All Members

On day two of the 62nd Annual Meeting in New Orleans, co-lead authors Subhasis Chatterjee, MD, of Baylor College of Medicine, and Stefano Schena, MD, PhD, of the Medical College of Wisconsin, presented a summary of The Society of Thoracic Surgeons’ (STS) 2026 Clinical Practice Guidelines for the Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation after Cardiac Surgery. Their presentation highlighted a comprehensive, surgery-specific framework designed to address new-onset postoperative atrial fibrillation (POAF), the most common complication following cardiac surgery.

To develop the guidelines, the STS Workforce on Evidence-Based Surgery convened a multidisciplinary panel to review contemporary evidence and generate practical, consensus-based recommendations focused specifically on POAF after cardiac surgery. Using a phase-based approach that spans the preoperative, intraoperative, and postoperative periods, the group synthesized data from randomized and observational studies and graded recommendations using standardized methods based on AATS/EACTS/ESTS/STS harmonization guidelines¹.

The final document includes a total of 15 recommendations: eight on preventive strategies, three on intraoperative adjunctive procedures, and four on postoperative management. Key guidance includes two Class I recommendations addressing perioperative oral amiodarone and rhythm cardioversion for hemodynamically unstable POAF. Two Class IIa recommendations supporting posterior pericardiotomy and perioperative beta-blockers. Eight Class IIb recommendations reflected areas of uncertainty and limited data. Three Class III recommendations addressed therapies without demonstrated benefit.

Image

A central theme of the guidelines is transparency around uncertainty and an emphasis on meaningful patient outcomes. “One of the goals of these guidelines was not to promote a single dominant therapy,” said Dr. Chatterjee, “but to provide a structured, phase-based approach that can reduce unwarranted practice variation while still allowing clinical judgment.” He emphasized that POAF should be viewed as a marker of perioperative vulnerability rather than an isolated rhythm disturbance, identifying patients at higher risk for complications and future atrial arrhythmias. This perspective supports targeted surveillance and follow-up rather than reflexive escalation of therapy.

The document also underscores that POAF is distinct from preexisting atrial fibrillation, with different mechanisms, natural history, and management implications. Core strategies include careful rhythm monitoring, early rate or rhythm control, and individualized anticoagulation decisions, while acknowledging persistent uncertainty around optimal anticoagulation timing and duration, arrhythmia burden, and the role of adjunctive surgical interventions.

Image

Dr. Schena highlighted how the guideline development process itself reshaped the panel’s collective thinking. “When we started this project, all nine members had their own way to address atrial fibrillation occurring de novo after cardiac surgery,” he said. “The time spent discussing and reviewing helped us recalibrate our stance and recognize how limited the evidence truly is for many commonly used interventions.” He noted that while no single strategy eliminates POAF, its clinical impact can be significantly reduced through a combination of measures applied across the preoperative, intraoperative, and postoperative phases of care. He also emphasized that the long-term implications of POAF in patients without prior atrial fibrillation remain uncertain and must be weighed against individual patient risk factors.

Together, the guidelines provide a pragmatic framework that clinicians can operationalize across the surgical continuum. By emphasizing evidence-based practices, openly acknowledging uncertainty, and discouraging ineffective interventions, the document aims to support thoughtful clinical decision-making and improve outcomes for patients undergoing cardiac surgery.

1: Milojevic, M., Freemantle, N., Hayanga, J. A., Kelly, R. F., Myers, P. O., Petersen, R. H., ... & Bakaeen, F. G. (2025). Harmonizing guidelines and other clinical practice documents: A joint comprehensive methodology manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS). The Journal of thoracic and cardiovascular surgery, 169(1), 170-185.

On Friday, Jan. 30, at 9:30 a.m., Stephanie Worrell, MD, of the University of Arizona, presented STS Perforation Guidelines during the "Esophageal Perforation Management" session. Her talk introduced a new Society of Thoracic Surgeons (STS) Expert Consensus Document designed to improve the diagnosis and management of esophageal perforation, a rare but potentially fatal condition.

Image

Esophageal perforation, often a complication of endoscopic procedures, requires early diagnosis, as mortality and morbidity increase if treatment is delayed beyond 24 hours. Despite advances in treatment, management remains inconsistent due to the condition’s rarity and limited clinical data.

To address this gap, the STS convened a multidisciplinary panel of thoracic surgeons and gastroenterologists, who reviewed studies from the past 14 years to develop consensus statements on diagnosis, treatment, and long-term care. For stable patients with confirmed perforation, the consensus supports endoscopic therapies when matched appropriately to anatomy and operator expertise. Surgical intervention remains essential for unstable patients or complex cases.

