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Dynamic Event Featured CVT Critical Care and ERAS Techniques, Strategies The multifaceted nature of cardiovascular and thoracic (CVT) critical care cases was the focus of the 19th Annual Perioperative and Critical Care Conference, held September 8–10, in Denver, Colorado. More than 150 cardiothoracic surgeons, cardiologists, anesthesiologists, nurses, perfusionists, and other medical professionals learned about new concepts, management protocols, and clinical experiences from a multidisciplinary faculty. In addition, Ronald M. Stewart, MD, from the University of Texas Health Science Center at San Antonio, delivered the special keynote address, “Team Management Through Crisis: Firearm Injury Prevention Initiative from the American College of Surgeons Committee on Trauma.” “For our first in-person meeting in 2 years, it was great to meet with a very engaged and interested group,” said Rakesh C. Arora, MD, PhD, one of the program directors. “Participation in every session was outstanding: the level of talks, the questions being asked, the conversations in-between. We had great science and breakout sessions, and meeting old friends again was a real treat.” Thomas Knapp, a third-year medical student from the University of Central Florida College of Medicine in Orlando, received the Best Overall Poster honor for his presentation, “Dexmedetomidine Withdrawal in Pediatric Cardiac ICU Patients: A Systematic Review and Meta-Analysis.” Thomas Knapp, from the University of Central Florida College of Medicine in Orlando, received the Best Overall Poster honor. He shared how much he enjoyed the hands-on sessions, especially the “ECMO 101” session. “I was really excited because it was smaller groups and very visual, which appealed to me. I appreciated the intimacy of the sessions and that the conference was niche.” The meeting content will be available for purchase this month through the STS Learning Center. More information is available at sts.org/criticalcare. New Award Will Honor Extraordinary Women in CT Surgery Nominations currently are being accepted for the inaugural Extraordinary Women in Cardiothoracic Surgery Award, which is co-sponsored by STS and Women in Thoracic Surgery. This honor will recognize outstanding women cardiothoracic surgeons who achieve excellence in clinical practice. Nominees also should exemplify one or more of the following characteristics: Selfless leadership in cardiothoracic surgery Mentorship/sponsorship of others in the specialty Exceptional advocacy on behalf of cardiothoracic surgery, the patient population, or fellow surgeons/trainees Integrity, innovation, creativity, and expertise in carrying out day-to-day professional responsibilities The Extraordinary Women in Cardiothoracic Surgery Award will be presented live during STS 2023 in January. Nominations are being accepted through October 21. For more information, visit sts.org/extraordinarywomen. STS 2023 Will Reconnect the CT Community in San Diego After 2 years of virtual-only Annual Meetings, STS is bringing the cardiothoracic surgery community back together for never-before-seen science, hands-on demonstrations, virtual OR experiences, industry showcases, and thought-provoking keynote lectures. STS 2023 will take place January 21–23, at the San Diego Convention Center. “There isn’t an STS Annual Meeting that I don’t walk away from having learned something new, thought about something differently, or gained a unique perspective about how another surgeon or institution is tackling a problem,” said S. Adil Husain, MD, Chair of the STS Workforce on Annual Meeting. “Being together face to face creates organic conversations and opportunities to learn from one another, as well as allows us to find joy, excitement, and commonalities in terms of challenges and successes we have as cardiothoracic surgeons.” For those who can’t travel to San Diego—or for those who want to do more with their in-person registration—a new option, Plenary Livestream-Plus, will allow registrants to livestream the President’s Address and the Thomas B. Ferguson, Vivien T. Thomas, and C. Walton Lillehei Lectures from anywhere onsite or across the globe. Plenary Livestream-Plus also gives participants access to all session recordings within 48 hours of presentation. Early registration guarantees a place—and the best choice of hotel rooms—at the most highly anticipated cardiothoracic surgery event in the world. Registration now is under way at sts.org/annualmeeting.   World-Class Faculty Will Headline Latin America Conference Featuring interactive panel discussions, original scientific abstracts, and hands-on courses, the 2022 STS/EACTS Latin America Cardiovascular Surgery Conference takes place December 1–3, in Cartagena, Colombia. The conference is an exceptional opportunity to explore the latest developments and best practices in coronary artery disease, congenital heart disease, thoracic aortic disease, atrial fibrillation, and the surgical management of heart failure. The final day of the conference will showcase industry-sponsored workshops that demonstrate mitral, tricuspid, and aortic valve repair, as well as valve sparing and the Ross procedure. “The Latin America Cardiovascular Surgery Conference this year will be a remarkable event as surgeons from South America, Europe, and North America come together to disseminate knowledge and learn from each other,” said program committee member Vinod H. Thourani, MD. “We will discuss cases, listen to didactic lectures, and watch videos about the best practices for adult cardiac, congenital, and heart failure surgery. I encourage you to attend this don’t-miss event.” For more information, visit sts.org/latam. 8 in 8s Provide Quick Tips for Hypoxemia, Reimbursement, Epicardial Pacing, and More The STS 8 in 8 Series is a collection of expert-presented videos that offer clear, concise explanations of cardiothoracic surgery topics—each features just 8 slides and is approximately 8 minutes long.  The newest videos cover hypoxemia during VV ECMO, academic promotion for advanced practice providers, post-cardiotomy temporary epicardial pacing in the ICU, surgeon reimbursement, and tracheostomy techniques.  The series is available at sts.org/8in8 and on the STS YouTube channel, ThoracicSurgeons. This 8 in 8 video identifies contributors to hypoxemia during VV-ECMO support, including cannula recirculation. Now Is the Time to Send Data Managers to AQO Surgeons are encouraged to register their data management teams for the 2022 Advances in Quality Outcomes (AQO): A Data Managers Meeting, October 26–28 in Providence, Rhode Island. Registrants can choose one or multiple in-person tracks—for the Adult Cardiac, Congenital, General Thoracic, and/or Intermacs/Pedimacs Databases—or choose a virtual pass to get access to digital content. STS members, including non-physician associate members, save even more. Details are available at sts.org/aqo. Blog Curates Conversations for Aspiring Surgeons The Aspiring CT Surgeons Blog launched to much celebration, providing a space for trainees to openly reflect on their experiences and share ideas to help each other navigate the troubles and triumphs of medical school, residency, fellowship, and beyond. New articles—which offer viewpoints from a diverse range of backgrounds and stages of training—are added regularly. The first few articles detail coping with complications, feeding the joy, and finding your own way to the operating room. Coping with Complications in Cardiothoracic Surgery: How Do We Grow as Trainees? by Linda Schulte, MD   The Scenic Route to Cardiothoracic Surgery by Mahnoor Imran, MD   Feed the Joy by Anna Olds, MD   Visit sts.org/aspiringctsurgeons, and carry on the discussion via social media with #aspiringctsurgeons. Webinar Challenges Teams to Prepare for Post-Surgical Arrest In the event of a sudden cardiac arrest after surgery, everyone on the perioperative team needs to know their roles and act fast. A recent installment of the STS Webinar Series teaches teams to establish a protocol that everyone can follow. In “Arrest after Cardiac Surgery: Is Your Team Ready?,” an expert panel demonstrates how to implement Cardiac Surgery Advanced Life Support protocols and their utility in failure-to-rescue algorithms. The free webinar is available to watch now at sts.org/videos. STS Traveled to Milan for EACTS Meeting The Society had an important presence at the European Association for Cardio-Thoracic Surgery (EACTS) Annual Meeting in Milan, Italy, in October. STS President John H. Calhoon, MD, met with colleagues from around the world, while other surgeon leaders gave presentations during the meeting. STS staff also promoted the benefits of STS membership at a booth in the Exhibit Hall.

