News & Media

Reassessing Efficacy: Understanding Failures in Lung Cancer Screening Despite Low-Dose CT Protocol Adherence, a study presented at the 2025 STS Annual Meeting by Case Western Reserve University medical student Victoria Shiqi Wu, analyzes clinical and demographic factors contributing to lung cancer deaths among patients undergoing low-dose CT (LDCT) screening. Despite the substantial benefits of LDCT in detecting lung cancer early, some patients still succumb to the disease, raising important questions about the effectiveness of current screening approaches for certain populations.

The study utilized data from the National Lung Screening Trial, examining 16,081 patients with negative (normal) initial LDCT scans. Screening success was defined as either remaining cancer-free or surviving lung cancer. Screening failure was characterized by:

•    Receiving three negative scans but dying of lung cancer.
•    Being diagnosed with stage 4 lung cancer.
•    Having a positive scan but still succumbing to the disease.
 

Key Findings

Out of the total cohort, 98.1% (15,775 patients) experienced screening success. Among the 306 patients diagnosed with lung cancer, 33.3% had successful outcomes, while 66.6% faced screening failure.

The study identified several factors significantly associated with screening failure, including:

• Age over 70: Patients in this age group faced a 2.65 times higher risk (95% CI: 1.66-4.12).
• Male sex: Male patients were 1.56 times more likely to experience failure (95% CI: 1.13-2.17).
• Current smoking: Smokers had a 2.03 times higher likelihood of screening failure (95% CI: 1.52-2.73).
• Chronic obstructive pulmonary disease (COPD): Patients with COPD had 2.20 times the risk (95% CI: 1.35-3.46).
• Emphysema and sarcoidosis: Patients with these conditions faced elevated risks, with sarcoidosis showing an especially strong association (OR=7.99; 95% CI: 1.24-29.0).
• Firefighting work: Although less common, individuals in this occupation showed higher failure odds (OR=2.14; 95% CI: 0.99-4.07).
  Implications

The findings underscore the need for tailored interventions to improve LDCT screening outcomes for high-risk populations. Enhanced strategies may include:

•    Developing personalized screening protocols.
•    Implementing more aggressive smoking cessation programs.
•    Increasing surveillance for patients with comorbidities like COPD and emphysema.
 

The study highlights the importance of understanding the limitations of LDCT screening and targeting vulnerable groups to maximize its lifesaving potential. By addressing the identified risk factors, healthcare providers can take meaningful steps toward reducing lung cancer mortality.

The Society of Thoracic Surgeons today announced Shanda Blackmon, MD, has been selected as the recipient of the 2025 STS Distinguished Service Award for her outstanding contributions to the field of cardiothoracic surgery at the Society’s 61st Annual Meeting.

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Dr. Blackmon, professor of surgery in the division of thoracic surgery at Baylor College of Medicine and director of The Lung Institute at Baylor Medicine, Houston, has demonstrated exceptional dedication to advancing the field of general thoracic surgery and the mission of the Society. 

Since joining STS in 2004, she has been an active leader and advocate, serving in numerous key roles, including member of the Board of Directors, Chair of the Clinical Practice and Membership Engagement Council, Chair of the Patient Reported Outcomes Task Force, and member of the Workforce on Health Policy, Reform, and Advocacy Committee. Her leadership and vision have significantly shaped STS programs and initiatives, fostering advancements in education, research, and advocacy. In January 2024, Dr. Blackmon received the Extraordinary Woman in Cardiothoracic Surgery Award from STS and Women in Thoracic Surgery.

Dr. Blackmon has served as a passionate mentor, inspiring the next generation of surgeons. She has been a staunch advocate for innovation in minimally invasive thoracic surgery techniques, digital health technology, and process improvement. Her contributions have improved patient outcomes and elevated the standards of care in thoracic surgery.

"Dr. Blackmon embodies the highest standards of leadership, innovation, and dedication to the field of cardiothoracic surgery. Her unwavering commitment to advancing thoracic care and mentoring the next generation of surgeons has left an indelible mark on our Society and the specialty as a whole,” said STS President Jennifer C. Romano, MD, MS.

A notable expert in the treatment of esophageal cancer and complex airway diseases, Dr. Blackmon has authored or co-authored more than 200 published articles. She holds multiple patents, including one for a novel esophageal anastomotic device, minimally invasive surgical instrumentation, and concepts for 3D printing. She also has an educational YouTube video-based platform for resident and patient education.

Dr. Blackmon earned a bachelor’s degree at the University of Texas in Austin, a Master of Public Health from Emory University, and a medical degree from Morehouse School of Medicine. She completed her general surgery residency in Atlanta and her cardiothoracic surgery residency at Baylor College of Medicine. She served as an instructor in thoracic surgical oncology at UT MD Anderson Cancer Center.