In her talk, Dr. Worrell discussed how the guidelines provide clarity in clinical scenarios that often prompt uncertainty. “These recommendations clarify when further investigation is appropriate and when it’s safe to observe or discharge,” she said. She notes that the guidelines are particularly valuable for conditions like spontaneous pneumomediastinum where further workup may be unnecessary. Additionally, there is now strong data for CT esophagrams and growing evidence for endoscopic approaches that are not yet used consistently.

STS Award recognizes groundbreaking scientific contributions that advance cardiothoracic surgery

Cardiothoracic surgeon Michael J. Mack, MD, was given the Earl Bakken Scientific Award at The Society of Thoracic Surgeons’ Annual Meeting in 2026 in New Orleans today, recognizing a career defined by transformative leadership, surgical innovation, and a lasting impact on cardiovascular medicine.

Image

Dr. Mack is internationally renowned for his pioneering contributions to minimally invasive cardiac surgery and valvular heart disease therapies, particularly transcatheter aortic valve replacement (TAVR). Over more than four decades in practice, he has played a central role in reshaping the treatment of complex cardiovascular disease by bridging the disciplines of cardiac surgery and interventional cardiology.

“Dr. Michael Mack’s career exemplifies visionary leadership and collaborative innovation,” said STS President Joseph F. Sabik III, MD. “His influence extends far beyond the operating room—through landmark clinical trials, guideline development, and the ‘heart team’ model that has become the standard of care worldwide. His work has fundamentally changed how we treat patients with structural heart disease.”

A key hallmark of Dr. Mack’s career has been his leadership in pivotal clinical trials that have redefined cardiovascular care. He played critical roles in the SYNTAX Trial, which compared percutaneous coronary intervention with coronary artery bypass grafting in patients with complex coronary artery disease, and the PARTNER Trials, which established the safety and efficacy of TAVR and accelerated its adoption into mainstream practice. These studies helped shape contemporary guidelines and expanded life-saving treatment options for patients previously considered inoperable or high risk.

Dr. Mack has authored or co-authored more than 400 peer-reviewed journal articles and numerous book chapters, with scholarship spanning coronary artery bypass surgery, transcatheter valve therapies, minimally invasive surgical techniques, outcomes research, and clinical practice guideline development. His work includes major contributions to expert consensus documents endorsed by leading cardiovascular societies and the development of risk models used widely in clinical decision-making.

Currently, he serves as Medical Director of Cardiovascular Surgery for Baylor Scott & White Health and Chairman of the Baylor Plano Research Center at The Heart Hospital Baylor Plano in Texas. He is also principal investigator for the Baylor Core Clinical Center of the National Institutes of Health–funded Cardiothoracic Surgical Network (CTSN), awarded in 2013, supporting large-scale, multicenter clinical research in cardiac surgery.

Throughout his career, Dr. Mack has balanced high-volume clinical practice with academic leadership. He has performed thousands of cardiac operations, with well over 4,000 involving heart valve procedures, and has been a global advocate for less invasive approaches that improve recovery and outcomes for patients.

In addition to his clinical and scientific achievements, he has held numerous leadership roles in professional societies. He served as STS president in 2011 and is a past president of The Thoracic Surgery Foundation (formerly the Thoracic Surgery Foundation for Research and Education), the Southern Thoracic Surgical Association, and the International Society for Minimally Invasive Cardiothoracic Surgery. He has also served on the American College of Cardiology Foundation Board of Trustees and multiple ACC, STS, and FDA committees.

This award recognizes Dr. Mack’s profound and enduring influence on cardiothoracic surgery, his role in advancing collaborative, evidence-based care, and his unwavering commitment to innovation. His career stands as a testament to how collaboration, rigorous science, and patient-centered thinking can redefine an entire field.

The Earl Bakken Scientific Achievement Award was established in 1999 through a grant from Medtronic, Inc. to honor individuals who have made outstanding scientific contributions that have enhanced the practice of cardiothoracic surgery and patient quality of life. The award was named for Medtronic co-founder Earl Bakken. Among numerous other achievements, Bakken developed the first wearable artificial pacemaker.