STS News, Fall 2022 — Whether they were called to the specialty by heritage or by destiny, these parent-child duos represent the evolving arena of cardiothoracic surgery in real time. Surender Reddy Neravetla, MD, and Soumya Reddy Neravetla, MD  At Springfield Regional Medical Center in Ohio, Surender Reddy Neravetla, MD, has earned accolades for his more than 10,000 valve repairs, beating-heart surgeries, and minimally invasive lung resections, as well as a most distinctive trophy: King of Dad Jokes. Dr. Surender Neravetla’s daughter, Dr. Soumya Neravetla, shares her father’s passion for preventative education and community outreach. Despite Dr. Neravetla encouraging his daughter, Soumya Reddy Neravetla, MD, to try out different career paths, Soumya found herself gravitating time and again toward cardiothoracic surgery. And when veteran surgeon Lofton N. Misick, MD, left the Springfield center for a position in Texas in 2016, Soumya stepped in to take on some of the workload. The plan was to stay “for a little while.” She’s still there. “I’ve been busy!” she said. “Launched a TAVR program and a lung screening program in Springfield. Met with the governor of Ohio about lung cancer. Served in multiple board positions with the Association of Physicians of Indian Origin (AAPI), Association of Telugu Medical Graduates of USA.” She served as president of AAPI’s physician’s section from 2021–2022, and she is currently the chair of the hospital’s Cancer Committee and Department of Surgery. The Drs. Neravetla may be the first father-daughter cardiothoracic surgeon pair to have operated as a team. Soumya referred to heart transplant pioneers, the late Norman E. Shumway, MD, PhD, and his daughter Sara J. Shumway, MD, who now serves as professor and vice chief of cardiothoracic surgery at the University of Minnesota Medical School in Minneapolis. “It’s my understanding that the Shumways never worked together, but I believe she’s the first daughter to follow her young father in this path. Dr. (Vinod) Thourani once pointed out to me that we may be the first father-daughter duo to actually work together,” Soumya said. Clearly, a passion for preventative medicine and public health also runs in the family. The senior Dr. Neravetla is a longtime champion of bringing health education to underserved communities. He’s the author of the 2012 book Salt Kills and its 2014 follow-up, Salt: Black America’s Silent Killer, and he maintains a public blog on prevention issues, explaining current medical literature in plain language. Dr. Soumya Neravetla says that she and her father are both calm but fun to work with in the OR. “My father, however, is the king of dad jokes—he has a trophy to prove it—resulting in my appropriate eye rolls.” A grassroots advocate for the American Heart Association’s positions on disease prevention, Dr. Surender Neravetla works with local health fairs and culture festivals, churches and social clubs, schools and city halls, lecturing and initiating vital conversations with the community. “Cardiac surgery is going through a tough transition, largely due to the rapid growth of technology,” the senior Dr. Neravetla said. “The patients under our care are at a later stage in the disease process; the surgeries and post-op care are increasingly complex. All the while, cardiac surgeons are facing increasing scrutiny. This poses significant difficulty for the younger surgeons—especially women—to get established and be respected in their field.” Dr. Soumya Neravetla says that she was surprised at just how deep the disparities run. “Even though you know about it, it’s still surprising to see how dramatic the difference is for female surgeons in the real world.” She’s also startled by the lack of awareness surrounding lung cancer, despite it being the number one cancer killer in men and women. While she and her dad are both relatively quick-handed, “my father is one of the fastest surgeons you’ll ever see,” said Soumya. “On the other hand, I’m known for my small incisions, and though we both do a broad range of open and robotic surgeries, the endovascular space is my playground.” As she monitors technologies in cardiac, vascular, and thoracic applications, Dr. Soumya Neravetla spearheads lung cancer screening and awareness in Dayton, serving on the Ohio Partners for Cancer Control lung committee. Her team also is preparing to launch another TAVR program at Kettering Health Dayton in Ohio. “It’s always exciting to develop a program from infancy and watch it mature,” she said.  Undoubtedly, her dad feels that, to a superb degree, about his daughter. Richard M. Engelman, MD, and Daniel T. Engelman, MD In 1968, when Richard M. Engelman, MD, was a resident at New York University, coronary artery bypass grafting (CABG) was in its infancy. Patients remained intubated for at least a day, were on mandatory bedrest for a minimum of 48 hours, and didn’t begin rehabilitation—which involved only limited ambulation—until 72 hours later. The senior Dr. Engelman (right) pioneered “Fast-Track” recovery after surgery, and his son Daniel continued to advance perioperative care through the ERAS Cardiac Society. “Discharge was routinely 1 to 2 weeks after surgery, and patients were encouraged to remain sedentary for the next 4 to 6 weeks,” Dr. Engelman said. “These practices remained the standard for cardiac surgical perioperative care for decades, and morbidity following surgery was not inconsequential.” With increased evidence supporting the success of mindful perioperative care, Dr. Engelman formed a team to introduce the “Fast-Track” approach to cardiac recovery in the early 1990s. This method involved a coordinator-led multidisciplinary team, who paid close attention to intravenous fluid intake, controlling atrial arrythmias, normalizing gut function, and getting patients quickly up and walking. Fast-Track dramatically reduced extubation times, ICU stays, and overall time in the hospital, all with improved outcomes for the patient. Richard’s son, Daniel T. Engelman, MD, picked up the torch in 1999, when he became a Board-certified surgeon after graduating from Brigham and Women’s Hospital in Boston, Massachusetts. “As my career progressed, I noticed waning interest in the Fast-Track protocols popularized by my father, coincident with increasing provider concern about patient-reported outcomes and the costs associated with care,” the younger Dr. Engelman said. Since stepping down from his role as head of cardiac surgery, the elder Dr. Engelman continues to serve as chief of cardiac surgical research—and as his son’s colleague—at Baystate. Changes in cardiac and surgical training and practice patterns—as well as improvements in percutaneous techniques—led to increased emphasis on reducing delays between patient evaluation and surgical procedures, explained Dr. Daniel Engelman. “Perioperative optimization was at odds with this new urgency.” Enter enhanced recovery after surgery (ERAS). After examining the successful outcomes surgeons and patients were enjoying in other specialties, Dr. Engelman put it to use within cardiac surgery. In 2017, he and a group of likeminded surgeons founded the nonprofit ERAS Cardiac Society. “The national and international interest was tremendous,” he said. “A few early studies were simultaneously being conducted outlining enhanced recovery protocols demonstrating improved outcomes within our specialty. What was old was new again.” Both Drs. Engelman served as authors of the 2019 Guidelines for Perioperative Care in Cardiac Surgery, which are the first of their kind. They’ve been downloaded more than 260,000 times. “The field continues to evolve throughout the years in ways we couldn’t even imagine when I started my career, and I’m thrilled to be able to witness it through Dan’s achievements,” said the elder Dr. Engelman. Meanwhile, although he’s retired from operating, he continues to work each day at Baystate Medical Center in Springfield, Massachusetts, as chief of cardiac surgical research. “I also continue to enjoy time with my wife, Jane, of 62 years, and spend time on the golf course with kids and grandkids!”   If you know of a unique member experience that should be featured in STS News, contact stsnews@sts.org.

