Does gender influence the likelihood or types of complications following cardiac surgery?

Amanda A. Fox, Nancy A. Nussmeier

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Over 410,000 cardiac surgeries are performed in American women each year. Women having coronary artery bypass graft (CABG) and valve surgery do so at an older age and with more cardiovascular risk factors than men. Women's smaller body size may also increase risk by increasing the technical difficulty of surgical procedures. Female CABG patients appear to have higher perioperative mortality and cardiac morbidity, although studies of neurologic outcomes in female CABG patients have produced equivocal findings. Women undergoing CABG tend to consume more hospital resources than men do in terms of blood transfusion, mechanical ventilation, and length of intensive care unit and overall hospital stay. With regard to valve surgery, women appear to have worse outcomes than men if the surgery is combined with a CABG operation. Women and men undergoing isolated aortic valve surgery have similar mortality, but little is known about gender differences in mitral and tricuspid valve surgery outcomes. Women who require heart transplantation tend to have idiopathic cardiomyopathy rather than the ischemic cardiomyopathy that is more common in male heart transplant candidates. Although female heart transplant recipients seem to have a stronger immunologic response after transplantation, which manifests in more frequent acute rejection episodes, it is not clear whether this increases women's mortality risk. Men appear to have a greater incidence of posttransplant vasculopathy than women. Further research is needed to identify risk factors for perioperative morbidity and mortality in women undergoing cardiac surgery and to develop medical interventions to mitigate these risks.

Original languageEnglish (US)
Pages (from-to)283-295
Number of pages13
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Volume8
Issue number4
DOIs
StatePublished - Dec 2004

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Thoracic Surgery
Coronary Artery Bypass
Transplants
Mortality
Cardiomyopathies
Morbidity
Tricuspid Valve
Body Size
Heart Transplantation
Aortic Valve
Mitral Valve
Artificial Respiration
Blood Transfusion
Nervous System
Intensive Care Units
Length of Stay
Transplantation
Outcome Assessment (Health Care)
Incidence
Research

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Does gender influence the likelihood or types of complications following cardiac surgery? / Fox, Amanda A.; Nussmeier, Nancy A.

In: Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 8, No. 4, 12.2004, p. 283-295.

Research output: Contribution to journalArticle

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