Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-044
Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Complex Left Main and Multi-Vessel Coronary Artery Disease: Insights From Contemporary Heart Team Recommendations
By Chien-Po Huang, Wei-Hsian Yin
Presenter
Chien-Po Huang
Authors
Chien-Po Huang1, Wei-Hsian Yin1
Affiliation
Cheng Hsin General Hospital, Taiwan1
View Study Report
TCTAP A-044
High-Risk Intervention (Diabetes, Heart Failure, Renal Failure, Shock, etc)
Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Complex Left Main and Multi-Vessel Coronary Artery Disease: Insights From Contemporary Heart Team Recommendations
Chien-Po Huang1, Wei-Hsian Yin1
Cheng Hsin General Hospital, Taiwan1
Background
Guidelines recommend heart team (HT) decision-making for CABG versus PCI in complex coronary artery disease (CAD) with high SYNTAX scores (>32), but real-world outcomes remain unclear. This study evaluates adherence to HT recommendations and patient outcomes based on revascularization strategy.
Methods
A retrospective analysis was conducted on 274 cases with left main coronary artery disease (LM-CAD) or multi-vessel CAD with SYNTAX scores >32, discussed by the HT between August 2019 and December 2021. We assessed concordance with HT recommendations and rates of major adverse cardiac and cerebral events (MACCE), including mortality, non-fatal myocardial infarction (MI), stroke, and repeat revascularization.
Results
Patients averaged 64 years old, 73% were male, 50% had diabetes, and 41% had LM-CAD. SYNTAX II scoring favored PCI in 7.7%, CABG in 65.3%, and equipoise in 27%. PCI was performed in 33.2% (concordant PCI: 12.4%, discordant PCI: 20.8%) and CABG in 66.8% (concordant CABG: 66.1%, discordant CABG: 0.7%), with 78.5% concordance to HT recommendations. After a median follow-up of 3.6 years, PCI and CABG showed no significant differences in mortality, MI, or stroke, though PCI had a higher rate of repeat revascularization (MACCE rates: PCI 17.6% vs. CABG 8.7%, P=0.032). Concordant PCI patients were older, had higher LM-CAD prevalence, more heart failure, and lower LVEF, with 76.5% meeting criteria for high-risk PCI (CHIP).
Conclusion
This study supports the HT approach, showing high concordance with recommendations and favorable outcomes. CABG is preferred in complex cases, though CHIP PCI provides a viable option for high-risk surgical candidates.