STS News, Fall 2022 — More than 50 cardiothoracic surgeons, residents, and medical students participated in the Society’s first in-person Advocacy Conference since 2019. STS members met with lawmakers to discuss several key issues of critical importance to STS members and their patients. “The Advocacy Conference is really important for each and every one of us in STS—to get together with colleagues and discuss what is really important in our specialty and, more importantly, for our patients, so that we can make health care better,” said Patrick T. Roughneen, MD, from UT Health Houston McGovern Medical School. “We are here together to talk with members of Congress, and they are very receptive to our voice.” Participants connected with several legislative decision makers during the conference. In addition, STS President John H. Calhoon, MD, presented Rep. Kim Schrier, MD (D-WA), with the STS Legislator of the Year Award. Rep. Schrier discussed the physician workforce shortage and her continued efforts to help stall physician Medicare payment cuts. “What we need is a permanent solution to Medicare reimbursement cuts,” she said. “Every year, the payment cuts come up, and it always is a crisis at the end of the year. I happen to think this is a good time for doctors to make their case, as we are losing physicians to retirement and resignation. This is a moment to make a play for that permanent solution, and I'm working with my committee to help.” STS members also heard from Rep. Larry Bucshon, MD (R-IN), a cardiothoracic surgeon, and Rep. Mariannette Miller-Meeks, MD (R-IA), an ophthalmologist, who provided perspective about the current Congress and its focus for the remainder of 2022. Reps. Bucshon and Miller-Meeks emphasized the importance of surgeon participation in advocacy and answered questions from participants. They explained their roles in temporarily halting Medicare reimbursement cuts for surgeons this year and their hopes to work with health care providers on a more permanent solution. Rep. Bucshon also discussed the bill he cosponsored with Rep. Schrier that would help registries like the STS National Database to facilitate innovation and quality improvement. Dr. Joseph Cleveland Jr. sits down with Rep. Jason Crow (D-CO) during the STS Advocacy Conference. During the conference, STS members met with House and Senate representatives in Congress and their staff, urging them to take action on three issues that are especially important to the specialty. “It’s a great experience to be in the city of Washington, DC, and connecting face to face with members of Congress and legislative assistants, talking about issues that help our specialty and our patients. There’s nothing like it—a lot of energy,” said Karen M. Kim, MD, from the University of Michigan in Ann Arbor. Ask #1: Stop Medicare Reimbursement Cuts The Centers for Medicare & Medicaid Services (CMS) has proposed to cut the Medicare conversion factor—the multiplier used to calculate the amount of Medicare payment using the relative value unit of a procedure or service—by 4.42%. Even worse, additional budget-related cuts will be layered on top starting in 2023. In addition, some estimates show the cost of running a medical practice has increased by 37% between 2001 and 2020. The startling reality is that, when adjusted for inflation in practice costs, Medicare physician pay actually declined 22% from 2001 to 2020. Unless Congress steps in again, cardiothoracic surgeons could see Medicare payment cuts of up to 8.5% in 2023. Reductions of this magnitude represent a very real threat to the financial viability of clinical practices and could limit patient access to care. Ask #2: Support Access to Claims Data Medicare claims data, when linked with clinical outcomes data in registries such as the STS National Database, allow researchers to conduct longitudinal analyses to measure quality improvement and improve patient safety. Currently, regulatory barriers prevent registries from linking claims data with clinical outcomes data. In order to help improve quality of care and perform important research, registries need timely, cost-effective, and continuous access to these data. Ask #3: Support the Resident Physician Shortage Reduction Act A key factor impacting the shortage of physicians is the artificial cap placed on Medicare-supported graduate medical education (GME) positions. This bill would help mitigate the physician shortage by creating 14,000 new GME slots over 7 years.  In December 2020, Congress provided 1,000 new Medicare-supported GME positions—the first increase of its kind in nearly 25 years. While this is progress, more support is needed. The Resident Physician Shortage Reduction Act of 2021 is a step in the right direction. Dr. John Calhoon and other STS members met with Rep. Larry Bucshon (R-IN) and other members of Congress. Miss the STS Advocacy Conference? You Still Can Be Involved! If you could not attend the STS Advocacy Conference, you still have a chance to meet with your federal representatives. STS members are the most effective advocates for the specialty and patients; contact the STS Government Relations office at advocacy@sts.org or 202-787-1230 for help with setting up a meeting or site visit. 

