Dear Members,
As a Michigan native, I have come to appreciate the seasons and how they offer new perspectives. Spring is here with more daylight, warmer temperatures, and trees full of buds ready to burst. I bought my house because of the 100-year-old crabapple trees full of blooms when we first saw it. I hope everyone is finding some renewed energy and fresh ideas this spring.
I recently had the opportunity to attend the General Thoracic Surgical Club (GTSC) meeting to bestow the STS awards for best abstracts, which were outstanding! I had heard so much about this meeting (as a congenital heart surgeon, I have not been on the invite list before). It was amazing! I loved the sense of community. The science was great. The attendees were energized. And the dance team led by Steve Yang was awesome.
Dr. Dustin Walters, chair of the Workforce on Wellness and section chief of thoracic surgery at the University of Connecticut, gave an inspiring presentation about the power of storytelling and vulnerability. I asked him to help incorporate these concepts into the 2025 Annual Meeting. There is so much healing and support that comes from sharing stories and allowing ourselves to be vulnerable. You will see this theme come up throughout the year as a concept that I think is important to help us maintain purpose, bolster wellness, and maintain balance.
Mentoring a Former Patient Toward a Career in Medicine
Shortly after I returned from the GTSC, I met with an undergraduate interested in a career in medicine. I always enjoy these opportunities to mentor the next generation. But this was not the usual student. I operated on her when she was six years old for a double aortic arch. It was in the days when we were trying to find a purpose for the robot in congenital heart surgery. As it turns out, there is not one, but we learned that the hard way.
She was the ideal candidate based on size and having an atretic arch. All was going well, as the first clip was deployed on the proximal atretic arch. The distal clip on the atretic portion, down near the spine as the aorta passed to the right, “scissored” when it was deployed and sliced the distal aorta. Her chest filled with blood within seconds and my heart sank. Dividing a vascular ring is a quick operation with minimal risk, no need for transfusions, and a small thoracotomy incision. We were quickly connecting the dots of her multiple trocar sites to create a thoracotomy while she received multiple transfusions. Bleeding from the distal aortic stump is challenging because it is bleeding at “the bottom of the bucket” and hard to control. Once her chest was open and vascular control was achieved, the operation was completed. She went home safely several days later.
For years, I carried the feeling that I had failed her. Her scar that would be with her for the rest of her life was worse than it should have been. She had received transfusions that would otherwise have been unnecessary. As surgeons, we always want perfection, and anything less, we are critical of ourselves. Here I was 17 years later, on a Zoom call because her experience as a child inspired her to pursue a career in medicine. She is currently an EMT and has incredible clarity of purpose. She has studied her heart defect and has so many questions about embryology and her surgery. We talked about my career path and her desire to be a doctor. She will shadow me in the OR and the ICU in the coming months to start navigating the journey of what specialty she wants to pursue.
When the call ended, I was struck by the juxtaposition of the best parts of our profession: caring for our patients and mentoring the next generation. It is not often you get to do that with the same person. Out of a moment of being so self-critical and feeling like I had failed, came this amazing opportunity to mentor this now young woman with so many dreams and aspirations.
More stories will come throughout the year. Meanwhile, I want to update you on exciting things occurring with STS. Dr. MacGillivray promoted some great new initiatives as STS president that I am excited and grateful to execute. Several new initiatives are underway to improve the value of the STS for our members.
The Board of Directors approved two major initiatives that will have significant impact on our members: the Nina Starr Braunwald Center and a new nominating process for STS leaders.
Nina Starr Braunwald Center
Last year, Dr. Eugene Braunwald reached out to the STS to express interest in further memorializing the amazing life and career of his wife, Dr. Nina Starr Braunwald. She was the first cardiac surgeon to replace a mitral valve with a prosthesis she created herself, as well as one of the first women to be certified by the American Board of Thoracic Surgery. She practiced in a time when few women were in this field and balanced the challenges of a dual career household and family while being a trailblazer in cardiac surgery. Through many conversations it became clear that her legacy was our future.
The STS will invest $3 million to create the Nina Starr Braunwald Center, a virtual home within the STS designed to support the lives and careers of our female members. The center will encompass a symposium at the STS Annual Meeting, the existing Nina Starr Braunwald Research grants through the Thoracic Surgery Foundation, the Extraordinary Women in Cardiothoracic Surgery Awards and breakfast, and innovative initiatives throughout the year to support, advocate, and educate our members with issues important to women in cardiothoracic surgery.
New Nominating Process for STS Leaders
The Board of Directors also approved a new open nominating process for STS officer and board positions. For the first time, any member may self-nominate or nominate other members for an officer or director position. The purpose is to bring greater transparency and member engagement into our nominating process. A full description of the open positions as well as the requirements of the various roles are posted at STS.org/nominations.
Nominations will be accepted between April 15 and May 31, 2024. I encourage individuals interested in leadership positions to nominate themselves and/or other qualified individuals. The new Nominating Committee, under the leadership of Dr. Bob Higgins, consists of the four immediate past presidents, the current president, and four individuals nominated by each Council.
New Task Force on Thoracic Surgery Initiatives
The STS is comprised of cardiac, thoracic, and congenital heart surgeons. Cardiac surgeons make up 60% of members and represent a sizeable portion of our current leadership slate. Our thoracic surgery colleagues make up 21% of members and have their own important needs and contributions. To better understand and serve their interests, I have created a Presidential Task Force for Thoracic Surgery Initiatives led by Dr. John Mitchell. This Task Force is charged with evaluating the current needs of our thoracic surgery colleagues regarding education, Database, advocacy, industry partnerships, and beyond. I have asked Dr. Mitchell to think big and offer innovative ideas on how STS can best support this valuable segment of our members.
STS National Database
The STS National Database is the “best in class” source of risk-adjusted data for cardiac, thoracic, and congenital heart surgeries. This massive repository of high-fidelity data drives quality care for our patients and defends the value of the work we do every day.
The Database is vast and complex. The world of data is rapidly changing with the evolution of artificial intelligence. It is important that we minimize the data burden and maximize the data benefit. We are engaging in conversations across the specialties to ensure that we are meeting the unique needs of each.
For adult cardiac surgeons, the expanding use of transcatheter valve technologies has changed the landscape in the treatment of valvular disease with a shift toward more complex scenarios. To inform heart team decisions on valve surgery, STS is rolling out new Adult Cardiac Surgery Risk Calculators to include new Isolated tricuspid valve repair and replacement models; updated SAVR models including adjusting for prior TAVR; and multi-valve surgery with or without concomitant CABG and other procedures.
International Leadership
STS is a global organization and often engages in educational programs and initiatives with our international partners. The Workforce on International Education is creating a structure to better engage and assess the purpose and value of our ongoing efforts to educate and support cardiothoracic surgeons around the globe. Through this process, we will provide clarity regarding the goals of our various commitments with measurable outcomes to track how best to support our global community.
Finally, I am looking forward to being together again at STS 2025 next January in Los Angeles. We have done a deep dive into the Annual Meeting structure and content. Our goal is to have a meeting that honors the outstanding tradition of late-breaking science and community while introducing some fresh concepts to meet the needs of our ever-changing profession. Keep your eyes out for updates regarding registration and abstract submissions.
Warm wishes as the trees begin to bloom, and the energy of spring takes hold. I hope that each day you have a moment that reminds you of your purpose and commitment to this great specialty. Too often the noise of the healthcare system and the world distracts us from the gift we are given each day, the opportunity to meaningfully change the life of a patient.
With gratitude for all you do,
Jennifer Romano