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The Society of Thoracic Surgeons participated in its first-ever meeting in Africa as a co-organizer of the inaugural EACTS/STS/CSIA Cardio-Thoracic Conference, held Sept. 4-6 at the University of Cape Town Academic Conference Centre in Cape Town, South Africa. View the photo gallery.

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Organized by the European Association for Cardio-Thoracic Surgery (EACTS), The Society of Thoracic Surgeons (STS), and the Cardiac Surgery Intersociety Alliance (CSIA), in association with the Society of Cardiothoracic Surgeons of South Africa, the conference brought together cardiothoracic surgeons, health care leaders, trainees, and other professionals from across Africa and around the world. Held under the theme "In Africa for Africa," the meeting focused on advancing clinical education while strengthening cardiothoracic care across the continent.

The three-day program featured presentations, panel discussions, and hands-on simulation covering coronary, aortic, valvular, thoracic, congenital, and pediatric surgery. Sessions also addressed perioperative care, quality improvement, clinical databases and registries, and strategies to strengthen cardiothoracic programs across Africa through workforce development, training, and infrastructure.

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Participants explored approaches to sustainable program development and institutional partnerships, reflecting the CSIA mission of expanding access to cardiac surgery through collaboration and capacity building. An international faculty from Africa, North America, Europe, Asia, Australia, and South America fostered knowledge exchange and new opportunities for collaboration.

Organizers envision the conference as the first in a series of events across Africa aimed at advancing education, partnership, and cardiothoracic care throughout the region. The meeting marked an important milestone in STS's efforts to support international collaboration and sustainable growth in cardiothoracic surgery worldwide.

The Centers for Medicare & Medicaid Services (CMS) has issued its updated National Coverage Determination (NCD) for transcatheter aortic valve replacement (TAVR), concluding a nine-month review process that included extensive engagement from The Society of Thoracic Surgeons (STS) and partner organizations representing the multidisciplinary heart team, including the American College of Cardiology (ACC), the Society for Cardiovascular Angiography & Interventions (SCAI), and the American Association for Thoracic Surgery (AATS).

The final NCD follows CMS' June 15, 2026, proposed decision to update the existing TAVR coverage policy. Throughout the review, STS provided extensive feedback and advocated for policies that preserve the multidisciplinary heart team model, maintain appropriate cardiac surgeon involvement in TAVR evaluation and care, and support continued evidence development as TAVR expands into additional patient populations and indications. View a comparison chart of the existing NCD, proposed changes, and final policy.

STS Advocacy Throughout the Process 

STS was actively engaged throughout the NCD review, working both independently and as part of a multi-society coalition. The Society submitted formal comments, met with CMS officials involved in developing the policy, engaged CMS leadership, and participated in discussions with the NCD requester Edwards Lifesciences and other professional societies regarding areas of potential consensus. 

Throughout the process, STS consistently advocated for three priorities:

• Preserving the multidisciplinary heart team model as an essential component of TAVR decision-making.
• Maintaining cardiac surgeon involvement in patient evaluation, treatment decisions, and TAVR care.
• Continuing evidence development in areas where important clinical questions remain unanswered.

STS also advocated for expanded evidence development requirements as TAVR moves into newer indications and lower-risk patient populations, including severe bicuspid aortic stenosis, moderate aortic stenosis, pure aortic regurgitation, valve-in-valve procedures, and patients at low surgical risk. 

From the Existing Policy to the Final NCD 

The original TAVR NCD, established in 2012, helped guide the measured adoption of TAVR in the United States by establishing coverage requirements that included participation by a multidisciplinary heart team and the availability of on-site cardiac surgical services.

CMS reopened the NCD in December 2025 following a request from Edwards Lifesciences. During the subsequent review, STS worked to ensure that an updated policy would recognize advances in TAVR while maintaining safeguards that support patient safety, multidisciplinary decision-making, and evidence-based care.

CMS released its final NCD on September 10, 2026. The NCD maintains requirements for hospitals to have on-site cardiac surgery capabilities and access to critical care resources and continues to recognize the multidisciplinary heart team. CMS removed coverage with evidence development (CED) status for severe symptomatic aortic stenosis (AS). It has approved TAVR for asymptomatic severe aortic stenosis but under the provision of CED.

CMS defined the heart team as at least one cardiologist and one surgeon, but also included advanced practice providers, nurses, and other members. While the suitability for surgical aortic valve replacement must be evaluated, the only mandated in-person visit is the TAVR operator. They state that another evaluation by an additional heart team TAVR operator is not required but is covered if performed. A single TAVR operator is acceptable, and it may be a cardiologist or surgeon. If determined appropriate by the heart team, a second operator would be supported and it may be a cardiologist or a surgeon.

What the Final NCD Means

The final policy maintains several important elements of the existing TAVR coverage framework, including:

• Continued requirements for hospitals to have on-site cardiac surgery capabilities.
• Continued access to critical care resources.
• Recognition of the multidisciplinary heart team.
• Coverage with evidence development for asymptomatic aortic stenosis.

Looking Ahead

STS will continue to monitor implementation of the final NCD and advocate for evidence-based TAVR care, patient safety, outcomes, and policies that support multidisciplinary decision-making, appropriate surgical expertise, and rigorous evidence development. 

Summary: The final NCD maintains key elements of the existing TAVR coverage framework, including hospital requirements for on-site cardiac surgery capabilities and critical care resources, continued recognition of the multidisciplinary heart team, and CED for asymptomatic aortic stenosis. While the policy does not incorporate all of STS' recommendations regarding cardiac surgeon involvement and expanded evidence development, STS will continue working to ensure that patient safety, multidisciplinary care, and high-quality clinical evidence remain central to TAVR treatment and coverage decisions. 

