المؤلفون: Gaudino, Mario, Lemma, Massimo, Sandner, Sigrid, Boening, Andreas, Harik, Lamia, Albert, Marc, Martin, Jose Albors, Alcocer, Jorge, Alexander, John H, Bhatt, Deepak L, Bonaros, Nikolaos, Borger, Michael, Danner, Bernhard C, Davierwala, Piroze, Deja, Marek A, Paulis, Ruggero De, Deutsch, Marcus-Andre, Flather, Marcus, Kappetein, Pieter, Kurlansky, Paul

المصدر: European Journal of Cardio-Thoracic Surgery; May2024, Vol. 65 Issue 5, p1-7, 7p

مصطلحات موضوعية: ARTERIAL grafts, MYOCARDIAL infarction, CORONARY artery bypass, COVID-19 pandemic

مستخلص: The ROMA trial is a large randomized clinical trial comparing single arterial grafting (SAG) and multiple arterial grafting (MAG) in coronary artery bypass surgery (CABG). The trial began in 2017 and is expected to conclude in 2023. It was initiated due to the inconclusive results of a previous trial. Challenges faced by the ROMA trial include high crossover rates and the impact of the COVID-19 pandemic. The trial's results are still pending but are anticipated to provide valuable insights into the effectiveness of MAG in CABG procedures. The success of the ROMA trial has led to the establishment of the ROMA network, which conducts other cardiac surgery trials. The trial involves multiple participating centers across different continents, including hospitals in Asia such as Jilin Heart Hospital, Fuwai Hospital, Teda Hospital, National Taiwan University Hospital, and Ruijin Hospital Shanghai Jiao Tong USM. The document also provides a list of hospitals and medical institutions from various countries involved in the trial. The ROMA trial is funded by the National Institutes of Health and the Canadian Institutes of Health and Research. [Extracted from the article]

: Copyright of European Journal of Cardio-Thoracic Surgery is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Alzghari, Talal¹ (AUTHOR), Sandner, Sigrid² (AUTHOR), Di Franco, Antonino¹ (AUTHOR), Harik, Lamia¹ (AUTHOR), Perezgorvas-Olaria, Roberto¹ (AUTHOR), Soletti, Giovanni¹ (AUTHOR), Dimagli, Arnaldo¹ (AUTHOR), Cancelli, Gianmarco¹ (AUTHOR), Demetres, Michelle³ (AUTHOR), Lau, Christopher¹ (AUTHOR), Girardi, Leonard N.¹ (AUTHOR), Gaudino, Mario¹ (AUTHOR) mfg9004@med.cornell.edu

المصدر: Heart, Lung & Circulation. Dec2023, Vol. 32 Issue 12, p1500-1511. 12p.

مصطلحات موضوعية: *CORONARY artery surgery, *CORONARY arteries, *CORONARY artery bypass, *INTERNAL thoracic artery, *RADIAL artery, *ILEAL conduit surgery

مستخلص: To review the available literature on the use of coronary artery bypass grafting (CABG) as a treatment option for anomalous origin of coronary artery in adults. A systematic literature search was performed in March 2023 (including Ovid MEDLINE, Ovid Embase, and the Cochrane Library databases) to identify studies reporting the use of CABG in adult patients with anomalous origin of coronary artery. A total of 31 studies and 62 patients were included, 32 patients (52%) were women, and the mean age was 45.1±16.1 years. The most common coronary anomaly was the right coronary artery arising from the left coronary sinus in 26 patients (42%), followed by an anomalous left coronary artery from the pulmonary artery in 23 patients (37%). A total of 65 conduits were used in 61 patients, and 1 case report did not report conduit type. Reported grafts included saphenous vein (23 of 65 [35.4%]), left internal thoracic artery (15 of 65 [23.1%]), right internal thoracic artery (23 of 65 [35.4%]), and radial artery (2 of 65 [3.1%]); right gastroepiploic artery and basilic vein were used once (1.5%) each. Ligation of the native coronary artery was performed in 42 (67.7%) patients. Patient follow-up was available in 19 studies with a mean of 31.2 months. Only 1 operative mortality was reported. Based on the limited available data, CABG can be performed with good early results. Use of arterial conduits and ligation of the native coronary artery may improve long-term graft patency. [Display omitted] [ABSTRACT FROM AUTHOR]

