Recent studies have revealed concerning disparities in the treatment of secondary conditions during heart surgeries, with women being less likely than men to have additional anomalies addressed simultaneously, according to findings published in The Journal of Thoracic and Cardiovascular Surgery.
Lead researcher Dr. Catherine Wagner, an integrated thoracic surgery resident at the University of Michigan (UM) Health, highlighted these disparities, noting that across various aspects of cardiovascular care, women often receive less treatment compared to men.
Study Findings on Atrial Fibrillation
One study focused on atrial fibrillation (a-fib), a prevalent irregular heartbeat that significantly elevates stroke risk if left untreated. The research analyzed approximately 5,000 patients with a-fib who underwent heart bypass or aortic valve replacement surgeries across nearly three dozen Michigan hospitals between 2014 and 2022. The study found that only 59% of female patients had their a-fib addressed during cardiac surgery, compared to 67% of male patients.
Dr. Robert Hawkins, senior author of the study and a cardiac surgeon at UM Health Frankel Cardiovascular Center, emphasized that repairing a-fib during cardiac surgeries does not increase surgical risks. The condition poses greater dangers for women than men, underscoring the importance of addressing it comprehensively during heart surgeries.
Study on Tricuspid Valve Repair
In a separate investigation, the research team examined nearly 400 patients who underwent mitral valve surgeries from 2014 to 2023. They found that while about 75% of male patients had their tricuspid valve repaired during mitral valve surgeries, only 57% of female patients received similar treatment. This discrepancy led to more severe tricuspid regurgitation or necessitated valve-related re-operations in women over the subsequent years.
Dr. Steven Bolling, professor of cardiac surgery at UM’s Medical School and senior study author, highlighted that additional tricuspid repair is a recommended practice during left-sided valve surgeries, yet it is underutilized in female patients.
Addressing Gender Disparities
The studies indicated that one potential reason for these disparities is the misconception among surgeons that women face higher risks with added procedures during heart surgeries, despite evidence to the contrary. In fact, female patients in the study demonstrated better outcomes in terms of mortality risk compared to men.
Dr. Wagner stressed the need for equitable care in cardiac surgery, emphasizing that while the field has made strides in delivering high-quality care, there is a critical opportunity to ensure this care is equally accessible to women. She called for improvements to maximize the benefits women receive from these complex and high-risk procedures.
The findings underscore the importance of advancing guideline-recommended treatments and eliminating gender biases in cardiovascular care to improve outcomes for all patients undergoing heart surgeries.
