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Cardiac Surgery 2023 Reviewed.

Hristo Kirov1, Tulio Caldonazo1, Murat Mukharyamov1

  • 1Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, University Hospital Jena, Jena, Germany.

The Thoracic and Cardiovascular Surgeon
|May 13, 2024
PubMed
Summary
This summary is machine-generated.

Coronary artery bypass graft (CABG) surgery shows superior long-term outcomes compared to percutaneous coronary intervention (PCI) for complex coronary artery disease. Transcatheter aortic valve implantation (TAVI) offers early benefits, while surgical valve replacement provides later advantages.

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Heart Valve Disease Management

Background:

  • The 2023 cardiac surgical literature reveals ongoing comparisons between surgical and interventional treatments for various heart conditions.
  • Key areas of focus include coronary artery disease, aortic stenosis, mitral and tricuspid valve disease, and end-stage heart failure.

Purpose of the Study:

  • To provide a results-oriented summary of significant publications in cardiac surgery from 2023.
  • To highlight advancements and confirm trends in treatment efficacy and patient outcomes.
  • To inform patient-specific decision-making regarding invasive cardiac procedures.

Main Methods:

  • A PRISMA approach was utilized to review and synthesize findings from the 2023 cardiac surgical literature.
  • PubMed searches for "cardiac surgery AND 2023" yielded nearly 34,000 results, from which key manuscripts were selected.
  • The review focused on mid- and long-term effects of interventions for coronary artery disease, aortic stenosis, and other cardiac conditions.

Main Results:

  • Coronary artery bypass graft (CABG) surgery demonstrated excellent long-term outcomes compared to percutaneous coronary intervention (PCI), particularly in complex coronary artery disease and left main stenosis.
  • Transcatheter aortic valve implantation (TAVI) showed an early advantage in aortic stenosis, though surgical aortic valve replacement maintained later benefits, with the Evolut Low Risk trial being an exception.
  • Interventional mitral and tricuspid valve procedures increased, with repair quality and residual regurgitation being critical factors; surgery currently offers higher repair rates and durability.
  • Advancements in heart transplantation and assist device therapy for heart failure, alongside aortic diameter management in aortic surgery, were also noted.

Conclusions:

  • CABG remains a preferred option for specific complex coronary artery disease scenarios due to its long-term efficacy and potential infarct-preventative effects.
  • While TAVI provides early benefits for aortic stenosis, surgical intervention remains crucial for long-term durability.
  • High-quality repair with minimal residual regurgitation is essential for favorable outcomes in mitral and tricuspid valve interventions, with surgery currently leading in durability.
  • Ongoing research and technical refinements are critical for improving outcomes in heart failure treatment and aortic surgery.