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View from North America's cardiac surgeons.
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. cosgrod@ccf.org
Summary
Cardiac surgery faces challenges due to reduced coronary procedures but sees growing demand for valve surgery in aging populations. Innovation is crucial for the specialty's future survival and advancement.
Area of Science:
- Cardiovascular Surgery
- Medical Innovation
Background:
- Cardiac surgery has been a primary treatment for heart disease, particularly coronary heart disease, the leading global cause of mortality.
- Coronary artery bypass grafting (CABG) volumes have declined in developed economies due to advancements in percutaneous coronary intervention (PCI).
- An aging demographic and epidemiological shifts towards degenerative valve disease increase the demand for mitral regurgitation and aortic stenosis surgeries.
Purpose of the Study:
- To analyze the evolving landscape of cardiac surgery.
- To highlight the impact of reduced coronary surgery volumes and increased valve surgery demand.
- To emphasize the necessity for innovation within the cardiac surgery specialty.
Main Methods:
- Review of historical trends in cardiac surgery practice.
- Analysis of epidemiological changes in heart disease.
- Assessment of the impact of interventional cardiology on surgical volumes.
Main Results:
- A plateau and subsequent decline in coronary surgery volumes have been observed.
- There is a rising trend in valve surgery, especially in elderly patients with degenerative conditions.
- The growth in valve surgery may not fully offset the decline in coronary surgery for many practices.
Conclusions:
- The future of cardiac surgery is threatened by the reduction in coronary procedures.
- Increased demand for valve surgery presents an opportunity but may not sustain all practices.
- Pioneering innovation is essential for the long-term viability and advancement of cardiac surgery.