المؤلفون: Gaudino, Mario¹ mfg9004@med.cornell.edu, Sandner, Sigrid², An, Kevin R.^1,3, Dimagli, Arnaldo¹, Di Franco, Antonino¹, Audisio, Katia¹, Harik, Lamia¹, Perezgrovas-Olaria, Roberto¹, Soletti, Giovanni¹, Fremes, Stephen E.⁴, Hare, David L.⁵, Kulik, Alexander⁶, Lamy, Andre⁷, Peper, Joyce⁸, Ruel, Marc⁹, ten Berg, Jurrien M.⁸, Willemsen, Laura M.⁸, Qiang Zhao¹⁰, Wojdyla, Daniel M.¹¹, Bhatt, Deepak L.¹²

المصدر: Circulation. 10/24/2023, Vol. 148 Issue 17, p1305-1315. 11p.

مصطلحات موضوعية: *CORONARY artery bypass, *MYOCARDIAL infarction, *DIAGNOSTIC imaging, *CLINICAL trials, *DATA analysis, *ARTERIAL grafts

مستخلص: BACKGROUND: Graft patency is the postulated mechanism for the benefits of coronary artery bypass grafting (CABG). However, systematic graft imaging assessment after CABG is rare, and there is a lack of contemporary data on the factors associated with graft failure and on the association between graft failure and clinical events after CABG. METHODS: We pooled individual patient data from randomized clinical trials with systematic CABG graft imaging to assess the incidence of graft failure and its association with clinical risk factors. The primary outcome was the composite of myocardial infarction or repeat revascularization occurring after CABG and before imaging. A 2-stage meta-analytic approach was used to evaluate the association between graft failure and the primary outcome. We also assessed the association between graft failure and myocardial infarction, repeat revascularization, or all-cause death occurring after imaging. RESULTS: Seven trials were included comprising 4413 patients (mean age, 64.4±9.1 years; 777 [17.6%] women; 3636 [82.4%] men) and 13 163 grafts (8740 saphenous vein grafts and 4423 arterial grafts). The median time to imaging was 1.02 years (interquartile range [IQR], 1.00-1.03). Graft failure occurred in 1487 (33.7%) patients and in 2190 (16.6%) grafts. Age (adjusted odds ratio [aOR], 1.08 [per 10-year increment] [95% CI, 1.01-1.15]; P=0.03), female sex (aOR, 1.27 [95% CI, 1.08-1.50]; P=0.004), and smoking (aOR, 1.20 [95% CI, 1.04-1.38]; P=0.01) were independently associated with graft failure, whereas statins were associated with a protective effect (aOR, 0.74 [95% CI, 0.63-0.88]; P<0.001). Graft failure was associated with an increased risk of myocardial infarction or repeat revascularization occurring between CABG and imaging assessment (8.0% in patients with graft failure versus 1.7% in patients without graft failure; aOR, 3.98 [95% CI, 3.54-4.47]; P<0.001). Graft failure was also associated with an increased risk of myocardial infarction or repeat revascularization occurring after imaging (7.8% versus 2.0%; aOR, 2.59 [95% CI, 1.86-3.62]; P<0.001). All-cause death after imaging occurred more frequently in patients with graft failure compared with patients without graft failure (11.0% versus 2.1%; aOR, 2.79 [95% CI, 2.01-3.89]; P<0.001). CONCLUSIONS: In contemporary practice, graft failure remains common among patients undergoing CABG and is strongly associated with adverse cardiac events. [ABSTRACT FROM AUTHOR]

المؤلفون: Schaefer, Andreas, Conradi, Lenard, Schneeberger, Yvonne, Reichenspurner, Hermann, Sandner, Sigrid, Tebbe, Ulrich, Nowak, Bernd, Stritzke, Jan, Kastrati, Adnan, Schunkert, Heribert, Scheidt, Moritz von, investigators, for the TiCAB

المصدر: European Journal of Cardio-Thoracic Surgery; Feb2021, Vol. 59 Issue 2, p417-425, 9p