Dr. Blackmon is deeply committed to community engagement and often participates in programs aimed at improving health literacy and access to care for underserved populations. A wife and mother of three children, she is an outdoor enthusiast who enjoys hiking, biking, and other activities with her family.

Cardiothoracic surgeon Mark Rodefeld, MD, today was presented with the Earl Bakken 2025 Scientific Achievement Award at The Society of Thoracic Surgeons’ 61st Annual Meeting in Los Angeles.

Dr. Rodefeld is renowned for his groundbreaking development of a "Fontan pump," designed to provide right-side or subpulmonary circulatory support for patients with single-ventricle heart defects. These patients face lifelong circulatory challenges following Fontan palliation due to the lack of a subpulmonary ventricle. Dr. Rodefeld's work addresses this issue by restoring a subpulmonary power source to effectively normalize circulation. Computational modeling, animal studies, and preclinical device development have demonstrated the pump’s potential to neutralize Fontan circulatory inefficiency, offering hope for improved long-term health and outcomes.

“Dr. Mark Rodefeld’s contributions as an innovator and pioneer in cardiothoracic surgery are a true testament to his veracity and perseverance,” said STS President Jennifer C. Romano, MD, MS. “His work will continue to inspire the field and revolutionize the treatment of single-ventricle heart disease. He shows us that with unyielding determination, even the most complex challenges can lead to transformative change.”

"This is a tremendous honor, and it is deeply humbling to be included among this group of exceptionally accomplished past awardees," said Dr. Rodefeld. "They are giants in the field, and many were my mentors who significantly impacted my clinical and scientific work. Recognition from colleagues and peers is profoundly rewarding and fuels my continued passion and enthusiasm."

A professor of surgery at the Indiana University School of Medicine, Dr. Rodefeld practices pediatric cardiac surgery at Riley Children’s Hospital in Indianapolis. He leads an independent research program focused on developing innovative treatments for single-ventricle heart disease—a field in which he has made significant strides.

While at Indiana University, Dr. Rodefeld has balanced clinical practice with research aimed at advancing univentricular Fontan circulation, an area that has traditionally been underserved. His pioneering work is supported by a National Institutes of Health (NIH) R01 grant and focuses on developing technologies that could replicate biventricular circulation in single-ventricle patients, potentially offering long-term curative solutions.

A key milestone in Dr. Rodefeld ’s career came in 2010, when his research team developed a novel blood pump with funding from the NIH’s National Heart, Lung, and Blood Institute. The pump uses a spinning disk to draw blood from the veins and propel it into the arteries of patients with a single functioning heart ventricle. This device provides modest multi-directional cavopulmonary blood flow augmentation, which holds promise to improve circulatory function in this patient population.

“The scientific accomplishments that stand out as most rewarding to me are the early proof-of-feasibility studies I conducted,” added Dr. Rodefeld. “Interestingly, some of these early studies were incredibly simple and performed in my garage (like Earl Bakken’s early pacemaker work), or in initial animal studies.”

Dr. Rodefeld also highlighted the invaluable mentorship he received from colleagues both within and outside of cardiothoracic surgery and expressed his pride in his independent NIH funding.

This recognition underscores Dr. Rodefeld's profound impact on the field of pediatric cardiothoracic surgery and his ongoing commitment to advancing the care of patients with complex heart conditions.

The Earl Bakken Scientific Achievement Award was established in 1999 through a grant from Medtronic, Inc. to honor individuals who have made outstanding scientific contributions that have enhanced the practice of cardiothoracic surgery and patient quality of life. The award was named for Medtronic co-founder Earl Bakken. Among numerous other achievements, Bakken developed the first wearable artificial pacemaker.

The 61st STS Annual Meeting kicked off with the inaugural Nina Starr Braunwald Lecture, featuring an engaging conversation between STS President Jennifer C. Romano, MD, MS, and Nobel Prize Laureate Jennifer Doudna, PhD. They explored the transformative potential of scientific innovation and its profound impact on the future of medicine.

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Co-sponsored by STS and Women in Thoracic Surgery, the 2025 Nina Starr Braunwald Extraordinary Women in Cardiothoracic Surgery Awards were given to Aya Saito, MD; Jessica Donington, MD; and Stephanie Fuller, MD.

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STS President Jennifer C. Romano, MD, MS, the first woman surgeon in the Society’s history to deliver the address, reflected on her career, key highlights of her presidency, and the profound importance of "extending grace to others and ourselves." 

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Congratulations to the champions of this year's CT Surgery Resident Showdown, representing the University of Iowa!

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Check out our day one wrap-up video!

A groundbreaking study to be presented at the 2025 Society of Thoracic Surgeons Annual Meeting sheds light on an important decision point for patients requiring aortic valve replacement. Utilizing data from the STS Adult Cardiac Surgery Database, researchers have delivered the most extensive analysis to date on the outcomes of prosthetic valve types for patients aged 60 and younger.

