News & Media

STS News, Fall 2022 — With nearly as many women as men presenting with signs of ischemia in today’s health care settings, clinicians should keep in mind that coronary artery disease (CAD) goes beyond vessel obstruction, especially in female patients—and should take advantage of tools like advanced imaging to see past anatomic walls. “More and more, I think we're recognizing that, when they’re designed for the identification of primarily obstructive CAD, conventional approaches can lead to repeated testing, especially in women,” said Viviany R. Taqueti, MD, MPH, from Brigham and Women’s Hospital in Boston, Massachusetts. “And yet, often without differentiating who’s truly at risk.” Obstructive CAD is just one phenotype of ischemic heart disease, and perhaps just the tip of the iceberg when physicians take into consideration the entirety of coronary circulation, Dr. Taqueti said. A physician needs to spot other pathologies such as diffuse non-obstructive CAD and coronary microvascular dysfunction, which can certainly impact patients’ cardiovascular outcomes, she explained. As an example, Dr. Taqueti referred to a study in Denmark that presented observational data from a large registry of more than 11,000 patients who were referred for coronary angiography. The investigators found that up to a 32% of the male patients—and a startling 65% of female patients—had no significant obstructive disease to explain their symptoms. “We need a more sophisticated toolbox that looks beyond regional wall motion abnormality or even regional perfusion abnormalities to consider and quantify absolute blood flow in the heart and quantify coronary flow reserve, or CFR,” said Dr. Taqueti. Coronary microcirculation is of course too small to be directly imaged in vivo, and it needs to be evaluated indirectly by perturbing function. A variety of technologies make this possible. Coronary microvasculature, especially in female patients, represents the future of prognosis after procedures like CABG, say experts. "Conventional approaches can lead to repeated testing, especially in women. And yet, often without differentiating who’s truly at risk.” Viviany R. Taqueti, MD, MPH In the invasive realm, historically, catheter-guided wire-based testing has provided measurements of CFR and microcirculatory resistance. But noninvasive methods, including cardiac magnetic resonance, Doppler ultrasound, and—the current gold standard—positron emission tomography, are revealing just how prevalent coronary microvascular dysfunction is in patients with angina or signs of ischemia. Data from more angiography studies demonstrated that just under half of the patients had no obstructive disease. “And these were evaluated quite objectively, using fractional flow reserve normal values above 0.8,” Dr. Taqueti explained. But from that group, a large majority—76% to 89%—had some evidence of objective coronary vasomotor dysfunction on testing. “The vast majority of these had coronary microvascular dysfunction, with a minority having pure vasospasm,” said Dr. Taqueti. “This is important because we know that impaired flow reserves—that can certainly be manifestations of coronary microvascular disease—are associated with worse outcomes in terms of cardiac mortality in our patients.” More revelations come with observational data that span multiple research centers: Even in patients with no obvious obstructive lesions or inducible ischemia on stress testing, impaired CFR is independently associated with major adverse events.  In those with significant obstructive CAD, CFR also modifies the outcome of coronary revascularization procedures, especially coronary artery bypass grafting (CABG), Dr. Taqueti pointed out. With long-term cardiovascular outcomes, patients with a severely reduced CFR who underwent CABG did as well as those with a preserved CFR to begin with (adjusted p for interaction = 0.03), suggesting that impaired CFR may serve as a marker for CABG benefit akin to diabetes or SYNTAX score, said Dr. Taqueti.     When severely impaired, coronary flow reserve is even more prognostically significant in women—and may be as useful of a marker for CABG benefit as diabetes or SYNTAX score. In women, severely impaired CFR appears to be even more prognostically significant. “You can see the divergence of the hazard for men and women with a significant interaction for sex as CFR values fall substantially below 2,” Dr. Taqueti explained. “Women appear to fare even worse at the very low range of CFR despite the fact that, when you look at anatomic findings, they are much less likely to have multivessel obstructive disease. In contrast, men were much more likely to have impaired CFR in the presence of multivessel disease—perhaps explaining their impaired flow reserves.” Dr. Taqueti encouraged physicians to consider how these factors reframe their approach to understanding CAD, and to emphasize appropriate diagnostic testing to identify risk, which can help to curb repeated conventional testing in patients at low risk. These recommendations were presented as part of the STS Coronary Conference this summer, in a session devoted to noninvasive diagnostic techniques for evaluation of high-risk ischemic heart disease. The conference united faculty and attendees from 18 countries with a multidisciplinary approach. Course director Marc Ruel, MD, MPH, who serves as STS Canadian Director, touted the camaraderie displayed by participants of all backgrounds. “Surgeons have to be the top experts at understanding the very reason why they operate—or not—on a patient,” Dr. Ruel said. “It comes down to much more than ‘I can do this,’; rather, it should be ‘It is a good idea to be doing this for the patient, and I have the skills to do it.’ The Coronary Conference aimed to achieve this: Expert knowledge and skills in the huge, knowledge-intensive area of coronary surgery.” Strong surgeons need strong cardiologists, anesthesiologists, radiologists, and other experts, Dr. Ruel said. “This is why we made the Coronary Conference so multidisciplinary and team-based, with a focus both on advanced practical knowledge and on advanced technical skills.” “We need to understand microvascular disease in order to better treat ischemia in both women and men,” Dr. Taqueti added. “Coronary microvasculature represents an exciting new frontier in cardiovascular disease reduction, and the future is pointing toward a role for coronary microcirculation in macrovessel disease prognosis. That’s something we need to think about in all our practices.”

