News & Media

By Steven J. Yakubov, MD, and Steven B. Duff, MD, from OhioHealth Physician Group in Columbus STS News, Summer 2022 — Valve replacement technology has focused on solving the challenges of lifetime durability, excellent hemodynamic performance that is persistent, avoidance of anticoagulation, and providing access to coronary arteries. Approximately 80% of surgical valve implants (SAVR) are bioprosthetic valves, despite the concerns of long-term durability. Since the advent of transcatheter aortic valve technology (TAVR), some of the durability concerns are lessened due to the availability of TAVR in SAVR. Newer designs in surgical bioprostheses have focused on the ability to enlarge the aortic surgical valve at the time of TAVR in SAVR, as well as newer leaflet treatment techniques to enhance durability of the initial implant. Surgical techniques to enhance hemodynamics have concentrated mostly on root enlargement techniques to allow for implantation of larger surgical valves, thus minimizing the chance of patient prosthesis mismatch and allowing best possible residual gradients. The Tria valve technology is designed to enhance durability and hemodynamic performance of aortic valve replacement. The Tria valve is composed of polymer leaflet technology using proprietary biomedicalgrade siloxane-based polyurethane-urea—LifePolymer (LP) from Foldax, Inc. LP has undergone extensive in vitro and in vivo testing. Surgical aortic valve prosthesis The aortic valve is composed of three flexible LP leaflets solution-cast onto a radiovisible polyether-ether ketone stent with a polytetrafluoroethylene felt sewing ring. This is performed using a robotic manufacturing process, which is highly precise and obviates the need for direct human contact. The valve is prepared in a dry state and requires no preparation prior to implantation. The initial surgical experience or early feasibility was performed as a single-armed clinical study in patients with severe, symptomatic aortic valve disease, evaluating 15 patients at five clinical centers. This demonstrated excellent and sustained outcomes with regard to effective orifice area and hemodynamics, transvalvular gradients, and improvements in New York Heart Association functional classification with a 1-year follow-up. Two postoperative deaths (60 and 90 days) resulted, one related to an unplanned surgery on a renal carcinoma and another not well defined. Surgical mitral valve prosthesis One patient experienced coronary thrombosis at day 92 with thrombus possibly related to the valve sewing ring. The specific leaflet design with linear closure and diastolic inward flexion of commissural posts contribute to the excellent hemodynamics. The early experience was continued for a total enrollment of 40 patients, the results of which are not yet available. An early feasibility surgical aortic valve study has begun in India. An early feasibility study with a surgical mitral valve is underway in the US. The latest iteration of polymer leaflet technology is the development of a transcatheter aortic valve replacement system. This consists of a nitinol frame designed for accommodation to coronary reaccess and a suprannular leaflet design for optimization of hemodynamic performance. The initial experience with this valve system consists of implantation in six ovine subjects for assessment of feasibility. TAVR prosthesis Long-term outcomes with polymer-based leaflet technology, including freedom from anticoagulation and leaflet tearing, will not be known for many years. However, it holds the promise of durability without anticoagulation and hemodynamic performance comparable to transcatheter valve technology. These ideas, as well as improvements in supply chain/production (i.e., fully robotic production and no need for animal products) hold tremendous promise for the advancement of valve replacement technology

Varghese Accepts New Quality Role at Huntsman Thomas K. Varghese Jr., MD, MS, MBA, has been named associate chief medical quality officer at Huntsman Cancer Institute (HCI) in Salt Lake City, Utah. He also will continue to serve as HCI chief value officer, chief of the Section of General Thoracic Surgery at the University of Utah, and professor of surgery at the University of Utah School of Medicine. In addition, Dr. Varghese recently earned his Executive Master of Business Administration degree from the University of Utah. An STS member since 2009, he currently chairs the STS Council of Meetings and Education and is a member of the Workforce on Media Relations and Communications. Dr. Varghese also is the Deputy Editor of Digital Media and Digital Scholarship for The Annals of Thoracic Surgery. Carpenter Named Assistant Dean A.J. Carpenter, MD, PhD, has been appointed assistant dean of graduate medical education for health science systems within the Long School of Medicine at University of Texas (UT) Health Science Center at San Antonio. She