Adult Cardiac

A groundbreaking study to be presented at the 2025 Society of Thoracic Surgeons Annual Meeting sheds light on an important decision point for patients requiring aortic valve replacement. Utilizing data from the STS Adult Cardiac Surgery Database, researchers have delivered the most extensive analysis to date on the outcomes of prosthetic valve types for patients aged 60 and younger.

The study, to be presented by Dr. Michael Bowdish, Cedars-Sinai Medical Center, examines the impact of valve choice—mechanical versus bioprosthetic—on long-term survival. By linking patient-level data from the STS ACSD with the National Death Index, researchers offer fresh insights into the critical question of how age and valve type affect surgical outcomes.

With its rigorous methodology and focus on tailoring care to individual needs, the study underscores the potential of advanced surgical techniques and data analytics to improve patient outcomes. It also highlights the pivotal role of the STS National Database, which provides robust national benchmarks for cardiothoracic procedures in the US, in driving impactful research and clinical innovation.

In presenting the Adult Cardiac Clark Paper on day two of STS 2025, Increased Risk of Surgical Aortic Valve Replacement After Prior Transcatheter Versus Surgical Aortic Valve Replacement with Concomitant Valve Disease, Dr. Robert Hawkins explores the heightened mortality risk for patients undergoing reoperation after transcatheter aortic valve replacement (TAVR) compared to those who have undergone surgical aortic valve replacement (SAVR).

Using data from the STS Adult Cardiac Surgery Database, which covers the years 2011 to 2021, Dr. Hawkins and his team examine the impact of concomitant mitral and tricuspid valve diseases on reoperation outcomes, with a particular focus on TAVR explants.

As part of the “Aortic Valve Surgery: What Do Our Patients Need to Know?” session on Saturday, Jan. 25 from 4:30 – 5:45 p.m., Dr. Hawkins will discuss findings that show patients with prior TAVR are more likely to suffer from severe concomitant valve diseases, such as mitral regurgitation, compared to those who underwent SAVR. These patients demonstrated a higher mortality rate during reoperation, particularly TAVR explants with an increase in the odds of mortality. The study further finds that severe valve disease is associated with significantly higher mortality in both TAVR explant and redo-SAVR cases.

During this session, Dr. Hawkins will share findings indicating that heart teams should consider these risks when deciding between TAVR and SAVR, as well as when addressing dysfunctional TAVR valves to avoid the heightened risks of reoperation. 

On Saturday, Jan. 24, from 10:15 to 10:25 a.m., Tomaz Mesar, MD, from the University of Pittsburgh Medical Center, will present An Age-Based Analysis of Transcatheter and Surgical Outcomes in Low-Risk Patients. The study compares outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in low-risk patients with aortic stenosis, with a particular focus on the impact of age on treatment outcomes.

Using a combined STS and TVT database, Dr. Mesar analyzed low-risk patients who underwent either SAVR or TAVR for degenerative aortic stenosis over a 13-year period, categorizing them into three age groups: under 65, 65-74, and over 75.

As part of the “Updates in Structural Heart: Surgeons are Still in the Game” session, Dr. Mesar will present on the crucial role of age in determining the optimal approach—TAVR or SAVR—for structural heart interventions. His presentation will address how current findings suggest that TAVR may not be suitable for younger, low-risk patients due to observed higher mortality rates. 

For patients aged 65-74, the choice between TAVR and SAVR requires a personalized assessment, as neither procedure demonstrates a clear survival advantage. Finally, for patients over 75, while TAVR may offer a reduction in certain complications, SAVR appears to provide better long-term survival outcomes for this patient population.

In patients undergoing coronary artery bypass grafting (CABG), a novel analysis evaluating surgeon preference for multi- versus single-arterial grafting may help explain the differing results between prior retrospective analyses and randomized controlled trials regarding long-term survival.

A novel study to be presented on Friday, Jan. 24, at The Society of Thoracic Surgeons’ 61st Annual Meeting by lead author Justin Schaffer, MD, a cardiothoracic surgeon at Baylor Scott & White Health, offers fresh insights into the long-debated question of whether multi-arterial grafting (MAG) improves long-term survival compared to single-arterial grafting (SAG) in patients undergoing CABG. The analysis evaluates over one million Medicare beneficiaries and incorporates an innovative approach using surgeon preference as a tool to address unmeasured variables.