STS 2023 Abstract Deadline Is Approaching Fast The STS 59th Annual Meeting—to be held January 21–23 in San Diego, California—is the premier forum for sharing research findings, quality initiatives, and cutting-edge techniques with the global cardiothoracic surgery community. Abstract submission closes July 22; there’s still time to submit materials for oral presentations, scientific posters, and surgical videos in: ⊲ Congenital heart surgery ⊲ General thoracic surgery ⊲ Basic science research ⊲ Quality improvement ⊲ Cardiothoracic surgical education ⊲ Physician/provider wellness ⊲ Perioperative management and critical care For authors involved in Phase I, II, or III clinical trials for which no preliminary data will be available by the July deadline, the Society will consider promissory abstracts (data must be available by December 16). In addition, the Society is accepting compelling session proposals that showcase emerging, innovative, and/or critical issues facing the specialty. The deadline for promissory abstracts and session proposals also is July 22. More information is available at sts.org/annualmeeting. Annals Impact Factor Reaches Record High The Society’s peer-reviewed journal, The Annals of Thoracic Surgery, has earned its highest impact factor to date—and the first one over five. The impact factor, an important metric indicating a journal’s influence, measures the frequency with which the average article has been cited in a particular year. For 2021, the impact factor was 5.102, as reported by Clarivate Analytics in its Journal Citation Reports. Notably, The Annals was the most cited journal in cardiothoracic surgery, with more than 45,000 total citations in 2021. Article topics that received the most citations last year include: the Intermacs and STS National Database annual reports; representation of women in STS authorship and leadership positions; adult cardiac infection mitigation strategies; tiered patient triage for adult cardiac and thoracic surgery; sexual harassment in cardiothoracic surgery; and social media’s influence in cardiothoracic surgical literature dissemination. A subscription to The Annals is a benefit of STS membership. To read the journal online, visit annalsthoracicsurgery.org. Leadership Institute Graduates Emerge with Crisis Management, Branding Skills In April, a select group of STS members gathered in Chicago for the capstone event of the 2021-2022 STS Leadership Institute. This program is designed to arm early- and mid-career cardiothoracic surgeons with the skills to lead teams in complex and everchanging health care environments. During the event, participants had plenty of face-to-face time with a world-class faculty—surgeons with exceptional experience in leadership and mentorship roles. Presenters explored the impact of organizational culture and how to influence change, identified tools for effective communication within a diverse working environment, examined strategies for achieving personal goals inside and outside the workplace, defined wellness, and pinpointed skill sets for obtaining work/life balance. In the months leading up to the event, Leadership Institute participants completed three virtual training courses that formed the core curriculum: “Leading During Crisis,” “Building Your Practice and Your Brand,” and “Promoting Your Brand.” The STS Leadership Institute is an educational opportunity with a limited number of seats, and it’s available only to STS Members. The 2022-2023 program is underway, and the next application round will be for the 2023-2024 track. Learn more at sts.org/leadershipinstitute. Anita R. Krueger, MD, connected with fellow faculty members Robert S.D. Higgins, MD, MSHA, and Mara B. Antonoff, MD, at the Leadership Institute capstone event. Latest Webinars Offer Hours of Self-Paced Learning The STS Webinar Series is designed to give participants access to training, techniques, and expert perspectives on a variety of topics in cardiothoracic surgery, allowing them to learn on their own time. The latest installments include: “Dos and Don’ts of the Mobile ECMO Team,” in which a multidisciplinary panel shares their expertise in establishing and maintaining an effective mobile ECMO unit. “Coronary Revascularization Guideline: Why STS and AATS Did Not Endorse,” paneled by senior leaders from STS and the American Association for Thoracic Surgery. The panelists discuss the concerns that informed the decision not to endorse the 2021 Guideline for Coronary Artery Revascularization published in December. “Bronchoscopy: Electromagnetic, Robots, & Ablation,” featuring an international panel of surgeons who share their experiences with electromagnetic and robotic approaches to bronchoscopy, as well as ablation of lung cancers. “Understanding and Implementing the New CoC Lung Cancer Standards,” in which an expert panel discusses the new Quality of Care Measures updated by the American College of Surgeons Commission on Cancer (CoC). “Management of Type B Aortic Dissection: Takeaways from the STS/AATS Guideline,” presented by guideline coauthors, who discuss the key takeaways from this comprehensive, up-to-date summary of the state of the evidence. “Robotic Mitral Valve Repair Essentials,” with world-renowned robotic cardiac surgeons, explores the essential components of successful robotic mitral valve repair and implications for the future of cardiac surgery. These videos and more are available at sts.org/webinars. Surgical Teams Encouraged to Send Data Managers to AQO By attending the 2022 Advances in Quality Outcomes (AQO): A Data Managers Meeting, data managers will learn the newest research discoveries, clinical guidance, and master techniques for harnessing the STS National Database. AQO, October 26–28 in Providence, Rhode Island, will offer tracks for all four components of the Database: Adult Cardiac, Congenital, General Thoracic, and Intermacs/Pedimacs. Surgeon leaders, data managers, and Database platform experts will share valuable findings and approaches to clinical data analysis. Attendees also can submit abstracts for presentation, highlighting the research and performance of participating sites. “Cardiothoracic surgery departments can benefit greatly from the insights presented at AQO,” said Felix G. Fernandez, MD, MSc, Chair of the STS Workforce on National Databases. “I encourage every data manager who works with the STS National Database—or who wants to see how it can help transform quality improvement methods at their site—to join us at the meeting, so that we can keep building upon the Database and optimize the care we provide to our patients.” To learn about AQO abstract submission and registration, visit sts.org/AQO.   