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VIDEO: Differing results in left main CAD trials underscore crucial role of heart team

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WASHINGTON — In this video, B. Hadley Wilson, MD, FACC, from Sanger Heart and Vascular Institute, Charlotte, North Carolina, and chair-elect of the board of governors of the American College of Cardiology, discusses the results of two similar but opposing trials presented at TCT 2016.

In patients with left main CAD, the EXCEL trial showed no difference in outcomes for PCI vs. CABG at 3 years, but the NOBLE trial showed superiority for surgery at 5 years. Wilson said the most important point is that mortality was no different between the groups in either trial.

“What that says to us, potentially, is that with proper adjudication by the heart team, now patients who are at low or intermediate risk, who formerly were always dogmatically relegated to bypass surgery, can ... be considered for PCI and stenting,” Wilson said. “Whether or not this changes the guidelines ... remains to be seen, but it does appear that with proper adjudication by the heart team, interventional cardiologists and surgeons ... can come together to decide what is best for the patient.”