STS University

The STS 54th Annual Meeting in Fort Lauderdale, Florida features hands-on wet labs during STS University, which will be held on Wednesday, January 31, 2018. Wet labs will be offered twice—from 7:00 a.m. to 9:00 a.m. ET and again from 9:30 a.m. to 11:30 a.m. ET—so attendees are able to pick two.

STS University wet labs will be strictly hands-on, and no didactic lectures will be given as part of the session. Attendees are strongly encouraged to view STS University lectures online before January 31. Please select the wet lab(s) you are interested in below to watch the didactic component supporting the sessions that the course directors have developed. Videos for courses 1, 3, 4, 6, 8, and 10 will be available by late November.

If you have not already registered for the Annual Meeting and STS University, please do so today. If you've already registered for the meeting and wish to add STS University or any other ticketed sessions to your registration, contact registration customer service at (866) 229-2386 or e-mail sts@experient-inc.com.

Please note: No CME credit is associated with the viewing of web-based content. These presentations were created for The Society of Thoracic Surgeons STS University courses, and STS retains sole rights to these materials.

Course 1: Essentials of TAVR 

COURSE DIRECTORS: Basel Ramlawi, Winchester, VA, and George Zorn, Kansas City, KS 
COMMERCIAL RELATIONSHIPS:  B. Ramlawi: Research Grant, LivaNova, Medtronic; Consultant/Advisory Board, AtriCure
FACULTY: William T. Brinkman, Plano, TX, Kevin L. Greason, Rochester, MN, Jefferson Lyons, Columbus, OH, S. Chris Malaisrie, Chicago, IL,Hersh S. Maniar, St Louis, MO, Himanshu J. Patel, Ann Arbor, MI, Liam Ryan, Alexandria, VA, and Eric L. Sarin, Atlanta, GA*

Proficiency in transcatheter aortic valve replacement (TAVR) requires the acquisition of multiple endovascular principles and techniques. This course will introduce attendees to balloon-expandable and self-expanding TAVR platforms, as well as the various sheaths, guidewires, and catheters relevant to TAVR. Basics of alternative TAVR access will be discussed, and all participants will gain operational knowledge of the various delivery systems.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Describe the decision-making process for choosing a TAVR access point (transfemoral, direct aortic, subclavian artery, and transapical)
  • State the salient differences in the deployment of balloon-expanded vs self-expanded devices
  • Describe the various types of sheaths and guidewires used during the TAVR procedure and understand reasons for their use

 

Course 2: TEVAR and Aortic Arch Debranching Procedures

COURSE DIRECTORS: Ali Khoynezhad, Los Angeles, CA, and Ourania A. Preventza, Houston, TX
COMMERCIAL RELATIONSHIPS:  A. Khoynezhad: Research Grant, AtriCure; Consultant/Advisory Board, Atricure; O. Preventza: Consultant/Advisory Board, Medtronic, W. L. Gore & Assoc.
FACULTY: Derek R. Brinster, New York, NY, Ankur Gupta, Long Beach, CA*, Sepehre Naficy, New York, NY*, and Rodney White, Long Beach, CA

This course will review basic catheter and wire skills for thoracic endovascular aortic repair (TEVAR). Participants will have hands-on experience with thoracic stent grafts and intravascular ultrasound (IVUS), as well as using vascular plugs from the brachial or femoral approach. Surgical techniques for zone 0-2 aortic arch debranching procedures will be discussed.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Identify the most common catheters and wires for TEVAR
  • Describe the deployment of commercially available stent grafts
  • Explain the use of IVUS and vascular plugs for subclavian artery occlusion
  • Describe the surgical techniques used in aortic arch debranching

Course 3: Mitral Valve Repair

COURSE DIRECTORS: Steven F. Bolling, Ann Arbor, MI, and Evelio Rodriguez, Nashville, TN
COMMERCIAL RELATIONSHIPS:  E. Rodriguez: Research Grant, Abbott, Boston Scientific, Edwards Lifesciences, Medtronic; Consultant/Advisory Board, Abbott, Boston Scientific; Speakers Bureau/Honoraria, Abbott
FACULTY: A. Marc Gillinov, Cleveland, OH, and Matthew A. Romano, Ann Arbor, MI

In this course, participants will be able to practice different mitral valve repair strategies for both anterior and posterior leaflet pathologies. These will include leaflet resection and non-resection techniques, commissural repair strategies, and different chordal approaches. In addition, different surgical therapies for secondary mitral regurgitation, including ring selection, leaflet extension techniques, and mitral valve replacement, will be reviewed.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Describe different leaflet resection and non-resection approaches, in addition to different chordal techniques required for successful mitral valve repair
  • Identify advance repair techniques for both primary and secondary mitral regurgitation
  • Demonstrate proper mitral valve replacement techniques
Course 4: Valve-Sparing Aortic Root Replacement

COURSE DIRECTORS: Duke E. Cameron, Baltimore, MD, Edward P. Chen, Atlanta, GA, and Bo Yang, Ann Arbor, MI
FACULTY: Jeffrey Brawn, Baltimore, MD, Ruggero De Paulis, Rome, Italy, Michael Deeb, Ann Arbor, MI, Philip J. Hess Jr, Indianapolis, IN*, Melissa Jones, Baltimore, MD, Bradley G. Leshnower, Atlanta, GA, and Luca A. Vricella, Baltimore, MD

This course will provide interactive, hands-on instruction of the surgical techniques and critical steps necessary for performing a successful valvesparing
aortic root replacement (VSRR).

