Introduction

Surgical revascularization, alongside percutaneous intervention, is a viable therapeutic option with satisfactory long-term results. Accumulating evidence indicates that biological sex modulates the predisposition to coronary artery disease and perioperative risk.

Aim

The study aimed to identify potential long-term prognostic factors after surgical revascularization in patients undergoing off-pump coronary artery bypass (OPCAB) using bilateral mammary arteries.

Material and methods

In total, 276 consecutive patients were operated on due to complex stable coronary disease with off-pump surgical revascularization using bilateral mammary arteries. The long-term survival rates, including the Kaplan-Meier survival curve, were compared based on all-cause mortality risk between the female and male populations.

Results

Among the 276 analyzed participants, 64 (23%) were deceased, with a median follow-up time of 3,307 days (range: 1,703–5,414 days). The 5-, 10-, and 15-year survival rates in the male and female populations were 90.5% vs. 96.5%, 78.1% vs. 91.4%, and 62.9% vs. 81.3%, respectively.

Conclusions

Female sex may be related to superior long-term survival in off-pump revascularization with bilateral mammary artery grafts. While early perioperative risks may be higher in women due to anatomical and referral delay factors, the long-term survival in women may surpass that of men once the immediate postoperative period is successfully navigated. Large-scale studies are required to confirm the suggested association.