Newsroom

A groundbreaking surgical achievement has been made by the team at West Virginia University (WVU) Heart and Vascular Institute, led by Dr. Vinay Badhwar, the executive chair of the WVU Heart and Vascular Institute and the second vice president of the Society of Thoracic Surgeons. On October 31, 2024, the team performed the world’s first combined robotic aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) through a single small incision.

Image

The pioneering procedure was performed on 73-year-old Poppy McGee, a patient with a complex medical history, including a stroke, brain surgery, and significant weight loss. Referred to Dr. Badhwar for treatment of both aortic valve disease and coronary artery disease, McGee initially faced the prospect of traditional open-heart surgery. However, when she and her family learned of its risks—over a 10% chance of mortality and nearly 50% likelihood of complications—they inquired about alternative options.

Dr. Badhwar explained his team had developed a novel robotic approach that had yet to be tested on a patient. After a thorough discussion of the risks and benefits, McGee and her family agreed to proceed with the innovative robotic surgery.

The procedure involved both AVR and CABG, performed entirely robotically through a single incision on the far right of McGee’s chest. The success of the surgery has sparked optimism about the potential for broader adoption of robotic heart surgery for patients with complex conditions.

“While we are still in the early days of this latest innovation, the ability to perform valve surgery and coronary artery bypass surgery fully robotically through a single incision has the potential to open up a new era of robotic heart surgery,” Dr. Badhwar noted in a prepared statement. “We must always keep quality outcomes at the forefront of all innovation. However, if surgeons adopt and gain experience with techniques such as this one, they will tackle this last frontier that previously limited a robotic approach. One day in the near future, this may serve as a platform to perform nearly all types of heart surgery.”

This revolutionary procedure potentially paves the way for less invasive operations. Dr. Lawrence Wei, a professor at the WVU Department of Cardiovascular and Thoracic Surgery, remarked on the impact of this advancement: "Patients who have both valve disease and coronary artery disease have traditionally been treated by open-heart surgery performed through the breastbone. This new robotic technique could redefine how we approach these cases."

Dr. Goya Raikar, an assistant professor at WVU and a member of Badhwar’s robotics team, also underscored the procedure's significance: "Until now, the main exclusion for us to perform a robotic approach has been the coexistence of valve and coronary artery disease. Building on our experience with robotic aortic valve surgery, this new approach may help us extend robotic surgery options to many more patients."

The patient’s daughter, Mollie Wilcosky, expressed gratitude for the groundbreaking care provided by the WVU team. “We are so thankful for Dr. Badhwar and the team at the WVU Heart and Vascular Institute for developing this robotic procedure to help my mother recover so well,” Wilcosky said. “She is getting stronger every day.”

The full details of the procedure will be in The Annals of Thoracic Surgery, highlighting how innovative approaches like this continue to redefine the future of cardiothoracic surgery.

References:
•    Cardiovascular Business article on the WVU Heart and Vascular Institute's groundbreaking surgery.
•    WV News article detailing the multidisciplinary team and procedural innovations at WVU Medicine’s WVU Heart and Vascular Institute.
 

The Society of Thoracic Surgeons (STS) and the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS) recently co-hosted the inaugural Aortic Summit 2024 in Tokyo, Japan. This international event brought together leading experts in the field to discuss advancements in the diagnosis and treatment of thoracic aortic lesions, including endovascular approaches.

The summit was designed to cater to a diverse audience, including cardiothoracic surgeons, cardiac anesthesiologists, CT residents, perfusionists, and ICU and OR nurses. 

The comprehensive three-day program covered a wide range of topics, including root, arch, descending aorta, TEVAR, dissection, and hybrid procedures. Participants had the opportunity to learn from experts, network with colleagues, and gain valuable insights into the latest techniques and technologies.

"The sessions delved into the latest developments through a series of presentations, panel discussions, and hands-on workshops," said Yutaka Okita, MD, Congress President for the STS-ASCVTS Aortic Summit 2024. "The event featured a number of eminent speakers from all over the world, who shared their expertise and achievements with attendees.”

