STS 2022 DAY 1 — Findings from highly anticipated multicenter trials on coronary revascularization—and discussions of the controversies surrounding them—are on showcase today at STS 2022.
“Controversies in Coronary Revascularization,” beginning today at 11:15 a.m. EST, is a don’t-miss session for adult cardiac surgeons, featuring five presentations of emerging data, including results from the XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) Trial.
Craig Jarrett, MD, MBA, from Case Western Reserve University in Cleveland, Ohio, will report 5-year EXCEL results, comparing on-pump versus off-pump coronary artery bypass grafting (CABG) for patients with left main disease.
In 957 patients randomized to CABG during the trial, 940 underwent revascularization, with CABG as the first procedure in 923 patients. Of these, 271 received CABG performed without cardiopulmonary bypass (off-pump) and 652 underwent bypass (on-pump). The researchers examined 5-year endpoints for death from any cause, spontaneous myocardial infarction, and stroke.
They found that on-pump CABG was associated with decreased 5-year all-cause and cardiovascular death when compared to off-pump CABG. “These data contribute to the evidence that optimal outcomes after revascularization with left main coronary artery disease are achieved by on-pump CABG,” the researchers observed.
Also within the session, Aziz Momin, MBBS, FRCS, CT, from St. George’s Hospital in London, will present results suggesting that for patients undergoing CABG, total arterial revascularization yields the best long-term survival over 20 years.
“There is a significantly reduced survival with mixed arterial and venous conduits, with the worst survival in the venous bypass conduit group,” noted the researchers.
The study involved 2,979 patients; 1,022 underwent total arterial revascularization, 1,839 had arterial and saphenous vein revascularization, and 118 had only saphenous vein revascularization. Dr. Momin will share detailed outcomes within each conduit group, as well as observations that the type of coronary artery bypass conduit impacts long-term survival despite full revascularization.
Attendees also will hear a report from the STS Adult Cardiac Surgery Database on multi-arterial CABG practice patterns in the United States, results from a randomized trial of the effect of ticagrelor after CABG in patients with clopidogrel resistance, and performance findings for machine learning algorithms to classify outcomes following isolated CABG.
STS 2022 is now an all-virtual experience, and there’s still time to register at sts.org/annualmeeting.