The study, to be presented by Dr. Michael Bowdish, Cedars-Sinai Medical Center, examines the impact of valve choice—mechanical versus bioprosthetic—on long-term survival. By linking patient-level data from the STS ACSD with the National Death Index, researchers offer fresh insights into the critical question of how age and valve type affect surgical outcomes.

With its rigorous methodology and focus on tailoring care to individual needs, the study underscores the potential of advanced surgical techniques and data analytics to improve patient outcomes. It also highlights the pivotal role of the STS National Database, which provides robust national benchmarks for cardiothoracic procedures in the US, in driving impactful research and clinical innovation.

In presenting the Adult Cardiac Clark Paper on day two of STS 2025, Increased Risk of Surgical Aortic Valve Replacement After Prior Transcatheter Versus Surgical Aortic Valve Replacement with Concomitant Valve Disease, Dr. Robert Hawkins explores the heightened mortality risk for patients undergoing reoperation after transcatheter aortic valve replacement (TAVR) compared to those who have undergone surgical aortic valve replacement (SAVR).

Using data from the STS Adult Cardiac Surgery Database, which covers the years 2011 to 2021, Dr. Hawkins and his team examine the impact of concomitant mitral and tricuspid valve diseases on reoperation outcomes, with a particular focus on TAVR explants.

As part of the “Aortic Valve Surgery: What Do Our Patients Need to Know?” session on Saturday, Jan. 25 from 4:30 – 5:45 p.m., Dr. Hawkins will discuss findings that show patients with prior TAVR are more likely to suffer from severe concomitant valve diseases, such as mitral regurgitation, compared to those who underwent SAVR. These patients demonstrated a higher mortality rate during reoperation, particularly TAVR explants with an increase in the odds of mortality. The study further finds that severe valve disease is associated with significantly higher mortality in both TAVR explant and redo-SAVR cases.

During this session, Dr. Hawkins will share findings indicating that heart teams should consider these risks when deciding between TAVR and SAVR, as well as when addressing dysfunctional TAVR valves to avoid the heightened risks of reoperation. 

On Saturday, Jan. 24, from 10:15 to 10:25 a.m., Tomaz Mesar, MD, from the University of Pittsburgh Medical Center, will present An Age-Based Analysis of Transcatheter and Surgical Outcomes in Low-Risk Patients. The study compares outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in low-risk patients with aortic stenosis, with a particular focus on the impact of age on treatment outcomes.

Using a combined STS and TVT database, Dr. Mesar analyzed low-risk patients who underwent either SAVR or TAVR for degenerative aortic stenosis over a 13-year period, categorizing them into three age groups: under 65, 65-74, and over 75.

As part of the “Updates in Structural Heart: Surgeons are Still in the Game” session, Dr. Mesar will present on the crucial role of age in determining the optimal approach—TAVR or SAVR—for structural heart interventions. His presentation will address how current findings suggest that TAVR may not be suitable for younger, low-risk patients due to observed higher mortality rates. 

For patients aged 65-74, the choice between TAVR and SAVR requires a personalized assessment, as neither procedure demonstrates a clear survival advantage. Finally, for patients over 75, while TAVR may offer a reduction in certain complications, SAVR appears to provide better long-term survival outcomes for this patient population.

Evaluating the performance of congenital heart surgery centers is essential for improving patient outcomes. However, traditional methods of assessing performance have their limitations. At yesterday’s STS 2025 session, Sharon-Lise Normand, PhD, a professor of health care policy at Harvard Medical School, presented Improving Risk Adjustment in the Assessment of Congenital Heart Center Surgical Quality, which explored the use of modern causal inference techniques. These techniques aimed to better account for differences in case mix across centers, enhance risk adjustment, and provide a more accurate evaluation of center performance.

Utilizing data from the STS Congenital Database over a five-year period, the study examined 115 heart surgery centers across the United States. It compared two approaches for predicting postoperative mortality rates:

1. Traditional Method: This approach employed a statistical model that included data from all types of heart surgeries, even those that differed significantly from the procedures performed at the specific center.
2. Causal Inference Method: In contrast, this method focused on identifying other centers that performed similar surgeries and compared the outcomes of patients at those centers to those at the center under study.

Key findings

Dr. Normand discussed how the study revealed that causal inference methods yielded significantly higher and more variable estimates of expected mortality compared to traditional regression models. This suggests that traditional methods may underestimate the complexity of risk adjustment and the variability in performance across different centers. Additionally, causal inference methods were more effective in aligning the distribution of risk factors between comparison and target centers, leading to more accurate estimates of expected mortality.

Implications

These findings emphasize the potential of causal inference methods to provide a more tailored approach to risk adjustment, enhancing the accuracy of performance assessments across various centers. “Further research is needed to explore the implications of these methods for quality improvement and reporting,” said Dr. Normand. “By refining risk adjustment techniques, we can more effectively identify high-performing centers, pinpoint areas for improvement, and ultimately contribute to better outcomes for patients with congenital heart disease.”