Cardiothoracic surgery professionals from around the world came together at the 60th Annual Meeting of The Society of Thoracic Surgeons in San Antonio, Texas, January 27-29, 2024.
More than 3,900 registrants from 57 countries were introduced to groundbreaking scientific research, engaged in hands-on demonstrations of new techniques and products, and reconnected with friends and colleagues.
“The Workforce on the Annual Meeting – in collaboration with many other STS Workforces, submitters of session proposals, and the tremendous STS staff – did a great job of putting together content that engaged the attendees, energized discussion, and encouraged practice changes," said STS Workforce on Annual Meeting Chair Karen Kim, MD, MS, an associate professor of surgery at UT Health Austin.
A Successful Prelude to the Annual Meeting
Approximately 130 surgeons, pulmonologists, anesthesiologists, and other transplant team members attended a pre-meeting event, the STS Lung Transplant Symposium: Surgical and Medical Insights for Transplant Assessment and Management. Throughout the day, meeting goers learned about best-practice approaches for surgical and medical care of lung transplant patients – from assessment as candidates through post-surgical care as recipients. Five 90-minute sessions, led by expert panels, covered recipient selection, donor selection, intraoperative management, postoperative management, and challenging situations.
STS National Database Continues to Support Evidence-Based Practice
Several presentations at STS 2024 illustrated the power of the STS National DatabaseTM as an invaluable tool for research and quality improvement. Multiple scientific abstracts throughout the three-day meeting illuminated topics from health disparities to comparative surgical techniques. A well-attended session, “Trends and Research from the STS Adult Cardiac Surgery Database (ACSD),” allowed participants to witness the contemporary and future utility of the Database for gleaning real-time outcomes analysis and advancing the specialty.
Another session examined the ongoing controversy surrounding the choice between multi-arterial grafting and single arterial grafting in coronary artery bypass grafting for multivessel coronary revascularization. The research, involving data on one million patients undergoing isolated CABG with more than two bypass grafts collected from the ACSD and linked to the National Death Index for comprehensive longitudinal survival analysis, found that multi-arterial grafting CABG is associated with superior long-term survival compared to single arterial grafting, establishing it as the preferred surgical strategy for multivessel revascularization.
Adult Cardiac Offerings Underlined Enduring Relevance of Surgical Intervention
Despite advances in percutaneous coronary intervention and transcatheter therapies, surgical intervention is still essential. This year’s adult cardiac sessions emphasized the importance of surgical treatment — be it CABG, SAVR, mitral and tricuspid valve surgery, or concomitant ablation — and its positive impact on long-term outcomes. Hands-on courses allowed attendees to gain the skills and confidence to perform annular enlargement and mitral repair.
The J. Maxwell Chamberlain Memorial Paper illustrated how current aortic valve guidelines for TAVR and SAVR, if not followed, could be risky, especially for younger patients. The expanding use of mechanical circulatory support options – no longer just for bridge-to-transplant or bridge-to-decision scenarios, but also to support higher-risk “everyday” cardiac surgery cases — were explored. World-renowned North American and international surgeons took attendees on an “Odyssey Through the Advanced Aortic Root Universe,” examining aortic valve repair options for severe aortic insufficiency.
Congenital Program Spotlighted Data-Driven Treatment Options
Parallel congenital sessions offered high-quality abstracts highlighting the surgical palliation of hypoplastic left heart syndrome, complex neonatal surgery and neurologic outcomes, big data in congenital cardiac surgery, and temporary and durable mechanical support options for heart failure. Attendees gained insights on long-standing, challenging congenital problems, such as major aortopulmonary collateral arteries, valve-sparing root replacement in pediatric patients, and the double-switch procedure. Additionally, a series of videos demonstrated repair of a complex unicuspid aortic valve using geometric ring annuloplasty and an Ebstein’s anomaly variant with anterior leaflet displacement.
