Future Directions in Cardiac Surgery: Bypass, TAVR, and Heart Failure Interventions

Jump To Section

• Coronary Bypass Surgery's Enduring Role
• Transcatheter Heart Valve Advancements
• Aortic Aneurysm Stent Grafting Growth
• Heart Failure Surgery Expansion
• Mechanical Devices for Heart Failure
• Future Non-Transplant Heart Operations
• The Shift to Minimally Invasive Approaches

Coronary Bypass Surgery's Enduring Role

Dr. Lawrence Cohn, MD, affirms that coronary artery bypass grafting (CABG) will maintain a critical place in cardiac surgery's future. He emphasizes that the internal mammary artery bypass to the left anterior descending (LAD) artery is the gold standard for revascularization. This specific procedure offers unparalleled long-term patency, with Dr. Cohn noting patients still have patent anastomoses over 30 years after their initial surgery.

Transcatheter Heart Valve Advancements

The field of heart valve surgery is undergoing a profound transformation with the adoption of catheter-based techniques. Dr. Lawrence Cohn, MD, predicts that transcatheter aortic valve replacement (TAVR) and similar procedures will assume an increasingly larger role. He explains that these methods are less traumatic for patients and deliver excellent functional results for heart valve function, driving their rapid adoption.

Dr. Cohn also highlights that cardiac surgeons are actively learning these endovascular skills, ensuring they remain central to valve disease treatment.

Aortic Aneurysm Stent Grafting Growth

Endovascular stent grafting for aortic aneurysms represents another major area of growth in cardiovascular intervention. Dr. Lawrence Cohn, MD, observes that the utilization of this minimally invasive technique is increasing greatly and shows no signs of declining. This shift away from traditional open surgery for aortic aneurysm repair reduces patient recovery time and surgical risk.

Heart Failure Surgery Expansion

Dr. Cohn identifies heart failure surgery as an enormous and rapidly expanding field. With only about 2,500 heart transplants performed annually in the United States, a significant treatment gap exists for the vast number of heart failure patients. This limitation is catalyzing innovation in surgical and mechanical solutions to support or repair the failing heart, moving beyond the constraints of donor organ availability.

Mechanical Devices for Heart Failure

Mechanical circulatory support devices are increasingly utilized to treat advanced heart failure. Dr. Lawrence Cohn, MD, points to the growing use of left ventricular assist devices (LVADs) and other machines as a cornerstone of future heart failure care. These devices provide life-sustaining support for patients who are not candidates for transplant or are awaiting a donor heart.

Dr. Cohn confirms that this technological area will continue to grow and evolve.

Future Non-Transplant Heart Operations

The next frontier in cardiac surgery involves developing novel, non-transplant operations specifically for heart failure. Dr. Lawrence Cohn, MD, envisions a future where surgeons will develop new methods that are relatively simple yet effective at helping patients with congestive heart failure. These future procedures, which have not yet been fully developed, represent a huge area of potential growth and innovation aimed at addressing the core pathophysiology of heart failure.

The Shift to Minimally Invasive Approaches

A consistent theme in the future of cardiac surgery is the overarching shift toward minimally invasive approaches. As discussed by Dr. Lawrence Cohn, MD, this trend is evident in the rise of TAVR, endovascular aortic stent grafting, and smaller incisions for various procedures. Dr. Anton Titov, MD, and Dr. Cohn agree that these techniques offer reduced trauma and faster recovery, improving the overall patient experience while maintaining high standards of surgical efficacy.

Full Transcript

Dr. Anton Titov, MD: Future of cardiac surgery. A view by pioneering cardiac surgeon with over 40 years of experience, Dr. Lawrence H. Cohn, MD. Breakthroughs in heart failure surgery. Endovascular transcatheter heart valve replacement. "The only way to predict the future is to invent it.” Dr. Norman Shumway. Eminent cardiac surgeon speaks about the future of cardiac surgery, Dr. Lawrence H. Cohn, MD.

Dr. Anton Titov, MD: What are advances in minimally invasive cardiac surgery? What is future treatment of aortic valve stenosis?

Dr. Anton Titov, MD: What advances are made in heart failure surgery? What is transcatheter aortic valve replacement (TAVR)? What is future of coronary artery bypass grafting surgery?

Video interview with Professor Lawrence H. Cohn. Video interview with leading expert in cardiac surgery. Second opinion confirms that heart failure diagnosis is correct and complete. Second opinion helps to choose the best treatment for congestive heart failure. Get second opinion on congestive heart failure and be confident that your treatment is the best.

Minimally invasive cardiac surgery. Aortic valve stenosis. Heart failure surgery. Dr. Norman Shumway, with whom you worked at Stanford University, said this: "The only way to predict the future is to invent it yourself."

Dr. Anton Titov, MD: Dr. Cohn, yes. Where do you see cardiac surgery going in the next decade?

Dr. Anton Titov, MD: What treatment methods will be available to patients that are rare or not existing today?

Dr. Lawrence Cohn, MD: I cannot speak for congenital heart surgery because I do not do children's heart surgery. But I think there is still going to be a place for coronary artery bypass grafting surgery. The mammary artery bypass to the LAD (Left Anterior Descending artery) is the best revascularization procedure that has ever been invented, or that ever will be invented.

Dr. Lawrence Cohn, MD: We have patients with patent anastomoses 30 years after bypass surgery. It's really very good. There still will be a need for that.

Dr. Lawrence Cohn, MD: In heart valve surgery, the surgeons are starting to learn how to do catheter-based heart valve insertion. I think that method of surgery is going to assume a bigger and bigger role, as it should be, because it's less traumatic. You get pretty good results of heart valve function.

Dr. Lawrence Cohn, MD: Surgeons will be more involved in catheter-based heart valve insertions. Also in aortic aneurysm surgery, stent grafting method now for aortic aneurysms is increasing greatly. It is really going way up. I think that is not going to go down.

Dr. Lawrence Cohn, MD: Finally, another area that is just enormous and increasing right now in our country is heart failure surgery. Obviously, very few patients are going to have a heart transplant. There are only 2,500 transplants done in our country every year.

Dr. Lawrence Cohn, MD: There is going to be a lot of machines for heart failure patients. New devices are increasingly being utilized for heart failure patients. There are left ventricular assist devices and all these things. Machines and devices to treat heart failure will continue to grow.

Dr. Lawrence Cohn, MD: Then maybe non-transplant heart failure operations will increase. That we have not even developed yet. Heart failure surgery methods will be developed. It will be relatively simple to help the patients with heart failure. That is a huge area.

Dr. Anton Titov, MD: Professor Lawrence Cohn, thank you very much for this most interesting discussion.

Dr. Anton Titov, MD: Thank you for sharing your vast experience with all our viewers. It was very illuminating to hear your view on state-of-the-art in cardiac surgery.

Dr. Anton Titov, MD: Thank you for discussing heart surgery direction in the future. Thank you very much!

Dr. Lawrence Cohn, MD: My pleasure. Future of cardiac surgery: coronary artery bypass grafting, abdominal aortic aneurysm repair, heart failure surgery, minimally invasive valve surgery, TAVR.