On day one of STS 2024, meeting goers attended numerous sessions that explored the growing debate between SAVR and TAVR as treatment options,
Dr. Michael Bowdish presents a late-breaking session on cardiac surgery after TAVR trends and outcomes.
"Improved Longitudinal Outcomes with Surgical Aortic Valve Replacement with Atrial Fibrillation Management over Transcatheter Aortic Valve Replacement Alone," part of the larger "Bring SAVR Back" session given by J Hunter Mehaffey, MD, unveiled Class I guideline recommendations that support atrial fibrillation (AF) treatment during surgical aortic valve replacement (SAVR). And how recently, many low to intermediate risk patients with AF and aortic stenosis (AS) are managed by transcatheter aortic valve replacement (TAVR). And finally, they evaluated real-world longitudinal outcomes of TAVR vs SAVR with or without AF treatment.
"We concluded that in Medicare beneficiaries with AF who required aortic valve replacement, SAVR with concomitant treatment of AF was associated with improved longitudinal survival and freedom from stroke compared to TAVR," noted Dr. Mehaffey. "Consideration should be given for SAVR with AF treatment as a first-line approach for patients with AF requiring aortic valve replacement."
In his discussion of "Robotic Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement: A Propensity Matched Analysis," Vikrant Jagadeesan, MD, presented findings on contemporary data that supports equipoise between surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) for the management of symptomatic severe aortic stenosis (AS). He further explained that controversy exists around the optimal management of patients in low to intermediate risk categories, and how the study compared outcomes of surgical robotic aortic valve replacement (RAVR) to TAVR.
"Compared to TAVR, RAVR was associated with lower stroke and PPM rates, less PVL, and improved 1 year survival," said Dr. Jagadeesan. "And RAVR may provide a safe and effective minimally invasive first-line alternative for low to intermediate risk patients presenting with symptomatic AS."
In a late breaking session titled, "Cardiac Surgery after Transcatheter Aortic Valve Replacement: Trends and Outcomes," Michael Bowdish, MD, illustrated how his research team set out to document trends and outcomes in cardiac surgery following transcatheter aortic valve replacement (TAVR), a topic gaining importance as reports of subsequent cardiac operations and early TAVR explantations increase. Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the study covers adult patients who underwent cardiac surgery after an initial TAVR from January 2012 to March 2023.
"The study findings underscore the escalating need for both aortic and non-aortic valve cardiac surgeries following TAVR," explained Dr. Bowdish. "They note a substantial increase in the frequency of these surgeries, emphasizing the importance of understanding outcomes." He observed elevated risk in these cases, as indicated by mortality and stroke rates, which calls for careful consideration, particularly given the expanding use of TAVR across a broader range of age and risk profiles. Finally, the study suggests the need for ongoing assessment and longitudinal evidence to inform decision-making in the evolving landscape of TAVR applications.
July 25, 2023, Chicago, Ill… The Society of Thoracic Surgeons has launched its next-generation Operative Risk Calculator to assess the risk of adult cardiac surgery operations.
Recent approvals by the U.S. Food and Drug Administration (FDA) have made available two new technologies for treating aortic disease. The GORE® TAG® Thoracic Branch Endoprosthesis (TBE) is single-branch aortic stent graft that provides an off-the-shelf solution for patients that need zone II aortic coverage and obviates the need for prior left subclavian revascularization. The Thoraflex Hybrid Frozen Elephant Trunk (FET) device is a pre-mated surgical graft and an aortic stent graft to facilitate single-stage treatment of arch and proximal descending aortic pathologies.
As an early career surgeon, you don’t want to be left on an island without the backing of your partners and department leaders., Robert M. Van Haren, MD, MsPH
Cardiothoracic surgeons from the US and Italy receive practice-changing funding support
CHICAGO (January 19, 2022)—Through a collaborative effort between The Society of Thoracic Surgeons (STS) and the European Association for Cardio-Thoracic Surgery (EACTS), two standout young surgeons recently each received $20,000 in fellowship grants to learn new techniques used by institutions across the world.
Longtime society efforts advance connecting clinical outcomes and claims data
WASHINGTON, DC (October 21, 2021) — The Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC) applaud Representatives Larry Bucshon, MD (R-IN), and Kim Schrier, MD (D-WA), for introducing the Meaningful Access to Federal Health Plan Claims Data Act of 2021.
The 2021 C. Walton Lillehei Lecture was presented during The Society of Thoracic Surgeons 57th Annual Meeting by Paul G. Yock, MD, MA, founder and director of the Stanford Byers Center for Biodesign in California.
During the lecture, Dr. Yock encourage participants to view innovation as a discipline—one that can be taught, practiced, and recreated. He acknowledged, though, that comprehensive innovation can be difficult in the health care setting because it involves multiple stakeholders. He likened the “user” in this scenario to an “eight-headed monster.”
They talk about how they got started in robotic surgery, the importance of institutional support for building and training a team, and the efficacy of robotic surgery as an instructional tool for residents and fellows.