General Thoracic Sessions Focused on Patient Outcomes, Emerging Technologies
General thoracic sessions featured advances in the treatment of lung and esophageal cancer, including insights from the latest clinical trials, innovative techniques, and therapies. The J. Maxwell Chamberlain Memorial Paper reported on a National Cancer Database analysis showing a survival benefit to neoadjuvant chemoimmunotherapy or adjuvant chemoimmunotherapy in stage IB-IIIA non-small cell lung cancer. Another presentation explored the impact of margin distance on locoregional recurrence and survival after thoracoscopic segmentectomy.
New research using information from the STS General Thoracic Surgery Database found that patients with postoperative pulmonary embolism had increased 30-day mortality, reintubation, and readmission rates. Andrea Axtell, MD, MPH, an assistant professor of surgery at the University of Wisconsin School of Medicine and Public Health and the study’s lead author, explained, “By increasing awareness of the increased risk for venous thromboembolism in Black patients, the team hopes to encourage more focused preventative measures in these patients.”
Among the dynamic video presentations were a uniportal video-assisted thoracoscopic surgery left upper lobe sleeve lobectomy, robotic tracheobronchoplasty, robotic-assisted thoracoscopic ligation of refractory thoracic duct leak, and robotic lung transplant.
Perioperative and Critical Care Program Highlighted Comprehensive Treatment Strategies
Topics covered in perioperative and critical care included current strategies for vasoplegic shock, navigating difficult ERAS scenarios, perfusion crisis management, and multidisciplinary team-based approaches to ECMO, whether for shock or pre- and post-transplant. Attendees delved into evolving topics such as frailty assessment and failure to rescue. Abstract presentations using the ACSD investigated the association between preoperative anemia and intraoperative transfusions with operative outcomes of isolated CABG and assessed whether treatment at high-volume centers reverses the adverse impact of area deprivation on outcomes of heart transplantation.
Celebrating Accomplished Women CT Surgeons, Present and Past
More than 340 people attended the second annual STS Extraordinary Women in Cardiothoracic Surgery Award breakfast to recognize and celebrate women cardiothoracic surgeons who have demonstrated excellence in clinical practice and made notable contributions to the specialty. This year’s recipients were Shanda Blackmon, MD, MPH, Baylor College of Medicine; Andrea Carpenter, MD, PhD, UT Health San Antonio; and Jane Schwabe, MD, Mosaic Life Care.
Dr. Blackmon, a thoracic surgeon, first gained recognition for her technical skills in both lung and esophageal surgery, while making significant contributions that extend beyond the operating room. She holds a patent for a novel esophageal anastomotic device, leads critical tumor boards, and has developed innovative digital solutions like the UDD App. And her role as a mentor has made her a role model for aspiring female students and trainees and she has been a vocal proponent of inclusivity.
A thoracic surgeon with an illustrious career marked by a remarkable academic and military background and pioneering surgical techniques, Dr. Andrea Carpenter’s military service is a testament to her resilience and determination. She became the first woman cardiothoracic surgeon to serve as Flight Commander of Cardiothoracic Surgery in the US Air Force’s 58th Medical Wing. Colleagues who work closely with Dr. Carpenter say she is a strong leader who will have a lasting impact in cardiothoracic surgery and a trailblazer for women in the field.
Dr. Schwabe, a thoracic surgeon, has emerged as a woman leader in the field for her clinical excellence – with a deep-rooted dedication to patient care, innovative surgical practices, and health-education focused community service. She has led the development and deployment of several community health initiatives, including Women's Wellness Initiatives, Mission to Move, Live Well St. Joe, and Pound Plunge.
Establishment of the Nina Starr Braunwald Center
In further recognition and support of women cardiothoracic surgeons, STS announced the creation of the Nina Starr Braunwald Center, a virtual destination offering innovative programs, advocacy efforts, education, and scholarships aimed at issues of special interest to women CT surgeons. Watch our video to learn more about Nina Starr Braunwald, MD.