has served on the faculty at UT Health San Antonio since 2002 and was appointed director of the residency program in 2014. Dr. Carpenter has been an STS member since 1998. MacGillivray Leads Cardiac Surgery at MedStar Thomas E. MacGillivray, MD, this fall will assume the position of physician executive director of cardiac surgery at MedStar Health and chair of Cardiac Surgery at MedStar Washington Hospital Center in Washington, DC. For 5 years, Dr. MacGillivray has served as the chief of the Division of Cardiac Surgery and Thoracic Transplant Surgery at Houston Methodist in Texas. An STS member since 2003, he is the STS First Vice President and serves on the boards of The Thoracic Surgery Foundation and The Annals of Thoracic Surgery. Kachroo Directs Thoracic Aortic Center Puja Kachroo, MD, has been named surgical director of the Center for Diseases of the Thoracic Aorta at the Washington University School of Medicine in St. Louis  and Barnes-Jewish Hospital in St. Louis, Missouri. She also will continue as cardiac surgeon, with expertise in aortic dissection and thoracic aortic aneurysms. Dr. Kachroo has been an STS member since 2010. Bowdish Assumes Full Professorship Michael E. Bowdish, MD, has been named professor and vice chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai in Los Angeles, California. Previously, he worked as an associate professor of surgery in the Division of Cardiac Surgery at the Keck School of Medicine at the University of Southern California in Los Angeles. An STS member since 2012, Dr. Bowdish serves as chair of the STS Adult Cardiac Surgery Database Task Force. Reddy Oversees Surgical Innovation in Michigan Rishindra M. Reddy, MD, MBA, has been named director of the Center for Surgical Innovation at the University of Michigan in Ann Arbor. Dr. Reddy, chair of the Comprehensive Robotic Surgery program and associate director of the Thoracic Quality Collaborative, will continue his research in lung and esophageal cancer, medical education, and health disparities. He has been an STS member since 2011. Guy Is Vice Chief in PA T. Sloane Guy, MD, MBA, has been appointed vice chief of the Division of Cardiac Surgery and clinical director of cardiac surgery at Jefferson Health in Philadelphia, Pennsylvania. Dr. Guy adds this position to his current roles as professor of surgery and director of minimally invasive and robotic cardiac surgery at Thomas Jefferson University Hospitals. He has been an STS member since 2006. Gunn Takes Helm of ECMO Program Tyler Gunn, MD, has joined the Department of Cardiac Surgery at Cedars-Sinai in Los Angeles, as assistant professor of cardiac surgery. He also will serve as director of the Extracorporeal Membrane Oxygenation Program (ECMO) within the Cedars-Sinai Health System. Dr. Gunn has been an STS member since 2014.

STS News, Summer 2022 — As the world around us becomes increasingly digital, so does the way we communicate, connect, share, and publish scientific research. The Annals of Thoracic Surgery recently launched Annals Short Reports—the new fully open access companion journal. This e-only publication provides a contemporary venue for authors to present their research in a digestible format, while also making it available immediately, permanently, and universally. “Annals Short Reports is a great way to publish and access concise research, reviews, feature articles, and videos—all peer reviewed by The Annals Editorial Board,” said Joanna Chikwe, MD, FRCS, Annals Editor-in-Chief. “Our expanded digital platform will allow readers to combine content from both journals to reflect their interests, with much more frequent updates and mobile access.” Annals Short Reports welcomes a wide range of short-form original research related to clinical advances, current surgical methods, and controversial topics and techniques in the following areas: Adult acquired and congenital cardiovascular disease Thoracic surgery Cardiothoracic transplantation Mechanical circulatory support Perioperative medicine Education and training The “short report” article type requires: < 2,500 words < 4 combined tables/figures < 10 references Also featured are engaging editorials, focused mini-reviews, educational and impactful case reports, “how to do it” technique papers, and images in cardiothoracic surgery. In addition, Annals Short Reports includes a special emphasis on digital media and supplemental content, designed for easy and open sharing of data, results, and content across social media and other channels. According to Dr. Chikwe, this format facilitates a more efficient review process, with a shorter time to decision. All published articles are expected to be indexed in PubMed within the next 6 to 12 months. Annals Short Reports follows the high standards of The Annals and is supported by the same expert Editorial Board team. The open access journal now is accepting submissions. For more information, visit sts.org/annals.

