Glean Tips to Simplify Cardiac Surgery Procedures

Gorav Ailawadi, MD

While unusual cases are interesting, most cardiothoracic surgeons will never see those operations. A new how-to session at the STS 52nd Annual Meeting will focus specifically on common operations to help surgeons improve their techniques, become more efficient, and optimize outcomes.

“This session is about providing a broad overview of the more challenging things we could see in the relatively common operations we face every day,” said moderator Gorav Ailawadi, MD, Chief of the Section of Adult Cardiac Surgery and Associate Professor of Surgery at the University of Virginia in Charlottesville. “Surgeons may think, ‘I’d like to do this operation, but it’s been a while, and I just don’t feel that comfortable doing it.’ This session will help them overcome that.”

During the session, How To: Technical Tricks and Pitfalls to Simplify Cardiac Surgery Procedures, expert faculty will share their tried-and-true tips during 21 presentations focused on four common adult cardiac areas: coronary artery bypass grafting (CABG) surgery, mitral valve surgery, aortic valve surgery, and aortic surgery. The session will be from 1:15 p.m. to 4:30 p.m. on Sunday, January 24.

“Our specialty is heavily based on technical skills, and every surgeon has some tricks they use to make their operations easier. The reality is we all do these operations, and we might do them differently. If attendees can learn one or two tricks from each talk, then that will lead to better outcomes. That’s a win in my mind,” Dr. Ailawadi said.

Presenters will only have one data slide each, and they will share their best tips while highlighting pitfalls to avoid via high-quality videos in their 8-minute presentations. 

Among the three CABG presentations is one on minimally invasive CABG. Although not a new procedure, Dr. Ailawadi said minimally invasive CABG has not been adopted by many surgeons. Other CABG talks will cover skeletonized internal mammary artery harvest and total arterial CABG, as surgeons have been criticized for not performing enough arterial bypass beyond just the left internal mammary artery.

The mitral valve section of the session will offer guidance in several areas, including anterior and bileaflet prolapse repair, as well as exposure tips in challenging patients.

“The goal of the mitral sessions is to encourage more widespread adoption of mitral surgery and make it easier to do difficult repairs, as well as total chordal preservation replacement,” Dr. Ailawadi said.

The aortic valve surgery presentations will give attendees tips to follow when performing newer procedures, including sutureless aortic valve replacement, which he said is expected to receive approval from the US Food and Drug Administration in the winter or spring.

“It’s possible that by the time of the STS Annual Meeting, at least one of the sutureless valves might be approved,” Dr. Ailawadi said. “The idea here is to give everyone exposure to how do this so that when it becomes approved, they’ll at least understand what this is all about.”

The afternoon will wrap up with a focus on aortic surgery, including repair of type A dissections.

“These typically are not done in elective settings, and you need to know how to fix them safely,” Dr. Ailawadi said. “I think most surgeons feel comfortable with this repair, but there are always tricks to be gained from experts.”

Other aortic surgery speakers will tackle more complex valve-sparing root replacement and Bentall with stented bioprosthetic valve.

“These operations are done a little more selectively, but we certainly want all surgeons to have exposure to them and feel comfortable doing them on their own,” Dr. Ailawadi said.