Harvard Heart Letter

Heart Beat: Newer bypass technique may be safer for women

Heart Beat

Newer bypass technique may be safer for women

Bypass surgery isn't easy for anyone, but it seems to be especially hard on women. Women are more likely than men to have a heart attack or stroke or die during the operation or soon after it. A large study from Emory University in Atlanta suggests that off-pump bypass surgery, which is done without stopping the heart or using a machine to circulate the blood, mitigates some of these hazards in women.

The researchers looked at the results of 11,413 consecutive bypass operations done at Emory and its affiliated hospitals between 1997 and 2005. Women, who made up one-third of the group, tended to be older and sicker than the men. As in other studies, they didn't fare as well as men. But when the researchers broke down the results by type of operation, something interesting emerged: Women who had off-pump bypass operations did much better than those who had traditional operations (see "On versus off"). The difference remained even after the researchers accounted for 31 other factors known to influence bypass results. Men benefited from off-pump bypass, too, but not nearly as much as women did.

On versus off

Off-pump bypass surgery appears to benefit women more than men.

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Women

Men

Outcome*

On pump

Off pump

On pump

Off pump

Died

4.1%

1.5%

1.8%

1.3%

Stroke

3.2%

1.7%

1.6%

1.0%

Heart attack

1.5%

0.8%

0.5%

0.6%

Any major cardiac problem

7.9%

3.6%

3.6%

2.6%

*Before leaving the hospital

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