During the Airway Issues session on Friday, Jan. 30 at 1:30 p.m., Joseph Nellis, MD, of Duke University Medical Center, will present the Richard E. Clark Memorial Paper, Impact of Preoperative Tracheostomy on Outcomes Following Congenital Cardiac Surgery: A Study of the STS Congenital Heart Surgery Database, at STS 2026. In this presentation, Dr. Nellis will examine how preoperative tracheostomy affects outcomes following congenital cardiac surgery, an area with limited prior data despite longstanding concerns about risk in this population.

Image

Congenital cardiac surgery patients with preoperative tracheostomy represent a small but increasingly recognized group with complex medical needs. To better understand how tracheostomy status influences surgical outcomes, Dr. Nellis and colleagues analyzed national registry data spanning a decade of congenital cardiac operations, comparing patients with preoperative tracheostomy to those without this airway history.

Overall, patients with preoperative tracheostomy experienced higher rates of postoperative complications, readmissions, and mortality compared with those without tracheostomy. Even after accounting for differences in baseline risk, preoperative tracheostomy remained associated with an increased likelihood of infection-related complications and early mortality, though it was not linked to longer hospital stays or higher overall morbidity.

In his presentation, Dr. Nellis will outline the implications these findings inform risk stratification and surgical planning for children with complex airway and cardiac disease. He emphasizes that while preoperative tracheostomy identifies a higher-risk patient population, it should not, by itself, exclude patients from consideration for definitive congenital cardiac surgery.
 

As part of the “Research in Focus: Landmark Science & Technology” session on day one of the STS meeting, Andrew Feczko, MD, of Cleveland Clinic presented the STS Landmark paper titled Lung Cancer Resection Longitudinal Risk Model. In his presentation, Dr. Feczko described the development and validation of a robust, data-driven model designed to predict long-term survival following curative-intent lung cancer resection—an area of growing importance as survival improves and quality benchmarking extends beyond perioperative outcomes.

Image

Drawing on the Society of Thoracic Surgeons General Thoracic Surgery Database, the investigators analyzed outcomes from a large, contemporary cohort of adults who underwent lung cancer resection. By linking STS data with national mortality sources, the team was able to assess survival over an extended follow-up period and construct individualized risk predictions across pathologic stages. Patients were divided into derivation and validation cohorts to ensure the model’s generalizability, and advanced statistical techniques were used to account for differences in risk over time.

The resulting longitudinal risk model demonstrated strong discrimination and excellent calibration, accurately aligning predicted survival with observed outcomes across multiple time points and disease stages. Risk scores were closely associated with long-term survival, effectively stratifying patients into distinct prognostic groups. Importantly, the model’s performance improved further when postoperative complications were incorporated, highlighting the lasting impact of perioperative events on long-term outcomes.

Dr. Feczko emphasized that this work addressed a critical gap in thoracic surgery by extending risk assessment beyond short-term mortality. As the field increasingly focuses on survivorship, quality improvement, and informed shared decision-making, the availability of validated long-term survival models represents a significant advance.

With this study, the STS General Thoracic Surgery Database now offers thoracic surgeons both short- and long-term risk prediction tools to support self-evaluation, programmatic quality improvement, and future research—reinforcing its role as the authoritative national resource for thoracic surgical outcomes.

On Thursday, January 29, the Society of Thoracic Surgeons (STS), in collaboration with the International Society for Heart and Lung Transplantation (ISHLT), hosted the inaugural STS/ISHLT Lung Transplantation Symposium as part of the STS 62nd Annual Meeting. This full-day specialty session provided a practical, multidisciplinary review of contemporary lung transplantation, covering donor selection through long-term management with an emphasis on intraoperative decision-making and complex clinical scenarios.

“Through its practical, comprehensive approach, the symposium offered attendees an in-depth perspective on modern lung transplantation,” said organizing chair Kewal Krishan, MD. “The program equipped surgeons and care teams with strategies for both routine and highly complex cases.”

The program combined didactic lectures, live debates, and case-based panels to highlight advances in donor management, organ preservation, surgical techniques, and perioperative care. Attendees earned CME credits while engaging in detailed discussions of common challenges in lung transplantation surgery.

Sessions delivered a case-based overview across the operative spectrum—from donor management and organ preservation to complex intraoperative rescue. Faculty reviewed retrieval strategies in donation after brain death and circulatory death, surgical implantation techniques, perioperative anesthesia and hemodynamic management, and the use of ECMO or cardiopulmonary bypass. Advanced scenarios, including robotic, redo, and heart–lung transplantation, concluded with interactive discussions focused on real-world, high-risk cases.

