Abstract
Cardiac surgeons have long appreciated that coronary artery bypass grafting may differ in its success for men and women. Early studies reported that coronary artery bypass grafting was associated with a higher early mortality in women, although long-term survival was similar in both sexes. A consistent finding was that women were more symptomatic, with a greater number of adverse risk factors at time of surgery, although they had less coronary disease and better cardiac function. Recent studies suggest that their disadvantageous clinical profile remains, but that they are now burdened with increased coronary disease and poorer cardiac function. There is increasing evidence that women are underreferred for coronary angiography, although it would appear that once investigated, they receive appropriate referral for coronary artery bypass grafting. These findings are not universal, and there are significant differences in clinical practice between institutions.
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