Introduction:
Differences by sex in patients undergoing off-pump bypass surgery (OPCAB) are still unclear. Our aim was to investigate the impact of gender on all-cause in-hospital mortality and short-term outcomes for men and women.

Methods:
The study was designed as a retrospective, non-randomised analysis of a double-centre OPCAB cohort. From January 2017 to August 2022, a total of 215 patients (men (n=163) and women (n=52)) underwent an OPCAB procedure due to coronary artery disease. The primary endpoint was all-cause in-hospital mortality. Secondary outcomes were: renal failure requiring dialysis, transient ischemic attack (TIA), low cardiac output, bleeding requiring reoperation, wound infection, postoperative delirium and length of hospital stay.

Results:
Mean age of the study population was 66.0±9.9 years. Mean EuroSCORE II predicted mortality was 3.8±2.9 %. There was significantly higher use of arterial grafts in the male group than in the female group (p=0.005). Additionally, there was much more frequent use of total arterial revascularisation in males than in females (p=0.013). In-hospital mortality remained not significantly higher in the female group compared to the male group (p=0.121). Secondary outcomes (renal failure requiring dialysis, transient ischemic attack (TIA), low cardiac output, bleeding requiring reoperation, wound infection, postoperative delirium and length of hospital stay) did not differ between the non-adjusted and the adjusted groups.

Conclusion:
Based on our findings, sex does not impact short-term outcomes after OPCAB surgery. Mortality rates were similar in both groups. Likewise, secondary outcomes did not significantly differ between male and female group. Thus, OPCAB surgery is a safe procedure for both male and female patients.