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<p>Despite widespread implementation of intravascular techniques in cardiovascular medicine, combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) have still been standard of surgical treatment. A purpose of this multicenter retrospective cohort study was to assess an impact of female sex on early outcomes and late survival rate following simultaneous AVR + CABG. This study comprised 12,626 patients (30.1% females; 69.9% males) that underwent AVR + CABG in 2006 through 2020. Primary endpoint was late survival. Thirty-day mortality and morbidity rates were also evaluated. In order to reduce an impact of inherent confounders, a propensity score (PS) matching was applied. PS matching selected 3,443 pairs and both gender groups were well balanced for baseline and operative characteristics. Women had higher 30-day mortality (OR: 1.42 (1.17–1.73), <i>p</i> &lt; 0.001), more prevalent respiratory failure (OR: 1.28 (1.06–1.55), <i>p</i> = 0.01) and increased risk of postoperative application of cardiac support devices (OR: 1.46 (1.09–1.94), <i>p</i> = 0.01), but reduced incidence of re-thoracotomy due to bleeding compared to men (OR: 0.8 (0.67–0.95), <i>p</i> = 0.01). A probability of survival of 4-year (76.2 vs. 76.1%) and 8-year (58.8 vs. 57.0%) follow-up was comparable between females and males, respectively. Women undergoing aortic valve replacement with concomitant artery bypass grafting presented worse early outcomes but comparable long-term survival to men.</p>

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Unfavorable impact of female gender on outcomes following aortic valve replacement combined with coronary artery bypass grafting

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月26日

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  • Bartłomiej Perek,
  • Sleiman Sebastian Aboul-Hassan,
  • Tomasz Hrapkowicz,
  • Radosław Gocoł,
  • Marek Deja,
  • Bogusław Kapelak,
  • Jan Rogowski,
  • Kazimierz Widenka,
  • Marcin Krasoń,
  • Bohdan Maruszewski,
  • Romuald Cichoń,
  • Marek Jemielity,
  • Marek Jasiński

摘要

Despite widespread implementation of intravascular techniques in cardiovascular medicine, combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) have still been standard of surgical treatment. A purpose of this multicenter retrospective cohort study was to assess an impact of female sex on early outcomes and late survival rate following simultaneous AVR + CABG. This study comprised 12,626 patients (30.1% females; 69.9% males) that underwent AVR + CABG in 2006 through 2020. Primary endpoint was late survival. Thirty-day mortality and morbidity rates were also evaluated. In order to reduce an impact of inherent confounders, a propensity score (PS) matching was applied. PS matching selected 3,443 pairs and both gender groups were well balanced for baseline and operative characteristics. Women had higher 30-day mortality (OR: 1.42 (1.17–1.73), p < 0.001), more prevalent respiratory failure (OR: 1.28 (1.06–1.55), p = 0.01) and increased risk of postoperative application of cardiac support devices (OR: 1.46 (1.09–1.94), p = 0.01), but reduced incidence of re-thoracotomy due to bleeding compared to men (OR: 0.8 (0.67–0.95), p = 0.01). A probability of survival of 4-year (76.2 vs. 76.1%) and 8-year (58.8 vs. 57.0%) follow-up was comparable between females and males, respectively. Women undergoing aortic valve replacement with concomitant artery bypass grafting presented worse early outcomes but comparable long-term survival to men.