While the findings highlight nuances in interpreting retrospective and randomized trial data, they also underscore the need for future randomized studies, such as the forthcoming results of the ROMA trial, to definitively guide clinical decision-making.

The researchers emphasized that understanding the survival benefit of MAG over SAG requires randomized data, and it remains an important and open clinical question. 
 

In a landmark achievement for healthcare in Southeast Asia, St. Luke's Medical Center has launched the region's first robotic cardiac surgery program. This historic initiative was made possible through a collaborative effort between St. Luke's multidisciplinary team, led by Drs. Marvin Martinez and Ramiro Pablo, and the expert team from West Virginia University's (WVU) Heart and Vascular Institute, including Dr. Vinay Badhwar, Dr. Lawrence Wei, and physician assistant Herald Fe.

The program debuted with a series of innovative robotic-assisted cardiac procedures, showcasing the transformative potential of this advanced technology. Among the groundbreaking surgeries performed were:

• Robotic MIDCAB (Minimally Invasive Direct Coronary Artery Bypass)
• Robotic bileaflet mitral valve repair for severe mitral regurgitation (MR) due to bileaflet myxomatous disease
• Robotic mitral valve repair for endocarditis, including anterior mitral leaflet perforation
• Robotic adult congenital atrial septal reconstruction using a bovine patch for a patient with a common atrium
• Robotic aortic valve replacement (AVR) for a patient from Papua New Guinea

The first robotic valve surgery—a repair of a severely regurgitant mitral valve in a 40-year-old patient—marked a defining moment in the program's success. With guidance from WVU's Heart and Vascular Institute, the procedure was completed with precision and excellence, underscoring the collaboration's impact.

Dr. Pablo expressed his excitement, saying, "This is a monumental step forward for cardiac care in Southeast Asia. Our partnership with the WVU team has empowered us to provide patients with less invasive, highly precise procedures and faster recoveries."

Dr. Martinez added, "Establishing this robotic cardiac surgery program has been a dream realized through our team's dedication and the invaluable expertise of our WVU partners. This is just the beginning of a new era in cardiac care."

Reflecting on the collaboration, Dr. Badhwar remarked, "Teamwork truly makes the dream work. The exceptional multidisciplinary team at St. Luke's has shown that vision, determination, and collaboration can achieve extraordinary outcomes."

St. Luke's Robotic Cardiac Surgery Program is set to advance care across the region, offering minimally invasive options that reduce pain, recovery time, and the risk of complications. 

The 2024 Latin American Cardiovascular Surgery Conference, held over three days in Buenos Aires, Argentina, attracted leading experts from Europe, Latin America, and North America to address topics in cardiovascular medicine, including coronary artery disease, congenital heart disease, atrial fibrillation, and heart failure.

"The conference provided a diverse range of sessions to accommodate surgeons at all stages of their careers," explained Program Chair Rafael Sadaba, MD, Navarra University Hospital, Pamplona, Spain. “Residents and early career surgeons benefited from dedicated sessions, while experienced surgeons had the opportunity to delve into complex procedures and cutting-edge techniques.”

The program offered a comprehensive overview of the latest advancements in cardiac surgery. It featured scientific abstracts, technical videos, and interactive discussions on a variety of topics, including the current state of heart transplantation in Latin America, the use of mechanical circulatory support devices, the role of ECMO in treating cardiogenic shock, and advanced surgical techniques for mitral and aortic valve repair.

“This year, I was particularly interested in the session on the Ross Procedure, an operation that has been around for a long time but has experienced renewed interest over the past few years," said EACTS Secretary General Patrick Meyers, MD, Lausanne University Hospital, Switzerland. 

The three-day event highlighted women's cardiac health, particularly tailored approaches and complex treatments for women of reproductive age.  Other sessions focused on managing aortic dissection, advancing transcatheter valve therapies, and providing lifelong care for patients with conditions such as aortic stenosis.

The conference concluded with hands-on workshops that allowed participants to practice skills such as mitral valve repair and ECMO cannulation, making it an essential platform for advancing cardiac care in Latin America.

Check out our event photo gallery.