News & Media

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.

STS News, Summer 2022 — From research funding to traveling fellowships to specialized training that can help surgeons introduce state-of-the-art programs worldwide, The Thoracic Surgery Foundation (TSF) offers career-changing opportunities for surgeons at every experience level. Support from TSF can fuel projects like Salvando Corazones (“Saving Hearts”), led by Aldo Rafael, MD, a recipient of the TSF Every Heartbeat Matters award. On their latest mission trip this spring, Dr. Rafael’s team was able to save the lives of 11 patients from underserved regions of Peru. These patients had rheumatic and degenerative cardiac conditions such as rheumatic valvulopathies, aortic aneurysms, and severe coronary artery disease. The team focused on minimally invasive valve replacement, working alongside local surgeons, anesthesiologists, perfusionists and nurses at Dos de Mayo hospital in Lima—and giving them hands-on training in new techniques. “We had the pleasure of showcasing this novel approach to the cardiac surgery department at the hospital,” wrote Dr. Rafael in his TSF report. “There was a collaborative effort with the education and hands-on teaching involved with each surgical case.” All of the patients did well postoperatively, with no significant surgical complications, the team reported. Dr. Rafael has a special place in his own heart for Dos de Mayo because it served as his training ground—he was the first graduate from the institution’s cardiovascular surgery program. Born and raised in Jauja-Junin, Peru, about 6 hours outside Lima, he says he now has the privilege of giving back to his Peruvian community. “Salvando Corazones has allowed me to form a close friendship—a brotherhood—with many healthcare professionals, including doctors, nurses, technicians, and administrative staff,” Dr. Rafael said. The March 2022 Salvando Corazones mission saved the lives of 11 patients who otherwise had no recourse to correct their heart defects. Minimally Invasive Techniques Help Combat Ripple Effects of Rheumatic Fever As a surgeon at Baylor University Medical Center in Dallas, Texas, Dr. Rafael has access to new procedural techniques that under-resourced countries don’t, he stated. “Minimally invasive valve replacement surgery for rheumatic heart disease is the current standard of care. Salvando Corazones focuses on training the local Peruvian medical staff while providing free-of-charge cardiac surgeries to an underserved population.” In 2013, Dr. Rafael’s team introduced Peru’s first minimally invasive valve surgery via mini-sternotomy and utilized new techniques to protect the brain during cardiopulmonary bypass. Then, in 2015, Dr. Rafael performed the first minimally invasive aortic and mitral valve replacements in Peru that were accessed via right mini-thoracotomy. “The March 2022 trip allowed me to introduce a left atrial appendage exclusion device to the surgeons at Dos de Mayo Hospital,” he said. These surgeries helped to ensure improved quality of life for the patients by providing a long-term solution in a region where rheumatic cardiopathy remains an ongoing concern. In low- and middle-income countries, rheumatic fever complicated by rheumatic heart disease still contributes to morbidity and premature death—accounting for up to a quarter of a million deaths every year, Dr. Rafael said. “In our patients at Dos de Mayo Hospital, we found high frequency of rheumatic valve disease—most of them in young patients. These patients usually contract rheumatic fever in childhood or adolescence and develop symptoms between 20 and 40 years of age.” In under-resourced countries, up to 3% of school-aged children have evidence of rheumatic heart disease detected by echocardiography. Dr. Rafael identifies this as a public health problem, one that, thanks to the generosity of donors to TSF and other entities, can be addressed in a concrete way, and can certainly make all the difference for individual patients. Amidst Pandemic, Mission Sent Lifesaving Equipment from Afar In 2020 and 2021, the COVID-19 pandemic prevented the Salvando Corazones team from traveling to Peru. However, they were able to ship two donated heart-lung machines to the hospital. “These costly machines are a limiting factor for regional hospitals in Peru to start cardiac surgery programs,” Dr. Rafael explained. “This has led to a 1,000-person waitlist at Dos de Mayo Hospital, the national referral center for cardiac surgery for 65% of the population on government insurance.” This insurance only partially covers the cost of the surgery and does so for only a limited number of patients per year, he said. Dr. Rafael’s staff teamed up with Peruvian surgeons, perfusionists, nurses, technicians, and administrative support personnel—leaving them with the tools and skills to continue the work. The team also was able to partner