Two STS 2024 sessions featured late-breaking research covering new findings on a research study focused on resectable early stage non-small-cell lung cancer and a study that used data to define characteristics associated with long-term survival following esophagectomy for cancer.
Impact of Surgical Factors on Event-Free Survival in the Randomized, Placebo-Controlled, Phase 3 KEYNOTE-671 Trial of Perioperative Pembrolizumab For Early Stage Non-Small-Cell Lung Cancer
In a talk given by presenting author Jonathan David Spicer, MD, PhD, of McGill University, he discussed new findings from the KEYNOTE-671 research study, focused on resectable early stage non-small-cell lung cancer (NSCLC), which have unveiled a significant breakthrough in the treatment landscape.
The study, titled "Impact of Surgical-Related Data on Event-Free Survival in KEYNOTE-671," demonstrated that neoadjuvant therapy with pembrolizumab plus chemotherapy did not delay surgery. "Results showed that neoadjuvant pembrolizumab plus chemotherapy with adjuvant pembrolizumab provided meaningful improvement in EFS," said Dr. Spicer. "This was shown when compared with neoadjuvant chemotherapy alone for resectable early stage NSCLC – regardless of clinical nodal status, baseline disease stage, or type of surgery."
Longitudinal Follow-up of Elderly Patients After Esophageal Cancer Resection in the Society of Thoracic Surgeons General Thoracic Surgery Database
In this study, Justin Blasberg, MD, of Yale School of Medicine, used the STS General Thoracic Surgery Database linked to the Centers for Medicare and Medicaid Services data to define characteristics associated with long-term survival following esophagectomy for cancer. The analysis included 4,798 patients from 207 STS sites who underwent esophagectomy between 2012-2019. "The researchers found that Medicare patients undergoing esophagectomy for cancer exhibit identifiable predictors for long-term survival and readmission," noted Dr. Blasberg. "The absence of pathologic T and N downstaging increases the risk for long-term mortality and readmission."
These findings suggest opportunities to enhance clinical practice and improve outcomes for Medicare patients undergoing esophagectomy for cancer.
On day one of STS 2024, meeting goers attended numerous sessions that explored the growing debate between SAVR and TAVR as treatment options,
Dr. Michael Bowdish presents a late-breaking session on cardiac surgery after TAVR trends and outcomes.
"Improved Longitudinal Outcomes with Surgical Aortic Valve Replacement with Atrial Fibrillation Management over Transcatheter Aortic Valve Replacement Alone," part of the larger "Bring SAVR Back" session given by J Hunter Mehaffey, MD, unveiled Class I guideline recommendations that support atrial fibrillation (AF) treatment during surgical aortic valve replacement (SAVR). And how recently, many low to intermediate risk patients with AF and aortic stenosis (AS) are managed by transcatheter aortic valve replacement (TAVR). And finally, they evaluated real-world longitudinal outcomes of TAVR vs SAVR with or without AF treatment.
"We concluded that in Medicare beneficiaries with AF who required aortic valve replacement, SAVR with concomitant treatment of AF was associated with improved longitudinal survival and freedom from stroke compared to TAVR," noted Dr. Mehaffey. "Consideration should be given for SAVR with AF treatment as a first-line approach for patients with AF requiring aortic valve replacement."
In his discussion of "Robotic Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement: A Propensity Matched Analysis," Vikrant Jagadeesan, MD, presented findings on contemporary data that supports equipoise between surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) for the management of symptomatic severe aortic stenosis (AS). He further explained that controversy exists around the optimal management of patients in low to intermediate risk categories, and how the study compared outcomes of surgical robotic aortic valve replacement (RAVR) to TAVR.
"Compared to TAVR, RAVR was associated with lower stroke and PPM rates, less PVL, and improved 1 year survival," said Dr. Jagadeesan. "And RAVR may provide a safe and effective minimally invasive first-line alternative for low to intermediate risk patients presenting with symptomatic AS."
In a late breaking session titled, "Cardiac Surgery after Transcatheter Aortic Valve Replacement: Trends and Outcomes," Michael Bowdish, MD, illustrated how his research team set out to document trends and outcomes in cardiac surgery following transcatheter aortic valve replacement (TAVR), a topic gaining importance as reports of subsequent cardiac operations and early TAVR explantations increase. Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the study covers adult patients who underwent cardiac surgery after an initial TAVR from January 2012 to March 2023.