Sessions Illuminated Progress Made Towards Equity
A special Vivien T. Thomas Symposium marked the 20th anniversary of the first healthcare disparities summit held at the STS Annual Meeting. This symposium, titled “The 2nd STS Achieving Equity in Clinical Care and Education Summit,” and Vivien T. Thomas Lecture given by Edward Barksdale, Jr., MD, division chief of pediatric general and thoracic surgery at University Hospitals Rainbow Babies & Children’s Hospital, explored topics such as equity in standard of care treatment, achieving health equity through tools aimed at quality improvement and patient safety, and building workforce equity. The symposium featured insightful panel discussions and an audience Q&A.
Other meeting topics dedicated to meaningful and productive discussions on equity and inclusion included workforce equity in building an environment of belonging and evaluating real-world results in attracting and retaining diverse and elite talent into the specialty.
Finding a Job and Securing a Favorable Contract
Career advancement featured prominently at the Annual Meeting, with a session titled "Let's Make a Deal" that explored how to align incentives to create more equitable and value-based compensation models.
Topics covered included negotiation tactics from the C-suite perspective and how race and gender intersect when it comes to representation and salary. Attendees gained insights on fashioning a successful career from early career surgeons and STS past presidents.
At a standing-room-only session, STS Past President Drs. Mike Mack and Cherie Erkman presented data from the STS’ first annual survey on surgeon compensation, designed to help US-based cardiothoracic surgeons understand their value and make informed career decisions using reliable benchmarks specific to the specialty.
The Hub Makes Its Debut at the 60th Annual Meeting
A new and exciting space, The Hub was the center of activity for programs, networking, and mentoring specifically for cardiothoracic surgery trainees and early career surgeons at STS 2024.
“Having The Hub here at STS for its first year, was super exciting for us," said STS member and STS 2024 attendee Anita Krueger, MD. "It’s great to have a central place for trainees and attendings to be able to come together and network, and answer questions and connect so that we can develop relationships with our trainees to create the future of our specialty. It has been fantastic!”
The Hub hosted a range of early career-focused sessions and educational programs, such as early career journey roundtable discussions with STS leadership, subspecialty training, STS mentorship program meetups, STS and TSRA trainee luncheons, mock oral exam courses, successful career journey tips, and more. Interactive presentations with Q&A included an "Ask the Experts: How I Succeeded as an Early Career Surgeon" expert panel and "Early Career Insights" with Leah Backhus, MD, MPH, an associate professor of surgery at Stanford Medicine.
"The Annual Meeting can be overwhelming to trainees and early career surgeons – I know it was for me when I attended my first one 15 years ago." said Dr. Kim. "The Hub allowed this group of attendees a smaller space to connect, share experiences, network, and relax, with content and activities specifically geared towards their interests and career stage."
Exhibit Hall and Wellness Activities Brought Life to Tools and Technologies
The STS Annual Meeting exhibit hall featured more than 140 exhibitors highlighting the latest tools and technologies for surgical practice and offering live, hands-on product demonstrations. Two exhibit hall theaters allowed meeting goers to experience e-posters and interactive industry presentations, as well as the CT Surgery Resident Showdown.
"The STS Annual Meeting is a great place to connect with others who share the same passion for cardiothoracic surgery, patient care, innovation, and education," said Dr. Kim. "I'm always inspired and energized by it, and I come away with a satisfying sense that for these few days, I was among friends and colleagues who may be the only people who truly understand my professional day-to-day experience and challenges."
Annual Meeting Online Offers Continued Learning Experience
STS 2024 registrants receive complimentary access to Annual Meeting Online, where they can revisit presentations and recordings of missed sessions and earn additional CME credit. Annual Meeting Online is available for purchase at a significant discount for STS Members who did not attend, and access is free to all Resident/Fellow and Medical Student Members. Recordings of the pre-meeting Lung Transplant Symposium are available for purchase separately. Visit STS.org/AMonline to purchase.