1 July 2025
A study carried out by the cardiac surgery team at Harefield Hospital has provided compelling new evidence on gender-based differences in outcomes following minimally invasive direct coronary artery bypass (MIDCAB) to treat advanced coronary artery disease.
Led by Mr Shahzad Raja, consultant cardiac surgeon, and Dr Maria Comanici, junior clinical fellow, this 20-year analysis sheds light on the long-term survival and perioperative risks between male and female patients undergoing MIDCAB.
Coronary artery bypass grafting (CABG) is a surgical procedure that involves grafting healthy blood vessels from the patient’s leg or arm to create a new pathway for blood to flow around blocked or narrowed arteries in the heart. It remains the gold standard treatment for advanced coronary artery disease.
However, minimally invasive techniques such as MIDCAB are continuing to evolve. MIDCAB involves making a smaller incision to access the heart compared to the standard CABG procedure, which reduces surgical trauma and enhances recovery.
But despite the increasing adoption of MIDCAB, limited evidence exists on gender-based differences in outcomes, which prompted this comprehensive investigation.
The study, which is the longest MIDCAB follow-up to date, demonstrates that males and females achieve similar survival outcomes following MIDCAB. It also underscores the importance of gender-specific risk assessment in preoperative planning and postoperative management.
Speaking on the findings, Mr. Shahzad Raja highlighted: “These results emphasise that MIDCAB offers equivalent long-term survival across genders while identifying key risk factors that should inform personalised surgical strategies. Our team is committed to further evaluating aspects to optimise patient outcomes.”
Commenting on what the study means for cardiac surgery innovation, Dr Comanici said: “This study reflects years of dedication and collaboration and leads the way to innovation in cardiac surgery. As MIDCAB continues to evolve, studies like this set the foundation for personalised cardiac surgery, ensuring evidence-based advancements in patient care. Our Harefield team remains at the forefront of innovation, striving to enhance accessibility, refine surgical techniques, and improve short- and long-term patient outcomes.”
The team was recently honoured with the prestigious Grundeman Scientific Research Award at the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) 2025 Annual Meeting in Istanbul, where the study was presented. The award recognises its academic significance and clinical impact.
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