with several companies for supply donations, including valves, sutures, lap sponges, cannulas, hemoconcentrators, and more, said Dr. Rafael. Supplies that remain after the Salvando Corazones team’s departure will be used year-round by the Peruvian staff to continue saving lives. Salvando Corazones will celebrate its 10th anniversary this year, and to mark the occasion, Dr. Rafael will host a minimally invasive cardiac surgery symposium at Dos de Mayo, imparting new techniques to more Peruvian surgical teams as part of a cross-continental faculty. “Together, we have delivered—and will continue to deliver—superior patient care, and we have served a role in advancing minimally invasive surgery and therapies for advanced heart failure among the cardiothoracic surgery residency program at Dos de Mayo Hospital,” Dr. Rafael said. “On behalf of all those involved, we are grateful for your generosity, your trust, and—most importantly—your commitment to our medical mission.” Every Heartbeat Matters Is One Among Many TSF Opportunities The TSF Every Heartbeat Matters Award, is only one of a wide array of grant and scholarship opportunities offered by the Society's charitable arm. Applications are open for TSF awards, and the deadline to apply for most is September 15. Learn more at thoracicsurgeryfoundation.org. Annual Report Highlights Results of Awardee Innovation, Donor Generosity Illustrating the stories behind the Foundation’s scholars, investigators, volunteers, and donors, the 2021 TSF Annual Report now is available. The report features breakdowns of award disbursements, testimonials from grant recipients, photos from clinical projects and mission trips, and a listing of major gift donors. In 2021 alone, TSF dispersed more than $1 million in funding for cardiothoracic surgery research, education, and outreach. All TSF administrative costs are absorbed by the Society and corporate grants, meaning that 100% of donations is directed toward award funding. Visit sts.org to read the report.

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.

By Steven J. Yakubov, MD, and Steven B. Duff, MD, from OhioHealth Physician Group in Columbus STS News, Summer 2022 — Valve replacement technology has focused on solving the challenges of lifetime durability, excellent hemodynamic performance that is persistent, avoidance of anticoagulation, and providing access to coronary arteries. Approximately 80% of surgical valve implants (SAVR) are bioprosthetic valves, despite the concerns of long-term durability. Since the advent of transcatheter aortic valve technology (TAVR), some of the durability concerns are lessened due to the availability of TAVR in SAVR. Newer designs in surgical bioprostheses have focused on the ability to enlarge the aortic surgical valve at the time of TAVR in SAVR, as well as newer leaflet treatment techniques to enhance durability of the initial implant. Surgical techniques to enhance hemodynamics have concentrated mostly on root enlargement techniques to allow for implantation of larger surgical valves, thus minimizing the chance of patient prosthesis mismatch and allowing best possible residual gradients. The Tria valve technology is designed to enhance durability and hemodynamic performance of aortic valve replacement. The Tria valve is composed of polymer leaflet technology using proprietary biomedicalgrade siloxane-based polyurethane-urea—LifePolymer (LP) from Foldax, Inc. LP has undergone extensive in vitro and in vivo testing. Surgical aortic valve prosthesis The aortic valve is composed of three flexible LP leaflets solution-cast onto a radiovisible polyether-ether ketone stent with a polytetrafluoroethylene felt sewing ring. This is performed using a robotic manufacturing process, which is highly precise and obviates the need for direct human contact. The valve is prepared in a dry state and requires no preparation prior to implantation. The initial surgical experience or early feasibility was performed as a single-armed clinical study in patients with severe, symptomatic aortic valve disease, evaluating 15 patients at five clinical centers. This demonstrated excellent and sustained outcomes with regard to effective orifice area and hemodynamics, transvalvular gradients, and improvements in New York Heart Association functional classification with a 1-year follow-up. Two postoperative deaths (60 and 90 days) resulted, one related to an unplanned surgery on a renal carcinoma and another not well defined. Surgical mitral valve prosthesis One patient experienced coronary thrombosis at day 92 with thrombus possibly related to the valve sewing ring. The specific leaflet design with linear closure and diastolic inward flexion of commissural posts contribute to the excellent hemodynamics. The early experience was continued for a total enrollment of 40 patients, the results of which are not yet available. An early feasibility surgical