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Gender Gaps in Cardiothoracic Surgery: Are Patient Outcomes Shaped by Workforce Inequity?
1Department of Surgery, Division of Cardiac Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
The Thoracic and Cardiovascular Surgeon
|May 12, 2026
Summary
Gender disparities in cardiac and thoracic surgery persist, affecting diagnosis, treatment, and outcomes for women. Addressing these requires tackling both patient-level factors and systemic workforce inequities for true gender equity.
Area of Science:
- Cardiovascular and Thoracic Surgery
- Health Equity Research
- Surgical Outcomes Analysis
Background:
- Persistent gender disparities exist in cardiac and thoracic surgical care, impacting access, procedural choice, perioperative risk, and long-term outcomes for women.
- Despite advancements, women face delayed diagnosis, lower referral rates for procedures like coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and aortic valve replacements (SAVR, TAVR).
- These clinical disparities are mirrored by inequities in the cardiothoracic surgery workforce, suggesting structural issues influence patient outcomes.
Purpose of the Study:
- To synthesize current evidence (2020-2025) on sex- and gender-based disparities in cardiac and thoracic surgery.
- To identify the interconnected root causes of these inequities.
- To outline strategies and research priorities for reducing gender disparities in cardiothoracic surgical care.
Main Methods:
- Conducted a narrative review of literature published between 2020 and 2025.
- Employed structured database searches of clinical trials and patient registries.
- Synthesized mechanistic and health-system literature to interpret diverse evidence on gender disparities.
Main Results:
- Women undergoing cardiothoracic procedures often present with increased frailty, smaller anatomy, and atypical symptoms, leading to greater complexity and risk.
- Higher early morbidity is observed in women for CABG and SAVR; PCI disparities persist despite narrowing, while TAVR shows higher early complications but better long-term survival.
- In thoracic surgery, women experience delayed diagnosis and lower utilization of minimally invasive approaches, alongside underrepresentation in the surgical workforce.
Conclusions:
- Gender disparities in cardiothoracic surgery are multifactorial, deeply linked to systemic workforce inequities.
- Effective solutions necessitate sex-aware risk assessment, equitable referral systems, inclusive device design, mandated sex-stratified reporting, and workforce reforms.
- Achieving lasting gender equity requires addressing both patient-level disparities and structural workforce imbalances.
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