مصطلحات موضوعية: CORONARY artery bypass, TREATMENT effectiveness, CEREBRAL revascularization, PERCUTANEOUS coronary intervention, ANGINA pectoris, CARDIOVASCULAR disease related mortality

مستخلص: Open in new tab Download slide Open in new tab Download slide OBJECTIVES In this post hoc analysis of the Ticagrelor in coronary artery bypass grafting (CABG) trial, we aimed to analyse patients treated with CABG receiving either complete revascularization (CR) or incomplete revascularization (ICR) independent from random allocation to either ticagrelor or aspirin. METHODS Of 1859 patients enrolled in the Ticagrelor in CABG trial, 1550 patients (83.4%) received CR and 309 patients (16.6%) ICR. Outcomes were evaluated regarding all-cause mortality, cardiovascular death, myocardial infarction (MI), repeat revascularization, stroke and bleeding within 12 months after CABG. RESULTS Baseline parameters revealed significant differences regarding clinical presentation (stable angina pectoris: CR 68.9% vs ICR 71.2%, instable angina pectoris: 14.1% vs 7.8%, non-ST elevation MI: 17.0% vs 21.0%, P ˂ 0.01), lesion characteristics (chronic total occlusion: CR 91.3% vs ICR 96.8%, P ˂ 0.01), operative technique [off-pump coronary artery bypass surgery (OPCAB): CR 3.0% vs ICR 6.1%, P ˂ 0.01] and number of utilized grafts (total number of grafts: 2.69/patient vs 2.49/patient, P ˂ 0.001). ICR patients displayed a significantly increased risk of repeat revascularization [hazard ratio (HR) 1.91, 95% confidence interval (CI) 1.16–3.16; P  < 0.01] and percutaneous coronary intervention (HR 1.95, 95% CI 1.13–3.35; P  < 0.05) within 12 months after CABG. Higher risk for repeat revascularization in ICR patients was independent from random allocation to either ticagrelor or aspirin and persisted after adjustment for baseline imbalances. CONCLUSIONS Patients with ICR presented more stable at the time of admission, but received less grafts, highly likely due to a higher rate of chronic total occlusion lesions and performed OPCAB. Although mortality presented no difference between groups, our results suggest that patients benefit from CR with regard to prevention of repeat revascularization. [ABSTRACT FROM AUTHOR]

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المؤلفون: Gaudino, Mario F L¹ (AUTHOR) mfg9004@med.cornell.edu, Sandner, Sigrid² (AUTHOR), Bonalumi, Giorgia³ (AUTHOR), Lawton, Jennifer S⁴ (AUTHOR), Fremes, Stephen E⁵ (AUTHOR), Surgery, in collaboration with the Coronary Task Force of the European Association for Cardio-Thoracic (AUTHOR)

المصدر: European Journal of Cardio-Thoracic Surgery. Dec2020, Vol. 58 Issue 6, p1111-1117. 7p.

مصطلحات موضوعية: *CORONARY artery bypass, *ARTERIAL grafts, *INTERNAL thoracic artery, *RADIAL artery, *MYOCARDIAL revascularization, SURGERY practice

الشركة/الكيان: EUROPEAN Society of Cardiology

مستخلص: Open in new tab Download slide Open in new tab Download slide Observational evidence shows that the use of multiple arterial grafts (MAG) is associated with longer postoperative survival and improved clinical outcomes. The current European Society of Cardiology/European Association for Cardio-Thoracic Surgery Guidelines on myocardial revascularization recommend the use of MAG in appropriate patients. However, a significant volume-to-outcome relationship exists for MAG, and lack of sufficient experience is associated with increased operative risk. A stepwise approach to building experience with MAG allows successful implementation of this technique into routine coronary surgery practice. [ABSTRACT FROM AUTHOR]

المؤلفون: Wollner, Gregor, Zimpfer, Daniel, Manduric, Marina, Laufer, Günther, Rieger, Armin, Sandner, Sigrid E.

