Article

Results of coronary artery surgery in women

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Abstract

Many clinicians have the impression that coronary artery disease in women is more diffuse and severe than in men, and hence the surgical results are often not as good. In a small series of patients, Bolooki et al1 showed that in women the results of saphenous vein bypass grafting to the coronary arteries were less than satisfactory. For these reasons we have reviewed the short-term results of coronary artery surgery in women at the Cleveland Clinic and compared them with those in men operated upon during the same time period.

Patients

The angiographic criteria used in the selection of patients for coronary artery surgery at the Cleveland Clinic are 70% to 80% or greater obstruction in a major branch of the coronary circulation, a distal segment relatively free of significant occlusive disease, and normal or mild to moderate ventricular impairment. Many patients had a myocardial infarction previously, and most had experienced classic or atypical angina pectoris. Initially, many of the operations consisted of single vein grafting, but now multiple grafting is done in the majority of cases.

This series includes both elective and emerency cases. Except for emergencies, contraindications to surgery have been gross obesity, florid tabacco bronchitis, recent treatment with propranolol, or active peptic ulcer disease. In recent years internal mammary artery (IMA) grafting has been performed more frequently.

Results

From 1971 through 1975, 7,941 patients underwent revascularization surgery. Saphenous vein grafting without the use of an IMA was done in 5,273 patients (76%). Women constituted 11% of the. . .


 

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