STS News, Fall 2022 — Douglas J. Mathisen, MD, is a giant in every sense of the word—a giant in his professional career as a master surgeon, a giant in education, and perhaps most significantly, a giant as a mentor and role model. There are few practicing cardiothoracic surgeons today who have not been touched in a meaningful way by the powerful influence of Dr. Mathisen, said Douglas E. Wood, MD, from the University of Washington in Seattle, about his longtime friend and colleague. “Dr. Mathisen is an incredible physical presence, easily found in a crowd, standing a head taller than everyone else. His hand engulfs one with a welcoming handshake accompanied by a warm smile,” said Dr. Wood. “The true measure of this giant is the enormous personal and professional respect that he holds from his peers for his integrity and generosity.” Dr. Mathisen—STS Past President and former Historian—trained in general surgery and cardiothoracic surgery at Massachusetts General Hospital (MGH) in Boston, where he has remained for almost all of his extraordinary career. It is not difficult to recognize the Midwestern roots of Dr. Mathisen. His easygoing demeanor, common sense, humility, and perfectionism have had a profound effect on the specialty and thousands of patients. “Dr. Mathisen has been a leader in almost every aspect of our profession, a voice for our specialty, a mentor to many, and a friend to all,” said Thomas E. MacGillivray, MD, STS First Vice President, from MedStar Health in Washington, DC. Dr. Mathisen was raised in the small town of Danville, Illinois, where his father was principal of the high school and his mother helped in her family’s auto shop. He earned his undergraduate and medical degrees from the University of Illinois in Urbana-Champaign. While growing up in Illinois, Dr. Mathisen was influenced by a surgeon in his hometown—Harlan English, MD. As a young boy, Dr. Mathisen was captivated by Dr. English’s sense of humor and the image of him being completely in charge. From the first time Dr. Mathisen met him, all he ever wanted to be was a surgeon. In fact, through medical school and residency, Dr. Mathisen stopped in regularly to see Dr. English. Over the years, Dr. Mathisen generously paid it forward. According to Dr. Wood, every MGH resident from the past 30 years likely would highlight Dr. Mathisen as one of their most important influences and an approachable senior colleague who helped shape their careers. But his mentorship has extended far beyond Boston, as his wise advice and generous support are sought by junior and senior surgeons from around the US and world. He has been a champion for literally several hundred aspiring surgeons: writing letters of support for society applications, advocating for positions on organizational committees and workforces, selecting volunteers to write board exam questions, and taking his personal time to vouch for early careerists professionally or coach them personally. During his long, remarkable career, Dr. Mathisen has authored more than 240 peer-reviewed publications, 160 book chapters, and five books. Perhaps his largest contribution, though, has been in pushing forward thoracic oncology and airway surgery. With world-renowned thoracic surgeon Hermes C. Grillo, MD, Dr. Mathisen helped set the surgical indications, techniques, and outcomes for tracheal and bronchial surgery that have served as the foundation for airway surgery. Dr. Mathisen also has made broad contributions in thoracic oncology: lung cancer, esophageal cancer, chest wall tumors, thymoma, and mesothelioma. Notably, he and his team were involved in tissue engineering research, building toward the ultimate goal of tracheal replacement. A Distinguished Career Recognized In recognition of his dedication to the specialty and its future, Dr. Mathisen recently was honored with a fellowship award in his name—the TSF/STS Douglas Mathisen Traveling Fellowship in General Thoracic Surgery. This fellowship highlights Dr. Mathisen’s commitment to refining the practice of cardiothoracic surgery, teaching innovative surgical skills, and advancing the careers of bright and motivated young surgeons, which is essential for the specialty to advance and thrive in the future. The Mathisen Award will provide financial support for early career general thoracic surgeons from North America, and potentially Europe, to travel domestically or internationally to learn a new technique, adapt an innovative technology, and collaborate with surgical investigators to further the progress of general thoracic surgery at the recipients’ home institutions. "The fellowship in Dr. Mathisen’s honor will be a lasting tribute to him by continuing his legacy as a champion of early career development and connecting colleagues from around the world,” said Dr. MacGillivray. Applications for the Douglas Mathisen Traveling Fellowship are expected to open in July 2023. In the meantime, fundraising to build the fellowship fund is under way. For more information on donating to this award, visit thoracicsurgeryfoundation.org.  Double Your Impact: Donate to TSF Today The Thoracic Surgery Foundation (TSF)/STS Surgeon Match Challenge is under way, and—to date—$89,680 has been raised toward research, education, and philanthropic initiatives that advance cardiothoracic surgery. For every dollar donated by surgeons during the challenge, STS will match contributions up to $200,000. So far this year, the Society’s charitable arm has awarded approximately $1.5 million in funding to support surgeon-scientists in cardiothoracic surgery. Award recipients are investigating topics such as an ambulatory pulmonary assist system for end-stage lung disease, opioid use in thoracic surgery, and the role of mechanical load in heart failure. They’re training with experts to learn new skills, including endovascular cardiac surgery, donation after circulatory death heart transplantation, and thoracoabdominal surgical approaches to treating aortic disease. TSF also has funded lifesaving care for underserved patients in developing countries, including Uganda, Mozambique, Kenya, Nepal, and Nigeria. In addition to matching surgeon donations, the Society covers all of TSF’s administrative expenses so that 100% of each donation is applied to award programs. Plus, TSF donations are tax-deductible to the extent permitted by law. If you have not given to the Foundation recently, consider a gift at this time when your donation will have double the impact. For more information, visit thoracicsurgeryfoundation.org/donate.

STS News, Fall 2022 — Just 10 months ago, Joanna Chikwe, MD, FRCS, from Cedars-Sinai Medical Center in Los Angeles, California, took over as Editor-in-Chief of The Annals of Thoracic Surgery, and already, the new leadership and ambitious agenda are paying off. The Annals is being touted as the most cited and read journal in the specialty, with a record-breaking 5.102 impact factor; the editorial board has been expanded to include new senior editor positions, teams of statistical and digital editors, and additional content experts (see below); and the digital companion journal Annals Short Reports was successfully launched. But there is much more important work to be done, including the expansion and strengthening of the digital footprint—an undertaking that is especially important to Dr. Chikwe, as reflected in some of the early changes to the journal. Dr. Chikwe recognizes that digital content offers immediacy, versatility, and reach—key considerations as readers make new demands and the quality and accessibility of technologies improve. “Digital platforms have taken us from reading print newspapers and magazines with yesterday’s news to real-time multimedia content on our phones and computers. The best academic journals are leveraging that,” she said. Right now, more content is being published than in recent years, and physicians are consuming it very differently. Recent research from an industry publication found that only 34% of physicians preferred to receive information about clinical trials through traditional sources such as print media, compared to 40% who chose a combination of print and digital. In addition, 26% of physicians indicated that in “the future” they would not have time for print at all. But reaching busy audiences with scientific news is about more than just putting existing print content online in a digital format. Readers are looking for formats