Improving Coronary Artery Bypass Grafting in Women: Difficulties and Outcomes

There continues to be a clear distinction between women and men after coronary surgery. Many argue that higher mortality, complication rate, and worse outcomes among women have been attributed to smaller artery size, higher technical complexity, and more comorbidities at the time of presentation. However, evidence of only a physiologic or anatomical reason for poor outcomes is severely lacking. In this paper, we review the sex differences in coronary artery bypass grafting, the influence of race and sex, and the choice of conduit on outcomes in women. Additionally, we elucidate strategies to improve outcomes, such as including female animals in basic science, enforcing the use of guideline-directed treatments, expanding women’s representation in clinical trials, increasing the number of women researchers, and developing Centers of Excellence. This review not only highlights the outcomes and challenges of women undergoing coronary surgery but also proposes avenues for potential solutions to this ongoing issue.