 2025 Feb;39(2):532-537. doi: 10.1053/j.jvca.2024.10.031. Epub 2024 Oct 23. PMID: 39547868