that are easier to digest, as well as more visual and more engaging. So, it’s important to build in as many mechanisms of engagement as possible to give them multiple ways to access the information and cut through the noise. Understanding this, Dr. Chikwe and the expanded editorial board are carefully considering how The Annals should adapt content for the evolving and growing online world. The digital future of The Annals is full of promise, according to Dr. Chikwe. Plans include not only providing subscribers with the opportunity to receive weekly content tailored to their specific interests, but also changing how it fosters exchanges with the audience. With the addition of several digital editors to the Annals editorial board, readers can expect to see new content types that help them access and engage with the latest research. This modern multimedia—including educational videos, visual abstracts, infographics, and tweetorials—will highlight various original articles and editorials from the journal, be shared online, and posted daily on social media. “We are working to develop content our readers want—content that encompasses high-impact science, expert reviews, consensus documents, and quality videos, and in the way they want it,” Dr. Chikwe said. “Timely, relevant content is key to real engagement, particularly if we can offer readers and authors ways to immediately comment on and share our digital content.” However, the printed journal will not be forgotten, according to Dr. Chikwe. The Annals team plans on improving the print experience of the journal as well, perhaps moving from large issues featuring more than 100 articles to a more appealing format—slimmer and more frequent, with an even higher-quality graphical design. The most important goal, though, is ensuring The Annals stays the first choice for research and education that informs cardiothoracic surgery, Dr. Chikwe explained. “We will work to guarantee you have a great journal that features an impressive breadth and depth of high-quality research, innovation, and education. You will want to read it every day, and it may even change your practice and your thinking.” Stay informed about the latest Annals news at annalsthoracicsurgery.org.   New Editorial Board Appointees NEW SENIOR EDITORS NEW ASSOCIATE EDITORS NEW EDITORIAL BOARD REVIEWERS Adult Cardiac Pedro Catarino, MD Los Angeles, CA Tirone E. David, MD Toronto, ON, Canada G. Chad Hughes, MD Durham, NC Vinod Thourani, MD Atlanta, GA Adult Cardiac Isaac George, MD New York, NY John Ikonomidis, MD Chapel Hill, NC Marjan Jahangiri, MD London, United Kingdom Niv Ad, MD Silver Spring, MD Bahaaldin Alsoufi, MD Louisville, KY Vinay Badhwar, MD Morgantown, WV Faisal G. Bakaeen, MD Cleveland, OH Yaron D. Barac, MD, PhD Petah Tikva, Israel Michael Chu, MD, FRCSC London, ON, Canada J. Michael DiMaio, MD Plano, TX Dominic Emerson, MD Los Angeles, CA James S. Gammie, MD Baltimore, MD Tracy R. Geoffrion, MD, MPH  Milwaukee, WI A. Marc Gillinov, MD Cleveland, OH Kendra J. Grubb, MD, MHA Atlanta, GA Makoto Hibino, MD Cleveland, OH Syed T. Hussain, MD New York, NY Masashi Kawabori, MD Boston, MA Katie S. Nason, MD, MPH Springfield, MA Olugbenga T. Okusanya, MD Philadelphia, PA Puja Parikh, MD Stony Brook, NY Valerie W. Rusch, MD New York, NY Ashish S. Shah, MD Nashville, TN Fawwaz R. Shaw, MD Atlanta, GA Betty C. Tong, MD, MHS Durham, NC Kerem M. Vural, MD Ankara, Turkey   Congenital Heart Danielle Gottlieb-Sen, MD Baltimore, MD Jeffrey P. Jacobs, MD Gainesville, FL David M. Overman, MD Minneapolis, MN Global Health Jacques Kpodonu, MD Boston, MA   General Thoracic Farhood Farjah, MD Seattle, WA Brian Mitzman, MD Salt Lake City, UT Biostatistics Natalia N. Egorova, PhD New York, NY Stephen Fremes, MD Toronto, ON, Canada Andrew B. Goldstone, MD, PhD New York, NY Gary Grunkemeier, PhD Portland, OR Alexander Iribarne, MD Lebanon, NH Paul Kurlansky, MD New York, NY Asishana A. Osho, MD Boston, MA David Ouyang, MD Los Angeles, CA   Biostatistics Michael E. Bowdish, MD Los Angeles, CA Mario F.L. Gaudino, MD New York, NY CME Gabriel Loor, MD Houston, TX   Perioperative Daniel Engelman, MD Springfield, MA Digital Media and Digital Scholarship Alexander A. Brescia, MD, MSc Ann Arbor, MI Sarah A. Chen, MD, CMI Davis, CA Aleksander Dokollari, MD Toronto, ON, Canada Joshua C. Grimm, MD Philadelphia, PA Jessica G.Y. Luc, MD Vancouver, BC, Canada Amy N. Roach, MD Los Angeles, CA Dominique Vervoort, MD, MPH Toronto, ON, Canada Moritz Wyler von Ballmoos, MD Houston, TX Muhammad H. Zubair, MD  Los Angeles, CA   Science Elaine Tseng, MD San Francisco, CA    

John H. Calhoon, MD STS News, Fall 2022 — As we emerge from the pandemic, it is fascinating to see how much has changed. Expectations of a return to normal just don’t seem possible. Although some things may be better, other daily experiences clearly are not. To me, one thing has become much worse: the relentless barrage of trivial and misleading information and negative news and commentary. The endless accusations of one faction’s bias or maltreatment of the other are difficult to reconcile. Without self-control, this societal noise could wear one out. To avoid these traps, we can remind ourselves how fortunate we are to be cardiothoracic surgeons with the opportunity to make a difference each day in the lives of our patients and their families. Gratitude for my family and friends, and for the many gifts offered by this world, this country, and my community, are a great comfort to me. Nonetheless, the seemingly ever-increasing loss of stability and predictability impacts our ability to effectively manage our lives, both at work and at home. It is all too easy as a surgeon to thrive on the illusion of stability, predictably, and control. With time, I have come to realize the significance of this illusion. The only thing we can control is our response to the noise. Reminding myself of this has helped me be less stressed and more relaxed. Have I experienced burnout? Yes. However, taking the time to occasionally relax and recharge is the best way to manage stress and aim for a bit of balance. Throughout my career, I have turned to senior surgeons—all of whom gave back to our specialty via volunteer work with STS and other organizations—for support and guidance. It is those surgeons and STS that have helped our specialty evolve tremendously since my days as a resident and early career surgeon. Many technologies and techniques that are common today did not exist then. STS has been and continues to be steadfast as a leader in providing hands-on education for thoracoscopic techniques, mitral valve knowledge, TAVR, and so much more. For many of us, STS has played an important role in strengthening our skills and abilities as surgeons and leaders. "We can remind ourselves how fortunate we are to be cardiothoracic surgeons with the opportunity to make a difference each day. John H. Calhoon, MD An array of STS education programs and services—including in-person meetings, webinars, on-demand content, and the STS Cardiothoracic Surgery E-Book—provide members access to the latest science and best practices. The Society also provides special opportunities for residents and early career surgeons to connect with peers and mentors, participate in hands-on training, develop leadership skills with renowned faculty, and participate in STS governance to advance the interests of the specialty. But STS is so much more. It is a catalyst for advances in CT surgery that help surgeons provide the highest quality care and deliver the best patient outcomes. The STS National Database and accompanying research and quality initiatives help drive cardiothoracic surgery innovation and safety. Hospitals and health systems depend on our data to strengthen their performance. Industry uses them to design and improve next generation devices and therapeutics. Data-driven research powers The Annals of Thoracic Surgery, the largest and most read journal in our specialty (congratulations to Dr. Jo Chikwe and her editorial and administrative teams!). And research is the basis for STS’s leadership in guideline development. Most importantly, STS is the only organization engaged in public policy advocacy for cardiothoracic surgeons and the patients, institutions, and communities we serve. STS-PAC is a political action committee in Washington, DC, that exclusively represents the specialty. Let me close by asking each of you: Are you unlocking the full value of your STS membership? Here are five things you can do to become more engaged and give back to the profession: Attend—in person—STS 2023, our 59th Annual Meeting in San Diego (see page 11) Submit an abstract for a presentation at an upcoming STS meeting Contribute an article to The Annals or Annals Short Reports Donate to STS-PAC and develop a relationship with your member of Congress Volunteer to serve as a mentor for a younger surgeon or join an STS Workforce or Task Force Details about these opportunities can be found at sts.org. More to come, John

