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Bypass 'Off-Pump' Boosts Women's Outcomes
Date:9/11/2007

at seen in women, he said.

Bypass surgeries already have a good record for safety and effectiveness, but if the mortality rate is reduced "by one-third to one-half, we're trying to make something that is very good even better," Puskas said. "Off-pump is a way to do that, especially for women."

The better results for off-pump surgery were not due only to lowered risk factors, Puskas added, because higher risk patients were also done off-pump.

Researchers for years have been trying to figure out why women tend to fare worse after heart surgery compared to men. One explanation was that female patients tended to be older, and their arteries were smaller in size.

The Emory study gets no further at explaining why off-pump surgery made such an improvement, Puskas added.

Last year, a University of Michigan study reported that 96 percent of the gender gap in mortality rates for women and men within 100 days of coronary artery bypass surgery might be explained by higher infection rates in women.

Puskas, however, said that infection rates did not play a role in results of the Emory study.

If the Emory results are replicated in additional studies, "they will change the practice patterns for women going for bypass, so these are highly significant findings," said Dr. Elizabeth Jackson, a cardiologist and assistant professor of medicine at Michigan. The Emory study now raises questions about "what kind of procedures benefit women more than men and vice-versa." added Jackson, who did not play a role in the Michigan infection study.

Another expert believes that women should be careful not to pressure their heart surgeons to do off-pump procedures.

"The surgeon's comfortability comes into play. I think, down the road, more off-pump surgeries will be done on women, but, ultimately, it will be the choice of the surgeon," said Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox
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