The Society of Thoracic Surgeons today announced the 2026 Nina Starr Braunwald Extraordinary Women in Cardiothoracic Surgery Award recipients at its 62nd Annual Meeting in New Orleans. Now in its fourth year, the award is co-sponsored by STS and Women in Thoracic Surgery (WTS) and recognizes women cardiothoracic surgeons who exemplify exceptional clinical expertise, leadership, and dedication to advancing the field.

This year’s honorees are Emily Farkas, MD; Carolyn Jones, MD; and Rosemary Kelly, MD.

Image

“We are proud to honor these outstanding women and celebrate their accomplishments as surgeons, leaders, and mentors,” said STS Immediate Past President Jennifer C. Romano, MD, MS. “Their dedication and example motivate and guide the next generation of cardiothoracic surgeons—women and men alike—to push the boundaries of innovation in their specialties.”

Meet these these accomplished surgeons:

Dr. Emily Farkas, a cardiothoracic surgeon whose career is defined by an unwavering commitment to patient care and global service. One of the approximately 3% of cardiac surgeons who are women, she also holds the distinction of being the first woman accepted into cardiothoracic surgery training at Yale University. After completing her training, she spent five years on the faculty at Saint Louis University as an assistant professor of surgery.

A passion for global medicine has shaped Dr. Farkas’s career from its earliest days, including delivering her first baby in Kenya and completing medical school electives in Sri Lanka. This commitment ultimately led her to step away from a traditional academic path to focus on humanitarian cardiac surgery. Through partnerships with various charitable organizations, she has directed or participated in more than 50 surgical missions worldwide, providing free, life-saving heart surgery in countries including Brazil, Ghana, Nepal, Mongolia, Myanmar, Nigeria, and Vietnam.

Dr. Farkas is an associate professor of surgery and associate director of global health in surgery at Indiana University School of Medicine, as well as chief of cardiac surgery at the Richard L. Roudebush VA Medical Center in Indianapolis. A recognized leader in the field, she serves on numerous STS and WTS committees, an associate editor for CTSNet, and holds leadership roles with CardioStart International, EMERGENCY USA, and the Cardiac Surgery Intersociety Alliance. Her career reflects a powerful blend of surgical excellence, service, and advocacy for equitable access to care.

Dr. Carolyn Jones' journey to leadership in cardiothoracic surgery is marked by resilience, compassion, and a lasting commitment to education and mentorship. She began her medical career as a nurse and went on to complete medical school at George Washington University while raising a family as a single mother. She trained in general and cardiothoracic surgery at the University of Rochester, where she later became the first woman hired as an attending cardiothoracic surgeon and now serves as chief of thoracic surgery.

An associate professor of surgery and chief of thoracic and foregut surgery at the University of Rochester Medical Center, Dr. Jones is widely admired for her clinical excellence, technical skill, and ability to work well with others. While she may not seek national recognition, her impact is deeply felt by patients, trainees, nurses, and colleagues throughout upstate New York. Known for her empathy, bedside manner, and dedication to patient-centered care, she has received numerous teaching and service awards over the course of her career.

Dr. Jones has played a vital role in surgical education, serving as associate residency program director and enhancing curricula and training experiences for residents and medical students. Later in her career, she adopted minimally invasive and robotic techniques to further improve patient outcomes, building strong, collaborative teams in the process. A steadfast mentor and role model, Dr. Jones exemplifies leadership grounded in service, respect, and inclusion, creating environments where patients and trainees alike feel valued and supported.

Dr. Rosemary Kelly, a nationally recognized leader whose career has advanced cardiothoracic surgery while opening doors for women and underrepresented groups across the specialty. She is professor of surgery at the University of Minnesota Medical School, executive vice chair for cardiovascular and thoracic surgery, chief of the heart and vascular service line at MHealth Fairview, and program director of the cardiovascular and thoracic surgery fellowship program. She also holds the C. Walton and Richard C. Lillehei Professorship in Cardiothoracic Surgery.

A dedicated mentor, Dr. Kelly supports trainees and junior faculty through formal programs and personal sponsorship, offering practical guidance on career development and work-life integration. Her research portfolio, supported by the NIH, VA, and other major agencies, includes more than 140 peer-reviewed publications spanning clinical innovation, as well as scholarship on mentorship and resilience in surgery. Clinically, she combines excellence with service, having led major cardiothoracic and transplant programs and delivered distinguished lectures at institutions dedicated to advancing women in medicine.

“Each of these women are shaping the future of cardiothoracic surgery,” said Mara Antonoff, MD, president of Women in Thoracic Surgery, “Their expertise, leadership, and dedication are driving progress in our field and opening doors for the women who will follow.”

