a Department of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove , Charles University , Hradec Kralove , Czech Republic.
Scand Cardiovasc J. 2019 Jun;53(3):141-147. doi: 10.1080/14017431.2019.1612088. Epub 2019 May 9.
. Female sex has been generally accepted as a risk factor for short-term mortality and adverse events in surgical myocardial revascularization. However, there have been no data published yet about sex differences in minimally invasive settings. The aim of our study was to analyse short- and long- term outcomes of minimally invasive direct coronary artery bypass grafting (MIDCAB) in terms of sex comparison. . We retrospectively analysed the in-hospital data of all patients ( = 384) undergoing MIDCAB at our department in years 2006-2016. Subsequently, the data were enriched by long-term outcomes from national registries. There were 96 women in our group (25%). Females were significantly older (67.1 vs 63.8 years; < .01) and were more often diabetic (43.8% vs. 31.8%; < .01). Surgery time was longer in females (160 vs 155 min; = .02), and also the need for blood transfusion (19.8% vs 10.4%; = .02) and wound complications (15.6% vs 2.4%; < .001) were more frequent in women. After multivariate analysis, the wound complications risk ( < .001) and longer surgery times ( < .01) remained associated with sex. All-cause in-hospital mortality (2.1% vs 0.7%; = .26), long-term mortality ( = .73), and the risk of coronary intervention post-operatively ( = .16) were the same in both sexes. Higher incidence of cardiac cause of death in women was observed from long-term aspect (69.6% vs 38.7%; = .01). However, after adjustment it lost its significance. Female sex is not connected with higher risk of mortality or other major events in MIDCAB. Wound healing complications remain the leading attribute associated with female sex.
. 性别已被普遍认为是外科血运重建术短期死亡率和不良事件的一个风险因素。然而，目前在微创环境下还没有关于性别差异的数据。我们的研究目的是分析微创直接冠状动脉旁路移植术（MIDCAB）的短期和长期结果，并进行性别比较。. 我们回顾性分析了 2006 年至 2016 年期间在我们科室接受 MIDCAB 的所有患者（ = 384）的住院数据。随后，从国家登记处获得了长期结果的数据。 在我们的研究组中，有 96 名女性（25%）。女性患者年龄明显较大（67.1 岁比 63.8 岁； < .01），且更常患有糖尿病（43.8%比 31.8%； < .01）。女性的手术时间较长（160 分钟比 155 分钟； = .02），输血需求（19.8%比 10.4%； = .02）和伤口并发症（15.6%比 2.4%； < .001）也更为常见。多因素分析后，伤口并发症风险（ < .001）和较长的手术时间（ < .01）仍与性别相关。两组患者的全因住院死亡率（2.1%比 0.7%； = .26）、长期死亡率（ = .73）和术后冠状动脉介入治疗风险（ = .16）相同。从长期来看，女性的心脏死亡发生率较高（69.6%比 38.7%； = .01）。但调整后该差异无统计学意义。. 女性性别与 MIDCAB 死亡率或其他重大事件的风险增加无关。伤口愈合并发症仍然是与女性性别相关的主要因素。