المصدر: Journal of Cardiac Surgery; Oct2020, Vol. 35 Issue 10, p2543-2549, 7p, 5 Charts, 3 Graphs

مصطلحات موضوعية: HIV infections, CORONARY artery bypass, HIGHLY active antiretroviral therapy, HIV infection complications, STROKE, SURGICAL complications, CARDIOVASCULAR diseases, RETROSPECTIVE studies, MYOCARDIAL infarction, TREATMENT effectiveness, CORONARY artery disease, DISEASE complications

الشركة/الكيان: MEDIZINISCHE Universitat Wien

مستخلص: Background: With early and effective antiretroviral therapy and improved survival for persons living with human immunodeficiency virus infection (PLHIV), this patient population now faces an increasingly elevated risk of cardiovascular disease. However, the data on outcomes after coronary artery bypass grafting (CABG) for revascularization of coronary artery disease (CAD) in HIV+ patients is limited.Methods: We conducted a retrospective analysis of 16 patients undergoing isolated CABG at the Medical University of Vienna from 2005 to 2018, who were HIV+ on admission. The primary endpoint of the study was survival. Secondary endpoints included the components of major adverse cardiac and cerebrovascular events (MACCE): cardiovascular death, stroke, myocardial infarction (MI), and repeat revascularization.Results: Patients were followed for a median of 49 months (range, 7-142 months). Survival was 100% and 90% at 1 and 3 years after CABG, respectively. There were no strokes. MI and subsequent repeat revascularization were observed in two patients.Conclusion: CABG provides excellent short- and midterm survival and freedom from MACCE in HIV+ patients with CAD requiring revascularization. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Cardiac Surgery is the property of Hindawi Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Sandner, Sigrid E¹ (AUTHOR) sigrid.sandner@meduniwien.ac.at, Schunkert, Heribert^1,2 (AUTHOR), Kastrati, Adnan^2,3 (AUTHOR), Wiedemann, Dominik¹ (AUTHOR), Misfeld, Martin⁴ (AUTHOR), Böning, Andreas⁵ (AUTHOR), Tebbe, Ulrich⁶ (AUTHOR), Nowak, Bernd⁷ (AUTHOR), Stritzke, Jan⁸ (AUTHOR), Laufer, Günther¹ (AUTHOR), Scheidt, Moritz von^2,3 (AUTHOR), Investigators, for the TiCAB (AUTHOR)

المصدر: European Journal of Cardio-Thoracic Surgery. Apr2020, Vol. 57 Issue 4, p732-739. 8p.

مصطلحات موضوعية: *CORONARY artery bypass, *ASPIRIN, *ARTERIAL grafts, *MYOCARDIAL infarction, *CEREBRAL revascularization, *TICAGRELOR

مستخلص: Open in new tab Download slide Open in new tab Download slide OBJECTIVES We evaluated the effect of ticagrelor monotherapy on outcomes after multiple arterial grafting (MAG) or single arterial grafting (SAG) in coronary artery bypass grafting (CABG). METHODS In a post hoc , non-randomized analysis of the TiCAB (Ticagrelor in CABG; ClinicalTrials.gov NCT01755520) trial, we compared event rates for ticagrelor versus aspirin in patients undergoing MAG and SAG. Primary outcome was the composite of cardiovascular death, non-fatal myocardial infarction (MI), stroke or repeat revascularization 1 year after CABG. Secondary outcomes included individual components of the primary end point, all-cause death and bleeding. RESULTS Among 1753 patients, 998 patients underwent MAG and 755 patients underwent SAG. There was no significant difference in the 1-year primary composite outcome for ticagrelor versus aspirin with MAG [7.2% vs 7.9%; hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.57–1.43; P  = 0.66] or SAG (12.3% vs 8.6%; HR 1.47, 95% CI 0.93–2.31; P  = 0.10). Event rates for cardiovascular death, MI, stroke, repeat revascularization and all-cause death were similar for both treatment groups with MAG and SAG. No significant difference in major bleeding was observed for ticagrelor versus aspirin with MAG (2.6% vs 2.7%; HR 0.95, 95% CI 0.44–2.05; P  = 0.90) or SAG (5.8% vs 4.0%; HR 1.49, 95% CI 0.77–2.89; P  = 0.24). CONCLUSIONS In patients undergoing either MAG or SAG in the TiCAB trial, ticagrelor monotherapy compared with aspirin did not affect the rate of cardiovascular death, non-fatal MI, stroke or repeat revascularization, or the rate of bleeding, at 1 year after CABG. [ABSTRACT FROM AUTHOR]

