Multiple arterial grafting: are women being left behind?

Multiple arterial grafting (MAG) has been evidenced to likely improve long-term mortality and morbidity outcomes compared with single arterial grafting during coronary artery bypass grafting (CABG), with current guidelines recommending its use. Notably, women make up less than 30% of the cohorts in the studies that inform these guidelines, and the use of MAG has not been well studied in the female population, despite the evidence that women present with more comorbidities and severe symptoms, and often perform worse after CABG compared with their male counterparts. Therefore, this comprehensive narrative review focuses on the currently available evidence examining MAG in women, and its use in on- and off-pump CABG.