"The study findings underscore the escalating need for both aortic and non-aortic valve cardiac surgeries following TAVR," explained Dr. Bowdish. "They note a substantial increase in the frequency of these surgeries, emphasizing the importance of understanding outcomes." He observed elevated risk in these cases, as indicated by mortality and stroke rates, which calls for careful consideration, particularly given the expanding use of TAVR across a broader range of age and risk profiles. Finally, the study suggests the need for ongoing assessment and longitudinal evidence to inform decision-making in the evolving landscape of TAVR applications.
Opening remarks were given by STS President Tom MacGillivary, MD, who introduced the C. Walton Lillehei Lecture from Mortimer J. Buckly, Chairman & CEO, Vanguard.
During the Plenary Speaker event on the main stage, Illya Yemets, MD, PhD, delivered his speech titled, "Ukraine Experience of Cardiac Care from 'Cradle to Longevity' During Russian Invasion," while poignantly reflecting on the past, with hope for the future of Ukraine, which “will not survive without help.”
Congratulations to the winners of this year's CT Surgery Resident Showdown Champions from ... the University of Iowa!
The Society of Thoracic Surgeons (STS) today announced the 2024 Extraordinary Women in Cardiothoracic Surgery Award recipients at its 60th Annual Meeting in San Antonio, Texas.
SAN ANTONIO (January 27, 2024) — The Society of Thoracic Surgeons released late-breaking research scheduled for presentation at the 2024 Annual Meeting taking place January 27 - 29 in San Antonio. The conference, healthcare’s leading scientific and educational convening specializing in cardiothoracic surgery, has a rich history of showcasing clinical trials with a strong foundation of detailed methodology and trusted data collection governed by ethical clinical principles.
On Saturday, January 27 at 9:45 a.m. CT, Christopher Mehta, MD, from Northwestern Memorial Hospital in Chicago, will present “Age-Stratified Surgical Aortic Valve Replacement for Aortic Stenosis: An Analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD).”
During his talk, Dr. Christopher Mehta will provide insight into how comprehensive data helps inform multidisciplinary heart teams in making decisions for patients.
The study is part of the STS 2024 session titled, “Trends and Research from the STS ACSD.” During his talk, Dr. Mehta will provide insight into how comprehensive data help inform multidisciplinary heart teams in making decisions between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) for patients.
Attendees will learn how the national landscape for SAVR and TAVR changed between 2011 and 2022, as experts evaluated age-specific trends and outcomes in surgical aortic valve replacement (AVR) in patients with bicuspid (BAV) or tricuspid (TAV) aortic valve by analyzing data from the STS ACSD.
Throughout the 11-year study, which followed more than 200,000 adult patients with BAV or TAV who underwent AVR for moderate and severe aortic stenosis, age-specific trends and outcomes were evaluated.
Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final rule aimed at reforming the prior authorization (PA) process. The U.S. Department of Health and Human Services (HHS) estimates that these changes will result in approximately $15 billion in savings for physician practices over the next decade.
An in-depth session on day one of STS 2024 will showcase study results of the potential importance of treating preoperative anemia — often a marker of more advanced coronary disease and illness, and often associated with adverse outcomes — to reduce intraoperative RBC transfusions to help improve outcomes after CABG.
“A Mediation Analysis of Anemia and Transfusions with CABG Outcomes in the National STS Database” will be presented at 1:15 p.m. CT on Saturday, January 27, during the STS Annual Meeting. The presentation is part of the STS “How to Achieve a 0% Transfusion Rate after CABG” session.
Dr. Motahar Hosseini, from Massachusetts General Hospital, will report on findings that utilize data of more than 53,000 patients from the National STS Adult Cardiac Surgery Database who underwent CABG in 2019, comparing operative mortality and outcomes of patients who presented with preoperative anemia to those who were non-anemic at baseline.
“Preoperative anemia is associated with increased risk of operative mortality and longer ICU and hospital stays,” said Hosseini. “Interestingly, the study results showed that most of these effects were mediated through the effect of intraoperative RBC transfusions, while the higher association of preoperative anemia and higher rates of postoperative dialysis were largely due to direct effects of anemia itself, and only partially mediated by intraoperative transfusions.”
On day one of STS 2024, Dr. Moritz Wyler von Ballmoos, of Texas Health Resources, will present a session titled, “The STS 2023 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation: Key Takeaways and How Do They Differ from the ACC/AHA Atrial Fibrillation Clinical Practice Guidelines?”
During his talk — one of several STS 2024 sessions to feature late-breaking studies that significantly influence advances in cardiothoracic patient care — Dr. Wyler von Ballmoos will share the latest evidence for surgical ablation (SA) and left atrial appendage occlusion (LAAO) across various clinical scenarios from the clinical practice guidelines. Emphasis is on the evolving role of surgical ablation and left atrial appendage occlusion in managing atrial fibrillation.