المؤلفون: Sandner, Sigrid E¹ (AUTHOR) sigrid.sandner@meduniwien.ac.at, Nolz, Richard² (AUTHOR), Loewe, Christian² (AUTHOR), Gregorich, Mariella³ (AUTHOR), Heinze, Georg³ (AUTHOR), Andreas, Martin¹ (AUTHOR), Kolh, Philippe⁴ (AUTHOR), Zimpfer, Daniel¹ (AUTHOR), Laufer, Guenther¹ (AUTHOR)

المصدر: European Journal of Cardio-Thoracic Surgery. Apr2020, Vol. 57 Issue 4, p684-690. 7p.

مصطلحات موضوعية: *CORONARY artery bypass, *COMPUTED tomography, *PROPENSITY score matching, *STROKE, *ANGIOGRAPHY

مستخلص: Open in new tab Download slide Open in new tab Download slide OBJECTIVES The aim of this study was to determine stroke rates in patients who did or did not undergo routine computed tomography angiography (CTA) aortic imaging before isolated coronary artery bypass grafting (CABG). METHODS We conducted a retrospective analysis of a prospectively maintained single-centre registry. Between 2009 and 2016, a total of 2320 consecutive patients who underwent isolated CABG at our institution were identified. Propensity score matching was used to create a paired cohort of patients with similar baseline characteristics who did (CTA cohort) or did not (non-CTA cohort) undergo preoperative aortic CTA. The primary end point of the analysis was in-hospital stroke. RESULTS In 435 propensity score-matched pairs, stroke occurred in 4 patients (0.92%) in the CTA cohort and in 14 patients (3.22%) in the non-CTA cohort (P  = 0.017). Routine preoperative aortic CTA was associated with a significantly reduced risk of in-hospital stroke [relative risk 0.29, 95% confidence interval (CI) 0.09–0.86; P  = 0.026; absolute risk reduction 2.3%, 95% CI 0.4–4.2; P  = 0.017; number needed to treat = 44, 95% CI 24–242]. CONCLUSIONS A preoperative screening for atheromatous aortic disease using CTA is associated with reduced risk of stroke after CABG. The routine use of preoperative aortic CTA could be applied so that surgical manipulation of the ascending aorta can be selectively reduced or avoided in patients with atheromatous aortic disease. [ABSTRACT FROM AUTHOR]

المؤلفون: Caliskan, Etem^1,2 (AUTHOR), Sandner, Sigrid³ (AUTHOR), Misfeld, Martin⁴ (AUTHOR), Aramendi, Jose⁵ (AUTHOR), Salzberg, Sacha P.⁶ (AUTHOR), Choi, Yeong-Hoon⁷ (AUTHOR), Satishchandran, Vilas⁸ (AUTHOR), Iyer, Geeta⁸ (AUTHOR), Perrault, Louis P.⁹ (AUTHOR), Böning, Andreas¹⁰ (AUTHOR), Emmert, Maximilian Y.^1,2 (AUTHOR) emmert@dhzb.de

المصدر: Journal of Cardiothoracic Surgery. 10/15/2019, Vol. 14 Issue 1, pN.PAG-N.PAG. 1p.

مصطلحات موضوعية: *CORONARY artery bypass, *SAPHENOUS vein, *ARTERIAL grafts, *RADIAL artery, *VASCULAR endothelium