Our work does not end with the CMS announcement. This is an opportunity for every surgeon involved in valve therapies to stay actively engaged in your heart team, make every effort to evaluate all patients being considered for TAVR or SAVR, and apply all available evidence to provide informed decisions that protect patients. STS will continue to advocate for evidence-based policies that support multidisciplinary care, appropriate surgical expertise and the highest-quality care for patients with structural heart disease. 

For Sean Jordan, MD, the need was clear: Too many patients across East Tennessee faced significant barriers to lung cancer screening—not because they lacked the need for screening, but because they lacked access to it.

East Tennessee has some of the highest smoking and lung cancer rates in the country, while screening rates remain below national averages. For patients in rural Appalachian communities, mountain roads, long travel distances, limited specialty care, and a lack of CT scanners in many counties can make screening especially difficult.

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Jordan, chief of thoracic surgery and director of lung cancer screening at the University of Tennessee Medical Center (UTMC), saw an opportunity to bring screening directly to the communities that needed it most.

The result is a 45-foot mobile CT lung cancer screening unit designed to serve patients across 21 counties in East Tennessee.

“We needed something that could navigate our geography and be convenient and inviting for patients,” Jordan said.

Making the Mobile Unit a Reality

Bringing the vision to reality required more than clinical expertise. It required funding, collaboration, persistence, and advocacy.

The University of Tennessee Medical Center already had a robust lung cancer screening program, but funding a mobile program presented a significant challenge. Working with Congressman Tim Burchett, the team secured $2.3 million through the U.S. Department of Agriculture to fund the mobile unit and supporting software.

The team then pursued a competitive Rural Health Resiliency grant through the Tennessee Department of Health to support program personnel. STS Advocacy strengthened the application by providing a letter of support from then-STS President Dr. Jenna Romano.

The effort ultimately resulted in a $5.45 million grant—one of the largest awarded in the state—to support personnel for the mobile lung cancer screening program and a mobile mammography program.

Jordan also credits Rob Headrick, MD, chief of thoracic surgery at CommonSpirit-Memorial Hospital-Rees Skillern Cancer Institute-Chattanooga and chair of the STS Workforce on Health Policy, Reform, and Advocacy, with providing guidance and connecting the team with STS Advocacy resources.

Bringing Screening to Patients

The mobile unit will bring CT screening and a multidisciplinary team—including technologists, nurses, patient liaisons, and behavioral health professionals—directly into underserved communities.

“Many patients are not willing to travel outside their communities to seek even basic care,” Jordan said. “We can bring our medical expertise and the CT scanner itself directly to their communities.”

The program will also provide tobacco cessation services, education, and centralized coordination to help patients who need additional care move through the health care system more quickly.

Ultimately, success will be measured by whether more cases of lung cancer are detected at an earlier, more treatable stage.

A medical oncologist once told him that fewer patients seemed to be arriving with stage II and III lung cancer. “That to me is the biggest win I can think of for this community,” Jordan said. “We are shifting the stage of lung cancer earlier to when it is most survivable.”

Leading Through Advocacy

The project took two years to move from funding to implementation, but Jordan hopes its impact extends beyond East Tennessee.

“Reaching out to other mobile lung programs and STS Advocacy can introduce you to a community of like-minded groups” who can share their experiences and help develop programs that work for individual communities, he said.

The experience reinforced Jordan's belief that thoracic surgeons should play a leading role in strengthening screening programs nationwide.

“Apart from patients and families, no one in the hospital sees the benefits of a robust lung cancer screening program as much as thoracic surgeons,” he said. “We should be leaders and advocates for strengthening our own programs and all programs nationwide.”

Now available in audio.

Latest Impact Factor places the journal first in the specialty and in the 95th percentile of surgery journals overall.

The Annals of Thoracic Surgery is now ranked first among cardiothoracic surgery journals based on the latest Journal Impact Factor. The ranking also places the journal in the 95th percentile of surgery journals overall and is the highest Impact Factor in its history.

The Journal Impact Factor is a widely used measure of how frequently on average articles published in a journal are cited by other researchers within two years of publication. It is among the most widely recognized of several indicators used to assess a journal's influence.

"It's a key milestone for the journal," said Editor-in-Chief Joanna Chikwe, MD, chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai Medical Center. "For many years, The Annals has been the primary journal cardiothoracic surgeons tend to read and submit their work to. So, seeing it ranked first in the specialty is a great reflection of the quality of that work and the care that goes into the review process."

The editorial team receives more than 3,000 manuscript submissions each year. Fewer than 10% of original research articles are accepted for publication in The Annals, with approximately 15 to 20 appearing in each monthly issue following editorial assessment and scientific peer review. Dr. Chikwe said the ranking reflects the contributions of the journal's international community of authors, reviewers, and editorial board members.

"Peer review depends on people giving their time and expertise," she said. "Our reviewers help strengthen the science, our editorial board provides thoughtful guidance, and our authors choose The Annals for some of their most important work. This recognition belongs to that community of volunteers who make the journal possible while balancing busy clinical and academic careers."

The journal has also launched the Annals Peer Reviewer Academy, a mentorship program designed to train early-career cardiothoracic surgeons in scientific peer review. The inaugural program received over 45 applications for ~10 available spots.

In 2025, articles published in The Annals of Thoracic Surgery during the previous four years received approximately 13,000 citations. Based on those citation metrics, the journal also ranked ahead of leading journals, including JAMA Surgery.

"We'll continue to focus on publishing compelling research, guidelines, clinical cases and reviews across adult cardiac, thoracic, and congenital heart surgery," Dr. Chikwe said. " Our north star is contributing to better patient care, in a landscape that science and technology are transforming."

Top 10 Cited Articles from The Annals of Thoracic Surgery in 2025