SURGICAL REVASCULARIZATION IN WOMEN

Surgical revascularization is an important therapeutic option for both men and women with symptomatic coronary heart disease (CHD). Although men have a higher incidence of CHD, a selection bias in currently utilized evaluation processes for persons with chest pain syndromes may also add to the observed gender difference in revascularization rates. The clinical and anatomical indications for surgical revascularization have been determined by studies which included mostly men. However, surgery should be considered in women with significant left main coronary stenosis, severe three-vessel coronary disease, severe two-vessel coronary disease (including a proximal left anterior descending artery stenosis) and unstable angina with left ventricular dysfunction. Surgical mortality, incomplete revascularization, recurrent symptoms and graft occlusion are more common in women than in men. However, the long-term prognosis for women surviving surgery is favorable.