Sex-specific outcome after minimally invasive direct coronary artery bypass for single-vessel disease: A propensity score matching analysis

Objective To evaluate the influence of gender on surgical outcome in patients with single-vessel disease undergoing minimally invasive direct coronary artery bypass (MIDCAB). Methods This retrospective, non-randomized study analyzed 471 patients who underwent MIDCAB between February 2012 and January 2021 through left lateral thoracic small incision in the Department of Cardiac Surgery of our hospital were selected. Data were collected on demographics, clinical characteristics, operative and postoperative outcomes, and follow-up mortality and morbidity. Propensity score matching (PSM) was used to match patients between the groups. Results Before matching, female patients were older, had higher incidence of DM (40.2% Vs 27.3%, p = 0.013), higher LVEF (66.7 ± 8.0 Vs 63.6 ± 10.1, p<0.001) and smaller LVEDD (4.7 ± 0.5 Vs 5.1 ± 0.6, p = 0.001). After matching, the differences in baseline characteristics between both groups were eliminated. PS matching selected 103 matched pairs for final comparison. No significant differences were observed between both groups in terms of in-hospital mortality, the incidence of MACCE, incidence of perioperative MI, incidence of stroke, reoperation for bleeding. Female patients had longer length of stay compared to male patients (18.9 ± 14.3 Vs 15.5 ± 5.9, p = 0.027). Conclusion 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.