News & Media

STS News, Fall 2022 — The highly anticipated new season of The Resilient Surgeon is underway, featuring game changers in the high-performance and wellness space, including a professor of leadership at Harvard Business School, a performance coach, and a psychiatrist. This provocative STS podcast series aims to help surgeons be their best selves inside and outside of the operating room. “The choice of guests featured this season parallels a paradigm I developed called ‘Best Self Pie,’” said Michael A. Maddaus, MD, host of The Resilient Surgeon. “I prefer the term ‘best self’ to the word wellness because it is an intuitive and personal reference point that we all have, if we are aware enough." The first piece of the “pie”—individual habits and activities such as sleep, diet, exercise, gratitude, and connection with others—were covered in the first season of the podcast; whereas the additional pieces—self-awareness, purpose, and connection at work and home—will be tackled in Season 2 of The Resilient Surgeon, which began airing in late August. The episodes will be released biweekly with a lineup that includes: Brad Stulberg: author of The Practice of Groundedness discusses being successful without crushing the soul (self-awareness and habits) Marcus Buckingham: world expert on engagement at work and the author of Love + Work provides a master class on finding purpose by embracing our "wyrd" (self-awareness and purpose) Amy C. Edmondson, PhD: professor of leadership at Harvard Business School and author of seven books discusses psychological safety and its crucial role in performance, creativity, and wellbeing (all four) Paul M. Conti, MD: psychiatrist who specializes in mental illness and the impact of life stressors breaks down the epidemic of trauma and how it impacts lives in ways that people may not even realize (self-awareness) Christine Porath, PhD: professor at Georgetown University and author of Mastering Community offers insights on the critical role of being valued and respected in the workplace (connection) Additional guests will include Rich Diviney, Brian R. Little, PhD, and Steve Magness. Subscribe to Surgical Hot Topics via your favorite podcast app, or find the episodes at sts.org/podcast. Social media postings about the series will include the hashtag #BeYourBestSelf.

Lui Promoted at Stanford Natalie S. Lui, MD, recently was appointed associate medical director for surgical services as part of the cancer destination service line (DSL) at Stanford Health Care in California. She will work collaboratively with cancer DSL leadership and key stakeholders throughout Stanford Medicine to ensure consistent representation of surgical oncology. Dr. Lui also is an assistant professor of cardiothoracic surgery at Stanford University. She has been an STS member since 2014. Thompson Is President at Nebraska Heart Richard B. Thompson, MD, MBA, took over as president of CHI Health Nebraska Heart in Lincoln. In addition to this new leadership role, he will serve as cardiothoracic surgeon, specializing in complex coronary revascularization, advanced surgical therapy for heart failure, and robotic lung surgery. Previously, Dr. Thompson worked at Bryan Heart in Lincoln, Nebraska. He has been an STS member since 2010. Kaneko Leads Cardiac Surgery at WashUMed Tsuyoshi Kaneko, MD, has been named the Shoenberg Professor and chief of cardiac surgery at Washington University School of Medicine and Barnes-Jewish Hospital, both in St. Louis, Missouri. He previously worked as surgical director of the Structural Heart Program at the Brigham and Women’s Hospital and associate professor in surgery at Harvard Medical School in Boston, Massachusetts. An STS member since 2014, Dr. Kaneko chairs the STS/ACC TVT Research and Publications Subcommittee and is vice chair of the STS Workforce on Technology and Innovation. Argote-Greene Begins Position in Florida Luis M. Argote-Greene, MD, is the new regional director of thoracic and esophageal surgery at the Cleveland Clinic Indian River Hospital in Vero Beach, Florida. Most recently, he was a thoracic surgeon with University Hospitals and clinical assistant professor at Case Western Reserve University, both in Cleveland, Ohio. Dr. Argote-Greene has been an STS member since 2011. Steliga Is Named Endowed Chair Matthew A. Steliga, MD, has been named the Kent Westbrook Distinguished Chair in Surgical Oncology at the University of Arkansas for Medical Sciences (UAMS)-Rockefeller Cancer Institute in Little Rock. Dr. Steliga—the division chief of thoracic surgery at the University of Arkansas and professor of surgery—led the development of the UAMS lung cancer screening and integrated tobacco cessation programs, and he is involved in the development of the UAMS mobile lung screening program. Dr. Steliga also will continue to serve as associate program director for the UAMS Surgery Residency Program. He has been an STS member since 2010. Han Honored for Exceptional Patient Care Jason J. Han, MD, received the Don Liu Humanism Hero in Surgery Award from Penn Medicine in Philadelphia, Pennsylvania. This award recognizes a member of the Penn surgical staff who exhibits compassion and sensitivity in the care of the surgical patient in a collegial, collaborative, selfless, and ethical manner. Dr. Han was selected by the chairman and vice chair of education based on peer and faculty nominations. He has been an STS member since 2018. Hoff Moves to Miami Steven J. Hoff, MD, has joined the Miami Cardiac & Vascular Institute in Florida. Previously, he served as chief of cardiothoracic surgery at Orlando Regional Medical Center and associate professor of surgery at the University of Central Florida College of Medicine in Orlando. Dr. Hoff also was part of the team at the Orlando Health Heart & Vascular Institute. He has been an STS member since 2000.