The recommendations highlight the importance of a multidisciplinary team, comprehensive assessment, and long-term follow-up with specific attention to diverse clinical scenarios. The Class I recommendation for LAAO and expanded use of SA signify the growing confidence in these interventions based on recent evidence.
This discussion is part of a larger session, titled "Leaving Money on the Table: Benefits of Ablation and Left Atrial Appendage Management in Atrial Fibrillation" that includes four additional presentations on the topic, as well as an expert panel discussion and question and answer sessions that follow each presentation.
The Society of Thoracic Surgeons is excited to reconvene for its 60th Annual Meeting January 27 - 29 in San Antonio, which brings together cardiothoracic surgeons from around the world and features late-breaking scientific research, cutting-edge technologies, innovative cardiothoracic surgery products, and meaningful networking opportunities.
STS 2024 will be held in San Antonio, Texas
This year’s meeting venue, the Henry B. Gonzalez Convention Center, offers attendees – more than 2,000 multidisciplinary cardiothoracic professionals at all career stages – everything they’ll need for a seamless experience with 80 educational sessions throughout the three-day conference.
The morning of Saturday, January 27, kicks off with the Extraordinary Women in Cardiothoracic Surgery Awards Breakfast, which recognizes women surgeons who have achieved excellence in clinical practice and demonstrate integrity, leadership, creativity, and expertise in carrying out day-to-day duties and supporting the specialty.
On Sunday evening, the President's Reception at The Witte Museum – a beautiful and immersive venue "where nature, science, and culture meet – will celebrate the term of current STS President Dr. Tom MacGillivray, as guests experience the history, culture, and natural artifacts of Texas while reuniting with – and meeting new – friends and colleagues.
The STS Annual Meeting exhibit hall will feature live product demonstrations, as well as more than 130 exhibitors showcasing the latest tools and technologies for surgical practice. Conference goers will not want to miss the CT Surgery Resident Showdown final, where the North American and European champions will face off against each other in a test of knowledge.
For the first time, the meeting will include a hub for early career surgeons. At The Hub, located next to the Exhibit Hall, you’ll find early career roundtable discussions with STS leaders, a trainee symposium, a mock oral exam course, an early career insight talk by Dr. Leah Backhus, and more. You also can join your peers in a “painting with a purpose” art installation activity for the Shriners Children's Texas in Galveston.
Attendees will also be able to engage in wellbeing activities, such as step tracking, wellness-related educational sessions, a golf simulator, and more. Industry symposia, held onsite during lunch and offsite in the mornings and evenings, offer opportunities to explore new techniques and interventions. Two exhibit hall theaters will allow attendees to experience e-posters and interactive industry presentations.
There’s still time to register, add ticketed events, and start planning your San Antonio experience at sts.org/annualmeeting.
In this episode of The Resilient Surgeon, Dr. Michael Maddaus interviews Monica Parker, author of The Power of Wonder: The Extraordinary Emotion That Will Change the Way You Live, Learn, and Lead.
Parker has spent decades helping people discover how to lead and live wonderfully by cultivating curiosity, empathy, and open mindedness. Here, she explains the elements and elicitors of wonder, and how it can transform people's brains and bodies. It's about "becoming more wonder-prone and reconnecting with a reverence for the world and all the magic in it."
The editors of the European Journal of Cardio-Thoracic Surgery (EJCTS), The Annals of Thoracic Surgery, and The Journal of Thoracic and Cardiovascular Surgery (JTCVS) recognize the value of a streamlined and consistent submission process. To provide a simplified experience for our authors as they submit, we have harmonized our submission requirements for full-length original research articles. The newly aligned standards are listed below:
4,500 word count maximum (this includes all elements of the manuscript)
Maximum combined limit of seven figures and tables
40 reference maximum
Strict adherence to the AMA Manual of Style for citations
No limit to the number of videos an author can submit
These changes are intended to reduce confusion and save time for our busy authors. These unified requirements will make it easier to resubmit to a different journal, if needed. Additionally, strict adherence to AMA style will make it easier for our authors to use reference management tools such as EndNote, Zotero, and Mendeley.
We are confident that this congruency will simplify the user experience when submitting to EJCTS, JTCVS, and The Annals.
Sincerely,
Joanna Chikwe, MD, Editor-in-Chief, STS Journals
G. Alexander Patterson, MD, Editor-in-Chief, AATS Journals
Matthias Siepe, MD, EACTS Editor-in-Chief