STS 2023 Abstract Deadline Is Approaching Fast The STS 59th Annual Meeting—to be held January 21–23 in San Diego, California—is the premier forum for sharing research findings, quality initiatives, and cutting-edge techniques with the global cardiothoracic surgery community. Abstract submission closes July 22; there’s still time to submit materials for oral presentations, scientific posters, and surgical videos in: ⊲ Congenital heart surgery ⊲ General thoracic surgery ⊲ Basic science research ⊲ Quality improvement ⊲ Cardiothoracic surgical education ⊲ Physician/provider wellness ⊲ Perioperative management and critical care For authors involved in Phase I, II, or III clinical trials for which no preliminary data will be available by the July deadline, the Society will consider promissory abstracts (data must be available by December 16). In addition, the Society is accepting compelling session proposals that showcase emerging, innovative, and/or critical issues facing the specialty. The deadline for promissory abstracts and session proposals also is July 22. More information is available at sts.org/annualmeeting. Annals Impact Factor Reaches Record High The Society’s peer-reviewed journal, The Annals of Thoracic Surgery, has earned its highest impact factor to date—and the first one over five. The impact factor, an important metric indicating a journal’s influence, measures the frequency with which the average article has been cited in a particular year. For 2021, the impact factor was 5.102, as reported by Clarivate Analytics in its Journal Citation Reports. Notably, The Annals was the most cited journal in cardiothoracic surgery, with more than 45,000 total citations in 2021. Article topics that received the most citations last year include: the Intermacs and STS National Database annual reports; representation of women in STS authorship and leadership positions; adult cardiac infection mitigation strategies; tiered patient triage for adult cardiac and thoracic surgery; sexual harassment in cardiothoracic surgery; and social media’s influence in cardiothoracic surgical literature dissemination. A subscription to The Annals is a benefit of STS membership. To read the journal online, visit annalsthoracicsurgery.org. Leadership Institute Graduates Emerge with Crisis Management, Branding Skills In April, a select group of STS members gathered in Chicago for the capstone event of the 2021-2022 STS Leadership Institute. This program is designed to arm early- and mid-career cardiothoracic surgeons with the skills to lead teams in complex and everchanging health care environments. During the event, participants had plenty of face-to-face time with a world-class faculty—surgeons with exceptional experience in leadership and mentorship roles. Presenters explored the impact of organizational culture and how to influence change, identified tools for effective communication within a diverse working environment, examined strategies for achieving personal goals inside and outside the workplace, defined wellness, and pinpointed skill sets for obtaining work/life balance. In the months leading up to the event, Leadership Institute participants completed three virtual training courses that formed the core curriculum: “Leading During Crisis,” “Building Your Practice and Your Brand,” and “Promoting Your Brand.” The STS Leadership Institute is an educational opportunity with a limited number of seats, and it’s available only to STS Members. The 2022-2023 program is underway, and the next application round will be for the 2023-2024 track. Learn more at sts.org/leadershipinstitute. Anita R. Krueger, MD, connected with fellow faculty members Robert S.D. Higgins, MD, MSHA, and Mara B. Antonoff, MD, at the Leadership Institute capstone event. Latest Webinars Offer Hours of Self-Paced Learning The STS Webinar Series is designed to give participants access to training, techniques, and expert perspectives on a variety of topics in cardiothoracic surgery, allowing them to learn on their own time. The latest installments include: “Dos and Don’ts of the Mobile ECMO Team,” in which a multidisciplinary panel shares their expertise in establishing and maintaining an effective mobile ECMO unit. “Coronary Revascularization Guideline: Why STS and AATS Did Not Endorse,” paneled by senior leaders from STS and the American Association for Thoracic Surgery. The panelists discuss the concerns that informed the decision not to endorse the 2021 Guideline for Coronary Artery Revascularization published in December. “Bronchoscopy: Electromagnetic, Robots, & Ablation,” featuring an international panel of surgeons who share their experiences with electromagnetic and robotic approaches to bronchoscopy, as well as ablation of lung cancers. “Understanding and Implementing the New CoC Lung Cancer Standards,” in which an expert panel discusses the new Quality of Care Measures updated by the American College of Surgeons Commission on Cancer (CoC). “Management of Type B Aortic Dissection: Takeaways from the STS/AATS Guideline,” presented by guideline coauthors, who discuss the key takeaways from this comprehensive, up-to-date summary of the state of the evidence. “Robotic Mitral Valve Repair Essentials,” with world-renowned robotic cardiac surgeons, explores the essential components of successful robotic mitral valve repair and implications for the future of cardiac surgery. These videos and more are available at sts.org/webinars. Surgical Teams Encouraged to Send Data Managers to AQO By attending the 2022 Advances in Quality Outcomes (AQO): A Data Managers Meeting, data managers will learn the newest research discoveries, clinical guidance, and master techniques for harnessing the STS National Database. AQO, October 26–28 in Providence, Rhode Island, will offer tracks for all four components of the Database: Adult Cardiac, Congenital, General Thoracic, and Intermacs/Pedimacs. Surgeon leaders, data managers, and Database platform experts will share valuable findings and approaches to clinical data analysis. Attendees also can submit abstracts for presentation, highlighting the research and performance of participating sites. “Cardiothoracic surgery departments can benefit greatly from the insights presented at AQO,” said Felix G. Fernandez, MD, MSc, Chair of the STS Workforce on National Databases. “I encourage every data manager who works with the STS National Database—or who wants to see how it can help transform quality improvement methods at their site—to join us at the meeting, so that we can keep building upon the Database and optimize the care we provide to our patients.” To learn about AQO abstract submission and registration, visit sts.org/AQO.   Industry Spotlight Videos Illuminate Unmet Needs, Optimal Screening for Lung Cancer The latest videos in Industry Spotlight, a collection from industry partners that highlights cutting-edge techniques, medical devices, and other industry news and education, cover clinically important findings and developments in lung cancer diagnosis and treatment. “Addressing Unmet Needs for Patients with Resectable NSCLC and the Benefits of an MDT Approach” and “The Importance of Early Detection of Lung Cancer: Best Practices to Optimize Screening Programs,” sponsored by AstraZeneca, are ready to watch now at sts.org/industryspotlight. Once posted, Industry Spotlight videos are available for a limited time. New videos will be added periodically. Upcoming STS Course Offers In-Person Critical Care Training Now is the time to join colleagues for face-to-face fellowship, the newest scientific breakthroughs, and the opportunity to learn state-of-the-art techniques in critical care. The 19th Annual Perioperative and Critical Care Conference will take place September 8–10 in Denver, Colorado. This event—which attracts attendees and faculty from around the world—is designed to enhance knowledge and expertise in cardiovascular and thoracic critical care as well as in enhanced recovery after surgery. Abstracts are being accepted through July 13 and registration is open at sts.org/criticalcare. Coronary Conference Marked First-of-Its-Kind Experience in Ottawa Attendees from 18 countries converged in June for the 2022 STS Coronary Conference, which delivered state-of-the-art training in coronary artery surgery, late-breaking science abstracts, and a world-renowned faculty. The 2-day conference, held in Ottawa, Ontario, Canada, was a unique experience, featuring didactic presentations, “How I Do It” video sessions on surgical techniques, practical tips and tricks, in-depth abstracts sessions, and case-based panel discussions.  