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Describe the anatomy of the aortic root
  • Summarize the technical steps necessary for a successful VSRR
  • List different methods in choosing a graft size
  • Discuss leaflet repair and annuloplasty methods
Course 5: Aortic Root Enlargement Procedures and Aortic Valve Leaflet Reconstruction

COURSE DIRECTORS: S. Adil Husain, San Antonio, TX, and Prashanth Vallabhajosyula, Philadelphia, PA
FACULTY: Arminder Singh Jassar, Boston, MA, Alberto Pochettino, Rochester, MN, Edward Y. Sako, San Antonio, TX, and Ibrahim Sultan, Pittsburgh, PA

This course will review two specialized subareas of technical expertise required to perform complex aortic root surgery. Participants will learn the anatomic approaches and surgical techniques employed in performing aortic root enlarging procedures, as well as aortic valve leaflet reconstructive techniques and the importance of providing annular stabilization in the context of a repaired aortic valve. Surgical strategies for root enlargement will include Nicks, Manougian, and Ross Konno. Surgical techniques involving aortic valve leaflet reconstruction will include primary simple cusp plication techniques, patch augmentation technique, Gore-Tex free margin shortening technique, and orienting the repaired bicuspid aortic valve into its aortic neoroot.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Identify the anatomy and appropriate surgical landmarks in the left ventricular outflow tract and aortic valve apparatus
  • Describe the incision sites and overall surgical techniques for a variety of root enlargement strategies
  • Discuss surgical pitfalls associated with each strategy and mechanismsby which to delineate options based upon patient and anatomic substrate
  • Describe how to set up and expose the aortic root for primary valve repair and identify the risk factors for repair failure based on the anatomy of the aortic valve
  • Recall the different aortic annual stabilization techniques and recognize the impact of each technique on valve repair – subcommissural annuloplasty, external aortic ring, and root reimplantation
  • Identify different bicuspid aortic valve types and explain the implications for valve repair and the choice of annular stabilization
  • Demonstrate how to implant a type I bicuspid aortic valve in the context of its neoroot and explain what the different bicuspid subtypes mean for orienting the repaired valve when performing a root reimplantation

Course 6: VATS Lobectomy

COURSE DIRECTORS: DuyKhanh P. Ceppa, Indianapolis, IN, and Betty C. Tong, Durham, NC
FACULTY: Mara B. Antonoff, Houston, TX, Mark F. Berry, Stanford, CA, William R. Burfeind, Bethlehem, PA, Todd L. Demmy, New Brunswick, NJ, Eric L. Grogan, Nashville, TN, John A. Howington, Nashville, TN, Sandeep Jitendra Khandhar, Falls Church, VA, Jeremiah Martin, Portsmouth, OH, and Scott I. Reznik, Dallas, TX

This course will review the indications, patient selection, technical steps, and recent advances for performance of lobectomy using video-assisted thoracic surgery (VATS). Participants will be able to perform a VATS left upper lobectomy on porcine heart-lung blocks.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Describe the indications and steps to perform VATS
  • Discuss potential pitfalls and strategies for intraoperative troubleshooting to successfully achieve minimally invasive lobectomy
  • Identify instruments and other technologies available to perform minimally invasive lobectomy
Course 7: Advanced Open Esophageal and Tracheal Procedures

COURSE DIRECTORS: Sidharta P. Gangadharan, Boston, MA, and Sandra L. Starnes, Cincinnati, OH
FACULTY: Rafael S. Andrade, Minneapolis, MN, Scott M. Atay, Los Angeles, CA, Andrew Chang, Ann Arbor, MI, James Huang, New York, NY*, Robert E. Merritt, Columbus, OH, John D. Mitchell, Aurora, CO, K. Robert Shen, Rochester, MN*, John Wain, Boston, MA*, and Jennifer L. Wilson, Boston, MA

This course will provide hands-on training for several esophageal anastomosis techniques, as well as airway anastomosis and repair. These advanced operative techniques are not frequently utilized in most general thoracic surgery practices, but competence in these techniques is important. Participants will be introduced to several techniques for airway and esophageal reconstruction with emphasis in the different technical aspects (“pearls”) of the anastomosis from content experts.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Identify and perform the appropriate esophageal anastomosis technique depending on anatomic or other considerations
  • Perform airway anastomoses and recognize technical pitfalls associated with the various techniques
  • Identify the key steps of tracheobronchoplasty

