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Ann Thorac Surg 2002;74:1435-1437
© 2002 The Society of Thoracic Surgeons

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Editorial

Bilateral internal mammary artery grafting for coronary artery bypass grafting: why men versus women?

^a George C. Griffith Center, Section of Cardiovascular Medicine, Department of Medicine, and University of Southern California Medical Center and Keck School of Medicine at University of Southern California, Los Angeles, California, USA

* Address reprint requests to Dr Rahimtoola, Keck School of Medicine at University of Southern California, 2025 Zonal Ave, Los Angeles, CA, 90033, USA.

The first 20% of the full text of this article appears below.

In this issue, Kurlansky and co-workers [1] present 15-years of follow-up data on 261 women and 261 computer-matched men undergoing bilateral internal mammary artery (IMA) coronary artery bypass grafting (CABG) operations between January 1972 and October 1994. Most of the patients were operated on from 1982 to 1994 and 60% were operated on after 1986. There was no significant difference between the two groups in operative mortality and postoperative complications and at 10 and 15 years in survival of patients discharged from hospital. Also there was no significant difference between the two groups in angina, need for reoperation, or percutaneous transluminal coronary angioplasty, and eventfree survival. The very interesting and important findings are (1) that the quality-of-life assessment showed that both men and women scored as well as or better than the general population corrected for age and gender; and (2) although men scored higher in physical health (p = 0.001), women scored higher in mental health (p = 0.011) when compared with their age-adjusted norms.

These are valuable data. However there are several limitations to their study: (1) The number of patients are small and there is no information as to how the 261 women were selected to undergo bilateral IMA; (2) There are no data on the incidence of systolic hypertension and low-density lipoprotein cholesterol at baseline. Of interest is the incidence of unstable angina (73.2% vs 28%), which is said to be statistically nonsignificant; (3) The incidence of hospital mortality of patients who had sternal and mediastinal complications in diabetics and nondiabetics is not given; (4) Criteria and methods used to ascertain cardiac and noncardiac causes of death are not provided, and the actual cardiac causes of death (myocardial infarction, heart failure, and so forth) are . . . [Full Text of this Article]

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