Topics focused on the current state of revascularization, conduit selection and harvest, graft configuration, off- and on-pump coronary artery bypass grafting (CABG), endarterectomy, low ejection fraction, minimally invasive CABG, myocardial revascularization, CABG and fractional flow reserve, and post-operative medical therapy. Sessions were highly interactive, with audience participation and questions encouraged throughout the conference. “We are pleased to report that the conference—the first of its kind—was a resounding success," said course director Marc Ruel, MD, MPH, who serves as STS Canadian Director. "It is germane that cardiac surgeons specialize deeply in advanced coronary surgery, as the field experiences a resurgence, represents about half of what adult cardiac surgeons do, and has been greatly promoted through a widespread emphasis on heart team discussions. More than ever, we need to regularly meet as a strong and innovative community." Those who registered for the Coronary Conference will receive free access to its recorded content. For those who couldn’t attend, the content will be available for purchase in the STS Learning Center at learningcenter.sts.org. STS Leadership Positions: Are You Interested? All members are invited to participate in the Society’s self-nomination process for standing committee and workforce appointments. In order to represent the full gender and ethnic diversity of the membership, STS encourages submissions from all practice types, career levels, disciplines, geographic areas, and other demographics. Submissions will be accepted in August; information on how to self-nominate is available at sts.org/selfnomination. A full list of the Society’s leadership and governance structure can be found at sts.org/leadership. Scholarships Support Attendance at STS Annual Meeting Aspiring cardiothoracic surgeons—and general surgery residents looking for a glimpse at a career in cardiothoracic surgery—have the opportunity to experience the STS Annual Meeting and see what a future in the specialty has to offer. The STS Looking to the Future Scholarship (LTTF) is intended for medical students and general surgery residents. Benefits of the 2023 LTTF scholarship include: ⊲ Complimentary registration for STS 2023—the Society’s 59th Annual Meeting—being held January 21–23 in San Diego, California ⊲ A 3-night stay at an STS-designated hotel ⊲ Participation in exclusive events ⊲ Reimbursement of up to $500 in related travel expenses The following are eligible to apply: ⊲ Medical students training at an institution in the United States or Canada ⊲ Clinical PGY1, PGY2, or PGY3 general surgery residents training at an institution in the United States or Canada ⊲ General surgery residents on dedicated research time who have not started their PGY4 clinical year training at an institution in the United States or Canada Application details will be available later this summer at sts.org/lttf. Previous scholarship recipients are not eligible; however, previous applicants are encouraged to re-apply.

STS News, Summer 2022 — Grassroots advocacy is action that grows organically from the heart of a constituency—its members. And, one of the most powerful types of this grassroots work is patient advocacy. Meet two STS members who have taken patient advocacy to the next level.  The 2019 STS Key Contact of the Year, Rob Headrick, MD, MBA, from CHI Memorial Chest and Lung Cancer Center in Chattanooga, Tennessee, traveled to the White House in late spring to advise the Administration on the mobile lung cancer screening program that he started. The program, known as “Breathe Easy,” features a built-from-scratch bus with a portable computed tomography scanner and brings opportunities for early detection of lung cancer directly into the community. Learn more about the program and Dr. Headrick’s grassroots efforts in the Q&A below. Former STS President Douglas E. Wood, MD, from the University of Washington in Seattle, has taken his patient advocacy to a global level, demonstrating that early detection of lung cancer can have a significant impact in reducing overall cancer mortality. Dr. Wood chaired the Lung Cancer Screening Panel of the National Comprehensive Cancer Network (NCCN) when it was created in 2009. The panel was in the process of creating the first lung cancer screening guidelines when the National Lung Screening Trial (NLST) was published in 2010 (the trial was launched in 2002, and the initial findings were released in November 2010). The NLST demonstrated that a lung cancer screening program could reduce lung cancer mortality by 20%. As Dr. Wood explained, until that point, lung cancer screening hadn’t been accepted as a screening modality and the NLST results “changed the conversation.” However, there was still considerable work to do to get patients access to low-dose CT (LDCT) lung cancer screening. In December 2013, the United States Preventive Services Task Force (USPSTF) granted a B rating for lung cancer screening in adults aged 55 to 80 years who had a 30 pack-year smoking history and were currently smoking or had quit within the past 15 years. The B rating required that private insurance companies cover LDCT scans, but did not extend to Medicare beneficiaries. A Medicare advisory panel advised against screening for Medicare beneficiaries, withholding early detection from those at highest risk for lung cancer. Dr. Wood helped lead a coalition of health professionals to work with Medicare administrators on the safe implementation of screening. In February 2015, Medicare issued a National Coverage Decision providing lung cancer screening as a covered benefit for Medicare beneficiaries. The USPSTF updated its LDCT lung cancer screening recommendations in March 2021 to include adults aged 50 to 80 years who have a 20 pack-year smoking history, and Medicare followed a year later. Unfortunately, they both maintain an upper age limit and the requirement that eligible patients must currently smoke or have quit within the past 15 years. Dr. Wood more recently worked with the President’s Cancer Panel on a report issued in early 2022 that highlighted lung cancer as one of the top four cancers of focus. He also is the vice chair of the National Lung Cancer Roundtable from the American Cancer Society, a consortium of public, private, and voluntary organizations that work together to fight lung cancer by engaging in research and projects that no one organization can take on alone. In addition, Dr. Wood participates in the Lung Cancer Collaboration—a partnership between the World Economic Forum and the Lung Ambition Alliance. This coalition of patient organizations, scientific and medical societies, and industry—which shares the urgent ambition to double 5-year survival in lung cancer by 2030—developed a report that examined lung cancer as global public health issue. The report was presented to the World Health Assembly in May 2022. More information, including important lung cancer references and documents, is available below.   