On October 25-26, 2024, more than 230 members of perioperative and critical care teams from around the world gathered in Philadelphia for the 2024 Perioperative & Critical Care Conference. The conference focused on the latest techniques and management strategies in cardiovascular and thoracic critical care, as well as enhanced recovery after surgery. Participants gained valuable insights and practical strategies aimed at optimizing patient care and improving outcomes. 

The two-day event covered a wide range of topics, including fundamentals of waveforms and monitoring, goal-directed hemodynamic therapy and AKI prevention, ECMO fundamentals, improving communication in the cardiothoracic intensive care unit, and vasoplegia management. 

Here's what a few attendees said about the Perioperative & Critical Care Conference:

•  "In the ECMO session, we not only saw the latest in technology and innovation, but also learned techniques that will help us treat our patients and get them out of the hospital in better condition,” Dr. Jeremiah Hayanga, West Virginia University Health System
• "The conference was well-paced and engaging. The speakers were captivating, and the discussions were thought-provoking. The two days flew by!"
• "The STS team did a fantastic job with the logistics of this large-scale conference. The recordings and slides will be a great way to review the material and share it with colleagues.”
• "The conference was informative and highlighted areas where we can improve our practices. I appreciate the multidisciplinary focus, which is essential for optimal patient care."
•  "As an APP, I truly enjoyed the conference and felt that the presentation and topics aligned well with my role. I look forward to attending again next year."

Check out our event photo gallery. 

At the 2024 European Association for Cardio-Thoracic Surgery (EACTS) meeting in Lisbon, Portugal, leaders in cardiac surgery and interventional cardiology came together, signaling a newfound harmony over coronary revascularization practices for complex heart conditions. This session marked a significant change from the intense disagreements that followed the EXCEL trial controversy five years ago, which raised concerns about data interpretation in revascularization treatments for left main disease.

In a joint session between EACTS and the European Society of Cardiology (ESC), Dr. Alaide Chieffo (Vita Salute San Raffaele University, Milan) and Dr. Patrick Myers (Lausanne University Hospitals, Switzerland) presented a united front on revascularization strategy, referencing the ESC’s recent guidelines for managing chronic coronary syndromes (CCS) with a patient-centered approach. The guidelines, collaboratively crafted by cardiologists and surgeons, reflect a shared understanding of both PCI and CABG as valuable options for coronary artery disease based on individual patient conditions.

“We've gone full circle,” Dr. Myers told TCTMD. “The latest guidelines have a left main chapter that EACTS endorses because we all feel that this represents the evidence best. It's very positive to see that we've gone from surgeons unilaterally looking at the data and saying, ‘Wait a minute, this is not reasonable. We don't agree with this,’ to saying, ‘Okay, let's work on this together.’” His comments underscore the shift from discord to collaboration in developing best practices for patients with multivessel coronary artery disease, left main disease, and heart failure.

EACTS President Dr. Volkmar Falk (German Heart Center Berlin) echoed this sentiment, emphasizing that the endorsed guidelines demonstrate alignment with cardiologists and aim to serve patient needs effectively. He urged further collaboration by encouraging attendance at cardiology-focused conferences, saying, “Go to ESC, go to EuroPCR, be present at these meetings, and engage in the discussion there. It’s one thing to discuss this here at EACTS… We have to also join our cardiology friends and go to their meetings.”

In her presentation, Dr. Chieffo underscored that a “patient-centered” approach should guide heart team discussions for complex cases and highlighted that care recommendations depend on various factors—including hospital capabilities. She explained that CCS guidelines offer a Class I recommendation for CABG in low-surgical-risk patients and for PCI in low-anatomic-complexity cases, stressing that patient-centered care takes into account individualized patient needs rather than simply following patient preferences.

With the introduction of these guidelines, both EACTS and ESC reaffirm their commitment to improving outcomes through collaboration and shared expertise across disciplines, reflecting a renewed spirit of partnership in cardiovascular care.