ACC @ STS Tackles Complex Clinical Scenarios



1:15 p.m. – 5:15 p.m.

Room 330AB

Cardiac surgery has entered a new era, with cardiologists and surgeons facing more complex cases. To manage these patients, it has become vital for specialists to interact, collaborate, and perform as one heart team.

Members of the American College of Cardiology and STS will examine difficult clinical scenarios facing heart teams, with a focus on aortic stenosis, atrial fibrillation, coronary artery disease (CAD), and mitral regurgitation.

Vinod H. Thourani, MD

Vinod H. Thourani, MD

“These topics embody the majority of cardiac care that practicing surgeons provide on a daily basis,” said co-moderator Vinod H. Thourani, MD, adding that each section of the session will include a patient case, data to back up decision making, and a panel discussion.

A highlight of the aortic stenosis section will be lessons learned from the STS/ACC TVT RegistryTM, which was created by surgeons and cardiologists. Among the data that will be shared will be volume trends for surgical and transcatheter aortic valve replacement (TAVR) in the United States.

“TAVR has been approved for extreme-, high-, and now medium-risk patients, but low-risk patients represent 80% of aortic valve surgical volume,” said Dr. Thourani, of Emory University in Atlanta.

With a growing population of atrial fibrillation patients, session planners seek to give attendees a better understanding of the medical, interventional, and surgical options.

“It remains alarming to me that so many patients present to our operating rooms with atrial fibrillation, yet we have no surgical therapeutic interventions. We have to be asking ourselves as a surgical community why this is the case,” Dr. Thourani said. Presenters will look at which patients are optimal candidates for transcatheter management, how to decide between biatrial and left atrial-only surgical ablation surgery, and how to perform biatrial ablation.

The content of the CAD section was developed in response to the innovation of percutaneous coronary interventions in hybrid revascularization, which are pushing the envelope for the management of CAD.

“This section will highlight the most recent technologies that interventional cardiologists and surgeons are performing to help physicians make decisions about the best options for care,” Dr. Thourani said. It also will include which patients with multivessel disease are best treated percutaneously and options for non-sternotomy multivessel coronary artery bypass grafting.

During the mitral regurgitation section, speakers will share insights about the ACC/American Heart Association Valve Guidelines, management of a patient with functional mitral regurgitation, and an update on transcatheter mitral valve devices. Dr. Thourani also will describe his worst transcatheter mitral valve case and how he handled it.

“Our goal in this section is to provide a standard of care defined by our societies and to uphold our surgical heritage with the management of mitral valve regurgitation,” Dr. Thourani said. “We’ll also highlight new technologies that can expand the armamentarium of tools for treating mitral valve disease.”

Dr. Thourani’s co-moderators are Niv Ad, MD, of Cardiac Vascular and Thoracic Surgery Associates in Falls Church, Va., Jodie Hurwitz, MD, of the North Texas Heart Center in Dallas, Roxana Mehran, MD, of Mount Sinai School of Medicine in New York, Patrick T. O’Gara, MD, of Brigham and Women’s Hospital in Boston, and Joseph F. Sabik III, MD, of University Hospitals Cleveland Medical Center.

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