Course 8: Chest Wall Resection, Reconstruction, and Pectus Surgery

COURSE DIRECTORS: Dawn E. Jaroszewski, Phoenix, AZ, Daniel L. Miller, Marietta, GA, and Mathew Thomas, Jacksonville, FL
COMMERCIAL RELATIONSHIPS: D. Jaroszewski: Consultant/Advisory Board, AtriCure, Zimmer BioMet ; D. Miller: Consultant/Advisory Board, Ethicon; Speakers Bureau/Honoraria, Medtronic; M. Thomas, Research Grant, Thoracic Surgery Foundation
FACULTY: Staci Beamer, Phoenix, AZ

In this hands-on course, participants will learn the various techniques for reconstruction of large chest wall defects after resection. Other highlights of the course include stabilization of rib and sternal fractures using the most current reconstruction systems and minimally invasive repair of adult pectus excavatum defects. At the end of this course, participants should be able to independently design and perform reconstruction of the chest wall forvarious indications.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Perform rigid and semi-rigid reconstruction of chest wall defects after resection, including the ribs and sternum
  • Demonstrate how to stabilize single and multiple rib fractures using rib fixation devices
  • Use sternal fixation devices to stabilize the sternum
  • Perform minimally invasive repair of adult pectus excavatum defects
NEW! Course 9: Minimally Invasive Aortic and Mitral Valve Surgery

COURSE DIRECTORS: Tom C. Nguyen, Houston, TX, and Vinod H. Thourani, Washington, DC
COMMERCIAL RELATIONSHIPS: T. Nguyen: Consultant/Advisory Board, Edwards LifeSciences; Speakers Bureau/Honoraria, Abbott; V. Thourani: Research Grant, Abbott, Boston Scientific, Edwards Lifesciences; Consultant/Advisory Board, Abbott, Boston Scientific, Edwards Lifesciences, W. L. Gore & Assoc.
FACULTY: Kevin D. Accola, Orlando, FL, Glenn Barnhart, Seattle, WA, Kuan-Ming Chiu, Taipei, Taiwan, Borut Gersak, Ljubljana, Slovenia, Peter A. Knight, Rochester, NY, Eric Lehr, Seattle, WA*, S. Chris Malaisrie, Chicago, IL, Carmelo Mignosa, Catania, Italy, Kazuma Okamoto, Akashi, Japan, Konstadinos Plestis, Wynnewood, PA, and Juan P. Umana, Bogota, Colombia*

Cardiothoracic surgeons face an increased demand to adopt minimally invasive valve techniques. Unfortunately, acquiring this skillset can be difficult in real-world practice. The objective of this course is to provide hands-on experience with the newest techniques in minimally invasive aortic and mitral valve surgery. Participants will work in alternating pairs at each station to learn critical exposure and cannulation techniques for minimally invasive aortic (right anterior thoracotomy and hemi-sternotomy) and mitral (lateral thoracotomy) surgery. Participants will then have an opportunity to perform aortic and mitral valve repair/replacement using simulators under both direct vision and via thorascopic guidance. For aortic valve replacements, participants will gain exposure to sutureless and rapiddeployment technologies. At the conclusion of the course, a handout will be distributed with a list of key instruments for minimally invasive valve surgery and suggested steps for building a minimally invasive valve program.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Explain exposure (right anterior thoracotomy, hemisternotomy, and lateral thoracotomy), cannulation, and cardioprotection techniques for minimally invasive valve surgery
  • Identify key operative steps for successful minimally invasive aortic and mitral valve surgery, including sutureless and rapid deployment technologies
  • Describe the indications and contraindications for minimally invasive valve surgery

NEW! Course 10: POEM Skills

COURSE DIRECTORS: Ralph W. Aye, Seattle, WA, and Inderpal S. Sarkaria, Pittsburgh, PA
COMMERCIAL RELATIONSHIPS: I. Sarkaria: Speakers Bureau/Honoraria, Intuitive Surgical
FACULTY: Francisco A. Arabia, Los Angeles, CA, David A. D’Alessandro, Bronx, NY, Richard H. Feins, Chapel Hill, NC, Akinobu Itoh, St Louis, MO, Duc Thinh Pham, Boston, MA, Pablo Sanchez, Baltimore, MD, Jacob N. Schroder, Durham, NC, and Hiroo Takayama, New York, NY

This is a practical, hands-on course for learning peroral endoscopic myotomy (POEM) using an explant model. Participants will learn how to plan landmarks for the procedure, how to access the submucosal space and create a long submucosal tunnel extending through the gastroesophageal junction, how to perform myotomy, and how to close the mucosotomy. The standard tools and electrothermy instruments for performing the procedure will be explored in detail.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Determine the proper landmarks for beginning and completing the procedure
  • Create a submucosal tunnel
  • Perform an endoscopic myotomy within the tunnel
  • Close the mucosotomy