Background: Cardiac tumors are rare, with a low incidence of between 0.0017 and 0.19%. The majority of cardiac tumors are benign and predominantly occur in females. The aim of our study was to examine how outcomes differ between men and women. Methods: From 2015 to 2022, 80 patients diagnosed with suspected myxoma were operated on. In all patients, preoperative, perioperative, and postoperative data were recorded. Such patients were identified and included in a retrospective analysis focused on gender-related differences. Results: Patients were predominantly female (n = 64; 80%). The mean age was 62.76 ± 13.42 years in female patients and 59.65 ± 15.84 years in male patients (p = 0.438). The body mass index (BMI) was comparable in both groups: between 27.36 ± 6.16 in male and 27.09 ± 5.75 (p = 0.945) in female patients. Logistic EuroSCORE (LogES) (female: 5.89 ± 4.6; male: 3.95 ± 3.06; p = 0.017) and EuroSCORE II (ES II) (female: 2.07 ± 2.1; male: 0.94 ± 0.45; p = 0.043), both scores to predict the mortality in cardiac surgery, were significantly higher in female patients. Two patients died early, within 30 days after surgery: one male and one female patient. Late mortality was defined as the 5-year survival rate, which was 94.8%, and 15-year survival rate, which was 85.3% in our cohort. Causes of death were not related to the primary tumor operation. The follow up showed that satisfaction with surgery and long-term outcome was high. Conclusion: Predominately female patients presented with left atrial tumors over a 17-year period. Relevant gender differences aside from that were not evident. Surgery could be performed with excellent early (within 30 days after surgery) and late results (follow up after discharge).

Objective: The aim of this study was to investigate the relationship between age and sex in regard to the development of deep sternal wound infections and sternal instability following median sternotomy. Methods: A propensity-score-matching analysis was conducted on 4505 patients who underwent cardiac surgery between 2009 and 2021, all of whom had a BMI of ≥30 kg/m². A total of 1297 matched pairs were determined in the sex group, and 1449 matched pairs we determined in the age group. The distributions of sex, age, diabetes mellitus, delirium, unstable sterna, wire refixation, wire removal, superficial vacuum-assisted wound closure, deep vacuum-assisted wound closure, clamp time, bypass time, logistic EuroSCORE, and BMI were determined. Results: The 30-day in-hospital mortality was found to be similar in the older and younger groups (8.149% vs. 8.35%, p = 0.947), and diabetes mellitus was also equally distributed in both groups. However, postoperative delirium occurred significantly more often in the older group (29.81% vs. 17.46%, p < 0.001), and there was a significantly higher incidence in men compared with women (16.96% vs. 26.91%, p < 0.001). There were no differences found in the incidence of sternum instability, fractured sternum, superficial vacuum-assisted wound closure, and deep vacuum-assisted wound closure between the age and sex groups. Conclusions: In conclusion, this study found that sternal instability and deep-wound-healing problems occur with equal frequency in older and younger patients and in men and women following median sternotomy. However, the likelihood of postoperative delirium is significantly higher in older patients and in men. These findings suggest that a higher level of monitoring and care may be required for these high-risk patient groups to reduce the incidence of postoperative delirium and improve outcomes following median sternotomy.

Background The increasing presence of female doctors in the field of cardiac surgery has raised questions about their surgical quality compared to their male colleagues. Despite their success, female surgeons are still underrepresented in leadership positions, and biases and concerns regarding their performance persist. This study aims to examine whether female surgeons perform worse, equally well, or better than their male counterparts in commonly performed procedures that have a significant number of female patients. Method A retrospective cohort of patients from 2011 to 2020 who underwent isolated coronary artery bypass graft (CABG) and aortic valve surgery was studied. To compare the surgical quality of men and women, a 1:1 propensity score matching (two groups of 680 patients operated by men and women, respectively, factors: age, logarithm of EuroSCORE (ES), elective, urgent or emergent surgery, isolated aortic valve, or isolated CABG) was performed. Procedure time, bypass time, x-clamp time, hospital stay, and early mortality were compared. Results After propensity score matching between surgeons of both sexes, patients operated by males (PoM) did not differ from patients operated by females (PoF) in mean age (PoM: 66.72 ± 9.33, PoF: 67.24 ± 9.19 years, p = 0.346), log. ES (PoM: 5.58 ± 7.35, PoF: 5.53 ± 7.26, p = 0.507), or urgency of operation (PoM: 43.09% elective, 48.97% urgent, 7.94% emergency, PoF: 40.88% elective, 55.29% urgent, 3.83% emergency, p = 0.556). This was also the case for male and female patients separately. Female surgeons had higher procedure time (PoM: 224.35 ± 110.54 min; PoF: 265.41 ± 53.60 min), bypass time (PoM: 107.46 ± 45.09 min, PoF: 122.42 ± 36.18 min), and x-clamp time (PoM: 61.45 ± 24.77 min; PoF: 72.76 ± 24.43 min). Hospitalization time (PoM: 15.96 ± 8.12, PoF: 15.98 ± 6.91 days, p = 0,172) as well as early mortality (PoM: 2.21%, PoF: 3.09%, p = 0.328) did not differ significantly. This was also the case for male and female patients separately. Conclusion Our study reveals that in routine heart surgery, the gender of the surgeon does not impact the success of the operation or the early outcome of patients. Despite taking more time to perform procedures, female surgeons demonstrated comparable surgical outcomes to their male counterparts. It is possible that women's inclination for thoroughness contributes to the longer duration of procedures, while male surgeons may prioritize efficiency. Nevertheless, this difference in duration did not translate into significant differences in primary outcomes following routine cardiac surgery. These findings highlight the importance of recognizing the equal competence of female surgeons and dispelling biases regarding their surgical performance.

Background: In all, 90% of patients in Germany are insured with statutory (SHI) instead of private health insurance (PHI). PHI offers significantly better benefits including earlier and more comprehensive diagnosis and therapy, which can reduce the complication rate and even mortality in fields where patients with high morbidity are treated, yet data on potential outcome differences between SHI and PHI patients in Germany is scarce. Methods: Between January 2023 and December 2025, 144 PHI and 2094 SHI patients underwent heart surgery at one institution. Preoperative baseline characteristics, risk factors, and peri- and postoperative information, including the surgeon’s experience level and distance of the referring hospital, were retrospectively compared. In addition, a propensity score matching (PSM) analysis was performed. Results: The SHI group presented with significantly higher BMI and EuroSCORE II, fewer male patients and higher NYHA states. Significantly more PHI patients were operated on by very senior staff members and none by a trainee, and their hospitalization time was significantly shorter. Neither early mortality (PHI 3.47%, SHI 5.35%, p = 0.432) nor distance levels of referring hospitals differed significantly. After PSM, only differences in the hospitalization time and surgical experience level remained significant. Early mortality came down to 4.86% in the SHI patients after PSM. Conclusions: In a multimorbid patient group, we found no evidence for a difference in outcome depending on insurance status, aside from a shorter hospital stay for PHI patients. Nonetheless, the situation in the pre- and post-hospital phases for SHI patients may have room for improvement. Efforts should be made to give all patients the same rapid and comprehensive access to healthcare services, increasing the system satisfaction of patients with SHI. In cardiac surgery, fortunately, there is no particular need for adjustments regarding the in-hospital phase.