STS News, Summer 2022 — While the fighting in Ukraine rages on, global congenital heart surgeon William M. Novick, MD, can be found in the operating rooms of hospitals throughout the war-torn country, saving lives of the littlest patients. These operations are considered challenging; they are complex, dynamic, and often time- and resource-constrained. Not to mention the additional risks that result from the fighting and life-threatening danger on the other side of the hospital walls. “When I hold a child’s heart in my hands, I experience an extremely scary, humbling, and challenging series of thoughts,” said Dr. Novick. “Scary, because that child might die. Humbling, in that God gave me the ability to do this. Challenging, because we want to save every child no matter how bad the defect is.” Dr. Novick, from the University of Tennessee Health Science Center in Memphis, and his team from the Novick Cardiac Alliance have traveled to Ukraine several times over the years, and they’ve committed to four visits in 2022. So far, they have completed three—traveling to the country in January, March, and, most recently, in June. “The physical damage being caused in the country is going to set back medical care in Ukraine years, maybe decades,” he said. “We were in the country during the last week of January and the first week of February. While our team was there, there was a developing threat of a Russian invasion, with troops already staging on the border and in Belarus.” Dr. William Novick champions the expansion of pediatric cardiothoracic surgery in under-resourced countries, both operating on children and training others to do so. Then, while the team was in Lviv this spring, the far western Ukraine city was bombed, said Dr. Novick. Even so, they worked day and night, desperately trying to complete as many surgeries as they could in a short amount of time. “They put us up in the hospital,” he said. “There’s no room anywhere in the city, in any hotel, because of all the refugees. We took a nap, I talked to the administrator, and then we got started.” Dr. Novick and his team operated on six children: three newborns, and another three who were just days old. Each year, 1 million children in low- and middle-income countries are born with congenital heart disease, according to Dr. Novick, and most do not have adequate pediatric cardiac care. The most challenging place in which he’s operated was Tashkent, Uzbekistan. The conditions included ancient equipment, unclean operating rooms, and dangerous power supplies. “There was a bypass machine—unplugged—on a counter,” said Dr. Novick. “Sitting on the floor next to the machine was a pair of heavy rubber gloves and rubber boots. Our perfusionist went to plug in the bypass machine. Simultaneously, six Uzbeks screamed, ‘NYET! Put on gloves! Put on boots!’ So he did, and when he plugged in the machine, sparks flew.” Dr. Novick explained that many of these countries don’t have any options for heart surgery unless it’s charitable. “And, what makes this work special is we are doing it in places where no one else wants to go,” he said. So Much More than Surgery In addition to their surgical skills and expertise, Dr. Novick and his team in March brought to Ukraine 14 massive bags of supplies to support pediatric heart surgery and pediatric cardiology, and for the trip in June, he shipped 12 pallets of equipment and materials. This is important to note because the Cardiac Alliance works to save lives, but also helps local teams assemble and sustain cardiac centers. In fact, the centers that the Cardiac Alliance builds typically are sustainable within 3 years. “We do pediatric heart surgery, but we also train pediatric cardiologists, and nurses in the ICU, respiratory therapists, those who run the heart-lung machine, and the catheterization lab technicians. We try to get all these people trained up to improve their diagnostic skills, or work on catheterization or anesthesia, and we do a lot of it in conflict zones,” said Dr. Novick. Dr. Novick and the Cardiac Alliance team visited Lviv, Ukraine in June 2022. ‘You Protect People…That’s Your Job’ Dr. Novick is not only doing much of the surgery himself, but he’s also gathering donated supplies, lining up financial contributions, and organizing training programs. Described as the undisputed leader of the Novick Cardiac Alliance, he’s known to run the team with a “thundering hand.” And his work in these countries—especially in Eastern Europe—holds personal significance for Dr. Novick. His grandmother, who is Ukrainian, and his grandfather, who is Russian, escaped Soviet Russia many years ago to settle in the US. With these roots, Dr. Novick credits his father for his “Russian temperament, tenacity, and persistence.” From his mother, he learned “all the soft things” such as his concern for children regardless of where they are in the world and his deep desire to repair children’s hearts. Just as importantly, his parents taught him, “You never, ever intimidate anybody. You protect people that are intimidated or bullied by other people. That’s your job. You’re big enough to do it.’ So that’s the way I was brought up: help those who are not able to help themselves,” Dr. Novick said. Over the years, he has done just that—made saving and protecting lives his life’s work, helping more than 10,000 children in 30+ countries, including places like Libya, Iraq, the Democratic Republic of the Congo, Russia, and China. “I’m very passionate about this work,” Dr. Novick said. “Unless you go to these places, I don’t think you can really grasp how desperate the situation is for these kids and their parents. Our team showing up, and their kid getting operated on—they truly consider it a miracle. I’m very humble about what we do, but you’re in a country of 85 million people and there’s no heart surgery for kids, and your child is one of 18 who gets operated on? I mean, holy moly.” For more information about the Novick Cardiac Alliance, visit cardiac-alliance.org.