مستخلص: Background: Vein graft disease (VGD) impairs graft patency rates and long-term outcomes after coronary artery bypass grafting (CABG). DuraGraft is a novel endothelial-damage inhibitor developed to efficiently protect the structural and functional integrity of the vascular endothelium. The DuraGraft registry will evaluate the long-term clinical outcomes of DuraGraft in patients undergoing CABG procedures.Methods: This ongoing multicentre, prospective observational registry will enrol 3000 patients undergoing an isolated CABG procedure or a combined procedure (ie, CABG plus valve surgery or other surgery) with at least one saphenous vein grafts or one free arterial graft (ie, radial artery or mammary artery). If a patient is enrolled, all free grafts (SVG and arterial will be treated with DuraGraft. Data on baseline, clinical, and angiographic characteristics as well as procedural and clinical events will be collected. The primary outcome measure is the occurrence of a major adverse cardiac event (MACE; defined as death, non-fatal myocardial-infarction, or need for repeat-revascularisation). Secondary outcome measures are the occurrence of major adverse cardiac and cerebrovascular events (MACCE; defined as death, non-fatal myocardial-infarction, repeat-revascularisation, or stroke), patient-reported quality of life, and health-economic data. Patient assessments will be performed during hospitalisation, at 1-month, 1-year, and annually thereafter to 5 years post-CABG. Events will be adjudicated by an independent clinical events committee. This European, multi-institutional registry will provide detailed insights into clinical outcome associated with DuraGraft.Discussion: This European, multi-institutional registry will provide detailed insights into clinical outcome associated with the use of DuraGraft. Beyond that, and given the comprehensive data sets comprising of patient, procedural, and graft parameters that are being collected, the registry will enable for multiple subgroup analyses targeting focus groups or specific clinical questions. These may include analysis of subpopulations such as patients with diabetes or multimorbid high-risk patients (patient level), evaluation of relevance of harvesting technique including endoscopic versus open conduit harvesting (procedural level), or particular graft-specific aspects (conduit level).Trial Registration: ClinicalTrials.gov NCT02922088 . Registered October 3, 2016.Ethics and Dissemination: The regional ethics committees have approved the registry. Results will be submitted for publication. [ABSTRACT FROM AUTHOR]

المؤلفون: Harik, Lamia¹ (AUTHOR), Habib, Robert H.² (AUTHOR), Dimagli, Arnaldo¹ (AUTHOR), Rahouma, Mohamed¹ (AUTHOR), Perezgrovas-Olaria, Roberto¹ (AUTHOR), Jr Soletti, Giovanni¹ (AUTHOR), Alzghari, Talal¹ (AUTHOR), An, Kevin R.¹ (AUTHOR), Rong, Lisa Q.³ (AUTHOR), Sandner, Sigrid⁴ (AUTHOR), Bairey-Merz, C. Noel⁵ (AUTHOR), Redfors, Bjorn⁶ (AUTHOR), Girardi, Leonard¹ (AUTHOR), Gaudino, Mario¹ (AUTHOR) mfg9004@med.cornell.edu

المصدر: Journal of the American College of Cardiology (JACC). Mar2024, Vol. 83 Issue 9, p918-928. 11p.

مصطلحات موضوعية: *CORONARY artery bypass, *ANEMIA, *CARDIAC surgery

مستخلص: Women undergoing coronary artery bypass grafting (CABG) have higher operative mortality than men. The purpose of this study was to evaluate the relationship between intraoperative anemia (nadir intraoperative hematocrit), CABG operative mortality, and sex. This was a cohort study of 1,434,225 isolated primary CABG patients (344,357 women) from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (2011-2022). The primary outcome was operative mortality. The attributable risk (AR) (the risk-adjusted strength of the association of female sex with CABG outcomes) for the primary outcome was calculated. Causal mediation analysis derived the total effect of female sex on operative mortality risk and the proportion of that effect mediated by intraoperative anemia. Women had lower median nadir intraoperative hematocrit (22.0% [Q1-Q3: 20.0%-25.0%] vs 27.0% [Q1-Q3: 24.0%-30.0%], standardized mean difference 97.0%) than men. Women had higher operative mortality than men (2.8% vs 1.7%; P < 0.001; adjusted OR: 1.36; 95% CI: 1.30-1.41). The AR of female sex for operative mortality was 1.21 (95% CI: 1.17-1.24). After adjusting for nadir intraoperative hematocrit, AR was reduced by 43% (1.12; 95% CI: 1.09-1.16). Intraoperative anemia mediated 38.5% of the increased mortality risk associated with female sex (95% CI: 32.3%-44.7%). Spline regression showed a stronger association between operative mortality and nadir intraoperative hematocrit at hematocrit values <22.0% (P < 0.001). The association of female sex with increased CABG operative mortality is mediated to a large extent by intraoperative anemia. Avoiding nadir intraoperative hematocrit values below 22.0% may reduce sex differences in CABG operative mortality. [Display omitted] [ABSTRACT FROM AUTHOR]