As the population undergoing mitral valve surgery continues to age, the choice between repair and replacement has taken on new urgency. At the "Masters of the Mitral Valve" session on Thursday, Jan. 29 at 10:10 a.m., Dr. Allen Razavi of Cedars-Sinai Medical Center will address this issue in the Is Degenerative Mitral Valve Repair Superior to Replacement in Patients Aged >65 Years? presentation.

Image

Drawing from a large national cohort within the Society of Thoracic Surgeons Adult Cardiac Surgery Database linked with Medicare data, Dr. Razavi and his team compared long-term outcomes for patients aged 65 and older who underwent mitral valve repair with those who received mitral valve replacement. Their objective was to evaluate differences in survival, major complications, and the need for future mitral valve interventions across treatment strategies.

The study found that mitral repair was associated with significantly improved long-term survival compared with replacement, with benefits persisting across much of the older age spectrum. Patients who underwent repair also experienced lower rates of heart failure readmission, stroke, and major bleeding. While overall reintervention rates were similar between groups, repair patients tended to require earlier surgical reintervention, whereas replacement patients were more likely to undergo late transcatheter procedures.

Dr. Razavi will present findings showing how evolving treatment options and advances in repair techniques prompted the team to reassess outcomes in this population. The growth of transcatheter mitral therapies and improvements in surgical durability have heightened the need to revisit traditional assumptions about when repair should be favored over replacement.

The Richard E. Clark Memorial Paper on day one of STS 2026, Optimal Management for Moderate Aortic Stenosis at the Time of Coronary Artery Bypass Grafting, will be featured during the “Optimizing AVR: Aiming for Perfection” session on Thursday, Jan. 29, at 11:00 a.m. In this presentation, Pey-Jen Yu, MD, of Northwell Health, will explore how best to manage moderate aortic stenosis (AS) in patients undergoing coronary artery bypass grafting (CABG), a question that has grown increasingly important as transcatheter approaches continue to reshape treatment pathways.

Image

Drawing from a large cohort in the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD), linked with national inpatient records, Dr. Yu and colleagues compared outcomes for patients who had isolated CABG versus those who received CABG combined with aortic valve replacement (AVR). The goal was to understand both the immediate risks and the longer-term implications of addressing—or deferring—valve intervention in patients with moderate AS.

The study found that patients undergoing CABG alone experienced slightly lower operative risk, but they were more likely to require later aortic valve intervention and were at increased risk for readmission related to heart failure. Meanwhile, those who underwent concomitant AVR faced a higher initial risk but significantly lower likelihood of needing future valve procedures. Importantly, mid-term survival was similar between the two groups.

In her presentation, Dr. Yu will highlight how the rapid expansion of transcatheter valve therapies served as a key motivation for this work, prompting the team to revisit longstanding assumptions about when to intervene on a moderately stenotic valve during open-heart surgery.
 

During the "Diagnosing Patients: Do You Know Before You Go?" session on day one of STS 2026 at 10:15 a.m., Talal Alzghari, MD, of One Brooklyn Health-Brookdale University Hospital Medical Center, will present Oncological and Surgical Outcome Differences in Never-Smoker Women Compared to Ever-Smoker Women and Men. In this presentation, Dr. Alzghari examines how gender and smoking status independently shape surgical and long-term outcomes following lung cancer resection—an increasingly important question as lung cancer rates continue to rise among women.

Image

Although smoking remains the leading risk factor for lung cancer, prior studies have shown conflicting results regarding its impact on postoperative outcomes when gender is considered. To clarify these relationships, Dr. Alzghari and colleagues analyzed national registry data to compare perioperative and oncologic outcomes among women and men with differing smoking histories who underwent resection for non-small cell lung cancer (NSCLC).

Analyzing more than 145,000 elective NSCLC resections from the Society of Thoracic Surgeons General Thoracic Surgery Database, the investigators found that never-smokers are becoming more common over time in both men and women. Never-smoker women emerged as a distinct group with fewer comorbidities, lower perioperative risk, and the most favorable long-term survival, while ever-smoker men experienced the highest complication rates and poorest survival. These differences persisted after risk adjustment, highlighting the independent influence of both gender and smoking status on surgical and oncologic outcomes..

In his presentation, Dr. Alzghari will discuss how these findings can inform preoperative counseling, risk stratification, and treatment planning for patients undergoing lung cancer surgery. He emphasizes that understanding the combined effects of gender and smoking history is essential to delivering more personalized, data-driven care for patients with NSCLC.