aortic valve study has begun in India. An early feasibility study with a surgical mitral valve is underway in the US. The latest iteration of polymer leaflet technology is the development of a transcatheter aortic valve replacement system. This consists of a nitinol frame designed for accommodation to coronary reaccess and a suprannular leaflet design for optimization of hemodynamic performance. The initial experience with this valve system consists of implantation in six ovine subjects for assessment of feasibility. TAVR prosthesis Long-term outcomes with polymer-based leaflet technology, including freedom from anticoagulation and leaflet tearing, will not be known for many years. However, it holds the promise of durability without anticoagulation and hemodynamic performance comparable to transcatheter valve technology. These ideas, as well as improvements in supply chain/production (i.e., fully robotic production and no need for animal products) hold tremendous promise for the advancement of valve replacement technology

Varghese Accepts New Quality Role at Huntsman Thomas K. Varghese Jr., MD, MS, MBA, has been named associate chief medical quality officer at Huntsman Cancer Institute (HCI) in Salt Lake City, Utah. He also will continue to serve as HCI chief value officer, chief of the Section of General Thoracic Surgery at the University of Utah, and professor of surgery at the University of Utah School of Medicine. In addition, Dr. Varghese recently earned his Executive Master of Business Administration degree from the University of Utah. An STS member since 2009, he currently chairs the STS Council of Meetings and Education and is a member of the Workforce on Media Relations and Communications. Dr. Varghese also is the Deputy Editor of Digital Media and Digital Scholarship for The Annals of Thoracic Surgery. Carpenter Named Assistant Dean A.J. Carpenter, MD, PhD, has been appointed assistant dean of graduate medical education for health science systems within the Long School of Medicine at University of Texas (UT) Health Science Center at San Antonio. She has served on the faculty at UT Health San Antonio since 2002 and was appointed director of the residency program in 2014. Dr. Carpenter has been an STS member since 1998. MacGillivray Leads Cardiac Surgery at MedStar Thomas E. MacGillivray, MD, this fall will assume the position of physician executive director of cardiac surgery at MedStar Health and chair of Cardiac Surgery at MedStar Washington Hospital Center in Washington, DC. For 5 years, Dr. MacGillivray has served as the chief of the Division of Cardiac Surgery and Thoracic Transplant Surgery at Houston Methodist in Texas. An STS member since 2003, he is the STS First Vice President and serves on the boards of The Thoracic Surgery Foundation and The Annals of Thoracic Surgery. Kachroo Directs Thoracic Aortic Center Puja Kachroo, MD, has been named surgical director of the Center for Diseases of the Thoracic Aorta at the Washington University School of Medicine in St. Louis  and Barnes-Jewish Hospital in St. Louis, Missouri. She also will continue as cardiac surgeon, with expertise in aortic dissection and thoracic aortic aneurysms. Dr. Kachroo has been an STS member since 2010. Bowdish Assumes Full Professorship Michael E. Bowdish, MD, has been named professor and vice chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai in Los Angeles, California. Previously, he worked as an associate professor of surgery in the Division of Cardiac Surgery at the Keck School of Medicine at the University of Southern California in Los Angeles. An STS member since 2012, Dr. Bowdish serves as chair of the STS Adult Cardiac Surgery Database Task Force. Reddy Oversees Surgical Innovation in Michigan Rishindra M. Reddy, MD, MBA, has been named director of the Center for Surgical Innovation at the University of Michigan in Ann Arbor. Dr. Reddy, chair of the Comprehensive Robotic Surgery program and associate director of the Thoracic Quality Collaborative, will continue his research in lung and esophageal cancer, medical education, and health disparities. He has been an STS member since 2011. Guy Is Vice Chief in PA T. Sloane Guy, MD, MBA, has been appointed vice chief of the Division of Cardiac Surgery and clinical director of cardiac surgery at Jefferson Health in Philadelphia, Pennsylvania. Dr. Guy adds this position to his current roles as professor of surgery and director of minimally invasive and robotic cardiac surgery at Thomas Jefferson University Hospitals. He has been an STS member since 2006. Gunn Takes Helm of ECMO Program Tyler Gunn, MD, has joined the Department of Cardiac Surgery at Cedars-Sinai in Los Angeles, as assistant professor of cardiac surgery. He also will serve as director of the Extracorporeal Membrane Oxygenation Program (ECMO) within the Cedars-Sinai Health System. Dr. Gunn has been an STS member since 2014.