STS News, Fall 2022 — With nearly as many women as men presenting with signs of ischemia in today’s health care settings, clinicians should keep in mind that coronary artery disease (CAD) goes beyond vessel obstruction, especially in female patients—and should take advantage of tools like advanced imaging to see past anatomic walls. “More and more, I think we're recognizing that, when they’re designed for the identification of primarily obstructive CAD, conventional approaches can lead to repeated testing, especially in women,” said Viviany R. Taqueti, MD, MPH, from Brigham and Women’s Hospital in Boston, Massachusetts. “And yet, often without differentiating who’s truly at risk.” Obstructive CAD is just one phenotype of ischemic heart disease, and perhaps just the tip of the iceberg when physicians take into consideration the entirety of coronary circulation, Dr. Taqueti said. A physician needs to spot other pathologies such as diffuse non-obstructive CAD and coronary microvascular dysfunction, which can certainly impact patients’ cardiovascular outcomes, she explained. As an example, Dr. Taqueti referred to a study in Denmark that presented observational data from a large registry of more than 11,000 patients who were referred for coronary angiography. The investigators found that up to a 32% of the male patients—and a startling 65% of female patients—had no significant obstructive disease to explain their symptoms. “We need a more sophisticated toolbox that looks beyond regional wall motion abnormality or even regional perfusion abnormalities to consider and quantify absolute blood flow in the heart and quantify coronary flow reserve, or CFR,” said Dr. Taqueti. Coronary microcirculation is of course too small to be directly imaged in vivo, and it needs to be evaluated indirectly by perturbing function. A variety of technologies make this possible. Coronary microvasculature, especially in female patients, represents the future of prognosis after procedures like CABG, say experts. "Conventional approaches can lead to repeated testing, especially in women. And yet, often without differentiating who’s truly at risk.” Viviany R. Taqueti, MD, MPH In the invasive realm, historically, catheter-guided wire-based testing has provided measurements of CFR and microcirculatory resistance. But noninvasive methods, including cardiac magnetic resonance, Doppler ultrasound, and—the current gold standard—positron emission tomography, are revealing just how prevalent coronary microvascular dysfunction is in patients with angina or signs of ischemia. Data from more angiography studies demonstrated that just under half of the patients had no obstructive disease. “And these were evaluated quite objectively, using fractional flow reserve normal values above 0.8,” Dr. Taqueti explained. But from that group, a large majority—76% to 89%—had some evidence of objective coronary vasomotor dysfunction on testing. “The vast majority of these had coronary microvascular dysfunction, with a minority having pure vasospasm,” said Dr. Taqueti. “This is important because we know that impaired flow reserves—that can certainly be manifestations of coronary microvascular disease—are associated with worse outcomes in terms of cardiac mortality in our patients.” More revelations come with observational data that span multiple research centers: Even in patients with no obvious obstructive lesions or inducible ischemia on stress testing, impaired CFR is independently associated with major adverse events.  In those with significant obstructive CAD, CFR also modifies the outcome of coronary revascularization procedures, especially coronary artery bypass grafting (CABG), Dr. Taqueti pointed out. With long-term cardiovascular outcomes, patients with a severely reduced CFR who underwent CABG did as well as those with a preserved CFR to begin with (adjusted p for interaction = 0.03), suggesting that impaired CFR may serve as a marker for CABG benefit akin to diabetes or SYNTAX score, said Dr. Taqueti.     When severely impaired, coronary flow reserve is even more prognostically significant in women—and may be as useful of a marker for CABG benefit as diabetes or SYNTAX score. In women, severely impaired CFR appears to be even more prognostically significant. “You can see the divergence of the hazard for men and women with a significant interaction for sex as CFR values fall substantially below 2,” Dr. Taqueti explained. “Women appear to fare even worse at the very low range of CFR despite the fact that, when you look at anatomic findings, they are much less likely to have multivessel obstructive disease. In contrast, men were much more likely to have impaired CFR in the presence of multivessel disease—perhaps explaining their impaired flow reserves.” Dr. Taqueti encouraged physicians to consider how these factors reframe their approach to understanding CAD, and to emphasize appropriate diagnostic testing to identify risk, which can help to curb repeated conventional testing in patients at low risk. These recommendations were presented as part of the STS Coronary Conference this summer, in a session devoted to noninvasive diagnostic techniques for evaluation of high-risk ischemic heart disease. The conference united faculty and attendees from 18 countries with a multidisciplinary approach. Course director Marc Ruel, MD, MPH, who serves as STS Canadian Director, touted the camaraderie displayed by participants of all backgrounds. “Surgeons have to be the top experts at understanding the very reason why they operate—or not—on a patient,” Dr. Ruel said. “It comes down to much more than ‘I can do this,’; rather, it should be ‘It is a good idea to be doing this for the patient, and I have the skills to do it.’ The Coronary Conference aimed to achieve this: Expert knowledge and skills in the huge, knowledge-intensive area of coronary surgery.” Strong surgeons need strong cardiologists, anesthesiologists, radiologists, and other experts, Dr. Ruel said. “This is why we made the Coronary Conference so multidisciplinary and team-based, with a focus both on advanced practical knowledge and on advanced technical skills.” “We need to understand microvascular disease in order to better treat ischemia in both women and men,” Dr. Taqueti added. “Coronary microvasculature represents an exciting new frontier in cardiovascular disease reduction, and the future is pointing toward a role for coronary microcirculation in macrovessel disease prognosis. That’s something we need to think about in all our practices.”

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.