Industry Spotlight Videos Illuminate Unmet Needs, Optimal Screening for Lung Cancer The latest videos in Industry Spotlight, a collection from industry partners that highlights cutting-edge techniques, medical devices, and other industry news and education, cover clinically important findings and developments in lung cancer diagnosis and treatment. “Addressing Unmet Needs for Patients with Resectable NSCLC and the Benefits of an MDT Approach” and “The Importance of Early Detection of Lung Cancer: Best Practices to Optimize Screening Programs,” sponsored by AstraZeneca, are ready to watch now at sts.org/industryspotlight. Once posted, Industry Spotlight videos are available for a limited time. New videos will be added periodically. Upcoming STS Course Offers In-Person Critical Care Training Now is the time to join colleagues for face-to-face fellowship, the newest scientific breakthroughs, and the opportunity to learn state-of-the-art techniques in critical care. The 19th Annual Perioperative and Critical Care Conference will take place September 8–10 in Denver, Colorado. This event—which attracts attendees and faculty from around the world—is designed to enhance knowledge and expertise in cardiovascular and thoracic critical care as well as in enhanced recovery after surgery. Abstracts are being accepted through July 13 and registration is open at sts.org/criticalcare. Coronary Conference Marked First-of-Its-Kind Experience in Ottawa Attendees from 18 countries converged in June for the 2022 STS Coronary Conference, which delivered state-of-the-art training in coronary artery surgery, late-breaking science abstracts, and a world-renowned faculty. The 2-day conference, held in Ottawa, Ontario, Canada, was a unique experience, featuring didactic presentations, “How I Do It” video sessions on surgical techniques, practical tips and tricks, in-depth abstracts sessions, and case-based panel discussions.  Topics focused on the current state of revascularization, conduit selection and harvest, graft configuration, off- and on-pump coronary artery bypass grafting (CABG), endarterectomy, low ejection fraction, minimally invasive CABG, myocardial revascularization, CABG and fractional flow reserve, and post-operative medical therapy. Sessions were highly interactive, with audience participation and questions encouraged throughout the conference. “We are pleased to report that the conference—the first of its kind—was a resounding success," said course director Marc Ruel, MD, MPH, who serves as STS Canadian Director. "It is germane that cardiac surgeons specialize deeply in advanced coronary surgery, as the field experiences a resurgence, represents about half of what adult cardiac surgeons do, and has been greatly promoted through a widespread emphasis on heart team discussions. More than ever, we need to regularly meet as a strong and innovative community." Those who registered for the Coronary Conference will receive free access to its recorded content. For those who couldn’t attend, the content will be available for purchase in the STS Learning Center at learningcenter.sts.org. STS Leadership Positions: Are You Interested? All members are invited to participate in the Society’s self-nomination process for standing committee and workforce appointments. In order to represent the full gender and ethnic diversity of the membership, STS encourages submissions from all practice types, career levels, disciplines, geographic areas, and other demographics. Submissions will be accepted in August; information on how to self-nominate is available at sts.org/selfnomination. A full list of the Society’s leadership and governance structure can be found at sts.org/leadership. Scholarships Support Attendance at STS Annual Meeting Aspiring cardiothoracic surgeons—and general surgery residents looking for a glimpse at a career in cardiothoracic surgery—have the opportunity to experience the STS Annual Meeting and see what a future in the specialty has to offer. The STS Looking to the Future Scholarship (LTTF) is intended for medical students and general surgery residents. Benefits of the 2023 LTTF scholarship include: ⊲ Complimentary registration for STS 2023—the Society’s 59th Annual Meeting—being held January 21–23 in San Diego, California ⊲ A 3-night stay at an STS-designated hotel ⊲ Participation in exclusive events ⊲ Reimbursement of up to $500 in related travel expenses The following are eligible to apply: ⊲ Medical students training at an institution in the United States or Canada ⊲ Clinical PGY1, PGY2, or PGY3 general surgery residents training at an institution in the United States or Canada ⊲ General surgery residents on dedicated research time who have not started their PGY4 clinical year training at an institution in the United States or Canada Application details will be available later this summer at sts.org/lttf. Previous scholarship recipients are not eligible; however, previous applicants are encouraged to re-apply.

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.