STS News, Summer 2022 — As the world around us becomes increasingly digital, so does the way we communicate, connect, share, and publish scientific research. The Annals of Thoracic Surgery recently launched Annals Short Reports—the new fully open access companion journal. This e-only publication provides a contemporary venue for authors to present their research in a digestible format, while also making it available immediately, permanently, and universally. “Annals Short Reports is a great way to publish and access concise research, reviews, feature articles, and videos—all peer reviewed by The Annals Editorial Board,” said Joanna Chikwe, MD, FRCS, Annals Editor-in-Chief. “Our expanded digital platform will allow readers to combine content from both journals to reflect their interests, with much more frequent updates and mobile access.” Annals Short Reports welcomes a wide range of short-form original research related to clinical advances, current surgical methods, and controversial topics and techniques in the following areas: Adult acquired and congenital cardiovascular disease Thoracic surgery Cardiothoracic transplantation Mechanical circulatory support Perioperative medicine Education and training The “short report” article type requires: < 2,500 words < 4 combined tables/figures < 10 references Also featured are engaging editorials, focused mini-reviews, educational and impactful case reports, “how to do it” technique papers, and images in cardiothoracic surgery. In addition, Annals Short Reports includes a special emphasis on digital media and supplemental content, designed for easy and open sharing of data, results, and content across social media and other channels. According to Dr. Chikwe, this format facilitates a more efficient review process, with a shorter time to decision. All published articles are expected to be indexed in PubMed within the next 6 to 12 months. Annals Short Reports follows the high standards of The Annals and is supported by the same expert Editorial Board team. The open access journal now is accepting submissions. For more information, visit sts.org/annals.

