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Women face disparity in bypass graft treatment: an internal mammary artery graft may be best.

The internal mammary arteries (IMA) that run along the inside of the chest wall make ideal conduits for coronary artery bypass surgery. Studies have proven that an IMA alone or in addition to saphenous leg veins contributes significantly to short-and long-term survival.

So when a 2009 review of 541,368 coronary bypass operations performed in 745 U.S. hospitals from 2002 to 2006 showed that more men than women were offered this lifesaving option, the researchers were perplexed. IMA is considered the gold-standard bypass graft, and there are few reasons it should not be used. The disparity is "not fully justified on a scientific basis," the researchers said.

According to the Society of Thoracic Surgeons' National Cardiac Database, 89 percent of female patients received one IMA, as compared with 93.7 percent of males; 2.3 percent of females and 4.7 percent of males received two (bilaterial) IMAs--a much newer procedure not recommended for every patient. This meant the odds of receiving an IMA were 35 to 40 percent lower for women than men.

Where the operation was performed or how many bypass operations a hospital performs yearly did not appear to make a difference. The IMA rate varied from 48 percent to 100 percent among hospitals. As the researchers noted, surgeons, not hospitals, make the decision about what type of bypass graft to use. Patients may benefit from asking their surgeon if an IMA will be used, and if the answer is no, a consultation with a different surgeon may be a good idea.

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Title Annotation:RESEARCH SHOWS ...
Publication:Heart Advisor
Article Type:Report
Geographic Code:1USA
Date:Jan 1, 2010
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