Cardiac Surgery 2025 Reviewed.
Hristo Kirov, Tulio Caldonazo, Murat Mukharyamov et al.
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In 30 seconds
This systematic review summarizes selected cardio-surgical literature published in 2025, drawing on randomized trials, meta-analyses, and registries. It reports consistent evidence that coronary artery bypass grafting (CABG) provides better long-term outcomes than percutaneous coronary intervention in complex coronary artery disease, mainly through fewer future myocardial infarctions. The review also describes findings on atrial fibrillation and antiplatelet therapy after CABG, and ongoing controversy over transcatheter aortic valve implantation age thresholds. For mitral and tricuspid disease, transcatheter therapies improved symptoms and quality of life without demonstrated survival benefit, while surgery had the most consistent long-term outcomes.
Key findings
- In complex coronary artery disease, CABG was associated with superior long-term outcomes versus percutaneous coronary intervention, driven mainly by sustained reductions in future myocardial infarctions.
- Atrial fibrillation after CABG was more frequent than expected, but its long-term burden was described as negligible.
- Prolonged dual antiplatelet therapy after CABG for acute coronary syndrome offered no benefit and increased bleeding risk.
- Transcatheter mitral and tricuspid therapies improved symptoms and quality of life without survival benefit; surgery had the most consistent long-term outcomes.
Why it matters
The review highlights that evidence and guideline interpretation differ across cardiac surgical conditions. For complex coronary disease, the summarized literature favors CABG for long-term outcomes, whereas valve interventions involve trade-offs between symptom improvement and survival evidence. Awareness of the reported bleeding risk with prolonged dual antiplatelet therapy and the controversy around aortic stenosis recommendations can inform balanced, evidence-aware discussions and patient-specific decision-making.
What to keep in mind
The authors state that the review is not comprehensive and may reflect individual interpretation.