STS News, Summer 2022 — While the fighting in Ukraine rages on, global congenital heart surgeon William M. Novick, MD, can be found in the operating rooms of hospitals throughout the war-torn country, saving lives of the littlest patients. These operations are considered challenging; they are complex, dynamic, and often time- and resource-constrained. Not to mention the additional risks that result from the fighting and life-threatening danger on the other side of the hospital walls. “When I hold a child’s heart in my hands, I experience an extremely scary, humbling, and challenging series of thoughts,” said Dr. Novick. “Scary, because that child might die. Humbling, in that God gave me the ability to do this. Challenging, because we want to save every child no matter how bad the defect is.” Dr. Novick, from the University of Tennessee Health Science Center in Memphis, and his team from the Novick Cardiac Alliance have traveled to Ukraine several times over the years, and they’ve committed to four visits in 2022. So far, they have completed three—traveling to the country in January, March, and, most recently, in June. “The physical damage being caused in the country is going to set back medical care in Ukraine years, maybe decades,” he said. “We were in the country during the last week of January and the first week of February. While our team was there, there was a developing threat of a Russian invasion, with troops already staging on the border and in Belarus.” Dr. William Novick champions the expansion of pediatric cardiothoracic surgery in under-resourced countries, both operating on children and training others to do so. Then, while the team was in Lviv this spring, the far western Ukraine city was bombed, said Dr. Novick. Even so, they worked day and night, desperately trying to complete as many surgeries as they could in a short amount of time. “They put us up in the hospital,” he said. “There’s no room anywhere in the city, in any hotel, because of all the refugees. We took a nap, I talked to the administrator, and then we got started.” Dr. Novick and his team operated on six children: three newborns, and another three who were just days old. Each year, 1 million children in low- and middle-income countries are born with congenital heart disease, according to Dr. Novick, and most do not have adequate pediatric cardiac care. The most challenging place in which he’s operated was Tashkent, Uzbekistan. The conditions included ancient equipment, unclean operating rooms, and dangerous power supplies. “There was a bypass machine—unplugged—on a counter,” said Dr. Novick. “Sitting on the floor next to the machine was a pair of heavy rubber gloves and rubber boots. Our perfusionist went to plug in the bypass machine. Simultaneously, six Uzbeks screamed, ‘NYET! Put on gloves! Put on boots!’ So he did, and when he plugged in the machine, sparks flew.” Dr. Novick explained that many of these countries don’t have any options for heart surgery unless it’s charitable. “And, what makes this work special is we are doing it in places where no one else wants to go,” he said. So Much More than Surgery In addition to their surgical skills and expertise, Dr. Novick and his team in March brought to Ukraine 14 massive bags of supplies to support pediatric heart surgery and pediatric cardiology, and for the trip in June, he shipped 12 pallets of equipment and materials. This is important to note because the Cardiac Alliance works to save lives, but also helps local teams assemble and sustain cardiac centers. In fact, the centers that the Cardiac Alliance builds typically are sustainable within 3 years. “We do pediatric heart surgery, but we also train pediatric cardiologists, and nurses in the ICU, respiratory therapists, those who run the heart-lung machine, and the catheterization lab technicians. We try to get all these people trained up to improve their diagnostic skills, or work on catheterization or anesthesia, and we do a lot of it in conflict zones,” said Dr. Novick. Dr. Novick and the Cardiac Alliance team visited Lviv, Ukraine in June 2022. ‘You Protect People…That’s Your Job’ Dr. Novick is not only doing much of the surgery himself, but he’s also gathering donated supplies, lining up financial contributions, and organizing training programs. Described as the undisputed leader of the Novick Cardiac Alliance, he’s known to run the team with a “thundering hand.” And his work in these countries—especially in Eastern Europe—holds personal significance for Dr. Novick. His grandmother, who is Ukrainian, and his grandfather, who is Russian, escaped Soviet Russia many years ago to settle in the US. With these roots, Dr. Novick credits his father for his “Russian temperament, tenacity, and persistence.” From his mother, he learned “all the soft things” such as his concern for children regardless of where they are in the world and his deep desire to repair children’s hearts. Just as importantly, his parents taught him, “You never, ever intimidate anybody. You protect people that are intimidated or bullied by other people. That’s your job. You’re big enough to do it.’ So that’s the way I was brought up: help those who are not able to help themselves,” Dr. Novick said. Over the years, he has done just that—made saving and protecting lives his life’s work, helping more than 10,000 children in 30+ countries, including places like Libya, Iraq, the Democratic Republic of the Congo, Russia, and China. “I’m very passionate about this work,” Dr. Novick said. “Unless you go to these places, I don’t think you can really grasp how desperate the situation is for these kids and their parents. Our team showing up, and their kid getting operated on—they truly consider it a miracle. I’m very humble about what we do, but you’re in a country of 85 million people and there’s no heart surgery for kids, and your child is one of 18 who gets operated on? I mean, holy moly.” For more information about the Novick Cardiac Alliance, visit cardiac-alliance.org.