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On April 24, 2026, the STS Leadership Institute convened in Chicago for its second session in a five-part leadership development series. Held at the Fairmont Chicago, the one-day program brought together more than 40 participants, six task force surgeons, and five faculty members to explore team dynamics, personal growth, and leadership effectiveness. The event began with a welcome reception the evening prior, fostering early connections among attendees.

The Leading Others session focused on core leadership competencies, including leading diverse teams, managing conflict, evaluating performance, and cultivating a culture of wellness—skills essential for cardiothoracic surgeons navigating increasingly complex clinical and organizational environments.

Interactive Learning and Practical Leadership Strategies

The program opened with remarks from STS President Vinay Badhwar, MD, and course director Mara B. Antonoff, MD, who emphasized the importance of continuous leadership development. Early sessions, led by Dr. Antonoff and Ram Kumar Subramanyan, MD, PhD, examined how individual growth strengthens team leadership.

Attendees engaged in interactive case scenarios and small-group discussions, with a focus on evaluating early-career colleagues—an increasingly important skill as participants step into leadership roles. “Programs like this reinforce that leadership is a skill we have to continually refine,” said Leadership Institute participant Evan Alicuben, MD. “The combination of self-reflection and practical application made it relevant to how we lead our teams every day.”

Afternoon sessions continued with case-based discussions on conflict management, drawing on the “Five Dysfunctions of a Team” framework. Participants worked in table groups to analyze interpersonal dynamics and develop actionable strategies. “The case-based format and small-group discussions really brought the concepts to life,” said Leadership Institute participant Kyla Joubert, MD. “We were able to work through real scenarios and leave with strategies we can apply right away in our own institutions.” A session on fostering a culture of wellness, led by Melanie A. Edwards, MD, reinforced the role of leadership in supporting team well-being and resilience.

Throughout the day, the emphasis on case scenarios and small-group dialogue created an engaging environment for exchanging perspectives and applying concepts in practice.

Looking ahead, the STS Leadership Institute will continue its curriculum with additional sessions leading to a capstone at the 2027 STS Annual Meeting in San Diego, creating an ongoing development experience to help participants lead effectively in a rapidly evolving healthcare landscape.

Postoperative atrial fibrillation (POAF) remains the most common complication following cardiac surgery—and a persistent challenge for clinicians seeking consistent, evidence-based management. In response, the Society of Thoracic Surgeons (STS) has released new clinical practice guidelines, now published in The Annals of Thoracic Surgery, outlining a comprehensive, surgery-specific framework for the prevention and treatment of POAF.

A Multidisciplinary, Evidence-Driven Effort

Co-led by Subhasis Chatterjee, MD, of Baylor College of Medicine, and Stefano Schena, MD, PhD, of Medical College of Wisconsin, the STS 2026 Clinical Practice Guidelines for the Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation after Cardiac Surgery were developed through a multidisciplinary effort by the STS Workforce on Evidence-Based Surgery. The group evaluated contemporary evidence to generate practical, consensus-based recommendations focused specifically on the prevention and treatment of POAF after cardiac surgery.

A Phase-Based Framework Across the Surgical Continuum

The document establishes a phase-based framework spanning the preoperative, intraoperative, and postoperative periods. Drawing from randomized and observational studies, the panel graded recommendations using standardized methods aligned with American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and STS harmonization guidelines.

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

The guidelines also underscore that POAF is distinct from preexisting atrial fibrillation, with different mechanisms, natural history, and management implications. Core strategies include careful rhythm monitoring, early rate or rhythm control, and individualized anticoagulation decisions. At the same time, the document acknowledges ongoing uncertainty regarding optimal anticoagulation timing and duration, arrhythmia burden, and the role of adjunctive surgical interventions.

Addressing Uncertainty and Variability in Practice

Dr. Schena noted that the guideline development process highlighted the variability in clinical practice and the limitations of available evidence. “The time spent discussing and reviewing helped us recalibrate our stance and recognize how limited the evidence truly is for many commonly used interventions,” he said. While no single strategy eliminates POAF, he emphasized that its clinical impact can be reduced through a combination of measures applied across all phases of care. He also noted that the long-term implications of POAF in patients without prior atrial fibrillation remain uncertain and must be weighed against individual patient risk factors.

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

Read the Annals article.