References and Documents from Dr. Doug Wood A report from the President’s Cancer Panel—Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access A report from the President’s Cancer Panel—Lung Cancer Companion Brief Lung Cancer Companion Brief  About the American Cancer Society National Lung Cancer Roundtable World Economic Forum: Urgent, Coordinated Global Action on Lung Cancer Q&A with Dr. Rob Headrick How did you get invited to the White House? We lobbied Washington, DC, and the Tennessee state government for funding to expand the mobile lunger cancer screening concept, but the pandemic put those efforts on hold. In 2021, we announced a partnership with the GO2 Foundation for Lung Cancer, AstraZeneca, Merck & Co., Inc., Bristol Myers Squibb, and a nonprofit foundation to expand the program. This collaboration caught the attention of the Biden Administration and the Cancer Moonshot initiative, and we received an invitation to the White House to help highlight important public-private partnerships that are critical to achieving the Cancer Moonshot goal of decreasing overall cancer mortality by 50% over the next 25 years. It was the highlight of my career to have our many years of work recognized by the White House and used as an example for the type of partnership they are looking for. What did you learn about the Administration’s work to advance lung cancer screening? It was clear to all involved that the quickest way to make progress toward the goal of reducing cancer mortality by 50% is through screening. Lung screening is the biggest first step that will start improving overall cancer mortality rates—which is why the White House was highlighting our mobile program and its effort to reach at-risk rural and underserved populations. The Moonshot leadership recognizes the importance of supporting continued improvements in screening policy. What is the latest on the mobile lung cancer screening bus initiative? The next mobile lung cancer screening bus is currently in the build stage and will hopefully be on the road by January 2023. In order to provide further value to these high-risk patients, the bus will include continued advancements in screening technology such as artificial intelligence (AI), calcium scoring, and possibly bone density assessment. Reliability, remote connectivity, and throughput also will remain priorities in the design. What innovations are there in the lung cancer screening space that STS members and patients should know? Low dose lung screening is much more than just finding lung cancer early. This population also is at high risk for ischemic cardiac mortality. We already use non-gated calcium scores with each lung screening to help protocolize patient risk and make sure appropriate medications are being prescribed. Smoking cessation also is encouraged. There is an opportunity to reduce the cardiac mortality in this population by 30%—similar to the lung screening benefit. In addition, so much data from these scans are not being used. For example, AI will play a role in our future by helping the radiologists read these scans and make better use of the data on the scans to improve the overall health of this population. We will become more efficient at predicting future risk for disease and focusing efforts to help mitigate that risk—all while staying within the low dose parameters and with a short single breath CT scan. How can STS members get involved in supporting the mobile lung cancer screening initiative? The Lung Ambition Alliance—with our help—currently is organizing an international mobile lung screening meeting that will feature all current mobile programs in the US (3) and United Kingdom (1). This meeting will allow those who are interested in developing such a program to learn from the existing programs and ask questions. We are hoping to have the meeting by the fall of 2022. It will likely be held in conjunction with one of the international lung meetings and will include a virtual option for those who cannot attend in person. Mobile lung screening isn’t for everyone, but for many, it is a great way to find lung cancer at an early stage and educate patients in areas where geographic or economic barriers prevent patient engagement. We are always willing to talk with STS members about the business model, discuss how we set up our program, and organize site visits to see the bus.

John H. Calhoon, MD STS News, Summer 2022 — Just a couple of months ago, I was sitting in my office thinking about the importance of leadership during crisis and trying to make sense of the latest tragedy within our borders and the ongoing conflict thousands of miles away in Ukraine. So much violence and so little sense. The Uvalde shooting hit very close to home as the school is located approximately 80 miles from where I live, work, and raise my family, and some of the victims were treated by the trauma team at The University of Texas at San Antonio. And not as close, but just as devastating, are the war in Ukraine and its terrible consequences. Major powers have been unable to stop the fighting, and the war continues with an ongoing loss of life and mounting strife realized by the entire world. Where do we sit in all this, and what should we be doing? Leaders Everywhere, Every Day We are leaders in our communities, our institutions, and our departments and teams. In these times, it is especially important to do our best to serve as wise and measured voices as we keep in mind the duties beyond those of our careers and professions. There are moments in life—like this—when people depend on our leadership to reassure those around us, build connectedness, and inspire confidence. Building Community Importantly, we must recognize the importance of CT surgeons and our professional associations collaborating with and supporting one another. We all have skin in the game and are working toward a common goal of advancing the specialty and providing quality care for our patients. Of course, we all are enthusiastic and excited to return to in-person meetings and resume live learning and networking. Thankfully, once again we are experiencing the power of face-to-face interactions—deeper, more meaningful conversation, handshakes and hugs, a joyful respite from our phones and computers. Meeting Successes The inaugural in-person STS Coronary Conference in Ottawa, Ontario, Canada, was a great success, with nearly 150 attendees gathering from 18 countries last month to discuss the latest techniques for coronary artery bypass surgery. The sold-out, hands-on Workshop on Robotic Cardiac Surgery in Atlanta, Georgia, this spring was another highly regarded success. Right around the corner is the Critical Care Conference in Denver, to be held Sept. 8-10. Boot Camp, scheduled for Sept. 29-Oct. 2, will provide 60 residents with an experiential foundation and hands-on practice in basic cardiothoracic operating skills. Other upcoming meetings include the LatAm meeting in Cartagena, Colombia, being held Dec. 1-3, in conjunction with our colleagues from EACTS. The Society also recently organized a leadership retreat, attended by Drs. MacGillivray, Romano, and Szeto, key STS staff, and me. Together, we began to map out critical initiatives and discussed future opportunities, including a variety of quality education programs that will ensure STS has a clear direction and purpose for years to come. Modernization of the Database During the AATS meeting in May, Dr. Vinay Badhwar, on behalf of his multidisciplinary co-authors, presented an invited landmark paper on mitral valve repair that used data from the STS National Database. This paper, along with several others, showcased the value of the information from the Database. Overall, the Database continues to get stronger, although it has not been without some hurdles as we evolve to a fully digital platform. The Society is continuing to transition data capture and data analytics to internal STS staff, eliminating the need to rely on outside vendors and giving us more authority and responsibility for accurate and timely reports. We are very resolute in this goal. Important Advocacy Work On the advocacy front, the cardiothoracic surgery specialty remains under attack with the possibility of additional cuts to clinical reimbursement. As a founding member of the Surgical Care Coalition, the Society continues to work with the American College of Surgeons and other associations to find longer-term solutions to Medicare’s broken payment system, while also protecting access to necessary surgical procedures and high-quality care for all patients. The STS Government Relations team also remains focused on other important regulatory and legislative issues that are relevant to cardiothoracic surgeons and our patients. There remains much to do—in the ORs, in our institutions, in our communities, for our specialty, and for each other. But I am optimistic that with the help of wise and selfless leaders like you, we have a much better chance. Stay grounded, and do not fall prey to the quicksand around us all. More to come, John.