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Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
Lucia Torracca Tenth International Symposium
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Lucia Torracca Tenth International Symposium

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  • 1. Lucia Torracca Tenth International Symposium HEART FAILURE & Co. CARDIOLOGY SCIENCE UPDATE FEMALE DOCTORS SPEAKING ON FEMALE DISEASES Milano 9 - 10 aprile 2010
  • 2. Il bypass aorto-coronarico: più rischioso e meno efficace? Direttore U.O. Cardiochirurgia A.O.U. Ospedali Riuniti “Umberto I- G. M. Lancisi- G. Salesi” Presidio Monospecialistico “G. M. Lancisi” Ancona L. Torracca
  • 3. Preoperative risk profile (women versus men)
    • Older
    • Diabetes/Obesity/Hypertension
    • Smaller body surface area
    • Lower hematocrit
    • Congestive heart failure/NYHA class IV
    • IV heparin/nitroglycerin
    • Urgent/emergent operation
    • Higher STS estimated mortality
    Aldea Ann Thorac Surg 1999 Single center consecutive 1743 pts
  • 4. Gender profiling in CABG Koch JTCVS 2003;126:2044 15,597 pts Cleveland Clinic
  • 5. Operative mortality 344,913 pts from STS database
  • 6. Operative mortality
  • 7. Operative mortality
  • 8. Operative mortality
  • 9. Operative mortality
  • 10. Operative risk factors Aldea Ann Thorac Surg 1999
  • 11. Operative risk factors Internal mammary artery use FEMALE vs MALE 64% vs 78% O’Connor 1993 65% vs 76% Edwards 1998 67% vs 80% Humphries 2007 83% vs 89% Bukkapatnam 2010
  • 12. Outcome 1113 pts followed for 6-8 weeks after CABG
  • 13. QOL before and after CABG Peric V. ICVTS 2010;10:232
  • 14. QOL before and after CABG Peric V. ICVTS 2010;10:232
  • 15. Quality of life
  • 16.  
  • 17. Women may benefit of a more aggressive rehabilitation program
  • 18. - 2 groups of patients 261 women and 261 men “computer-matched” - All pts bilateral IMA graft - Hospital mortality 3,4% vs 3,8% (women vs men)
  • 19.  
  • 20.  
  • 21.  
  • 22. Gender and off-pump
  • 23. Gender and off-pump
  • 24. Female and leg wound complications Paletta Ann Thorac Surg 2000;70:492
  • 25. Endoscopic vein harvesting Yun JCTS 2005;129:496
  • 26.
    • Increase the use of “at least” one or “better” two mammary arteries
    • Optimal management of blood glucose level (100-150mg/dl)
    • Intraop management of anemia (nadir Ht>22 during CPB): reduce pump prime, ultrafiltration
  • 27.
    • Use of off-pump surgery ?
    • Optimization of thyroxine treatment
    • Hormone replacement therapy???
  • 28. Thanks for the attention!

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