Clinical Decision-Making

On day three of the STS 2025 Annual Meeting, Dr. Jeremiah Hayanga, professor of thoracic surgery, Department of Cardiovascular and Thoracic Surgery, West Virginia University, will present a session titled, Endobronchial Valve Therapy (EVT) versus Lung Volume Reduction Survey (LVRS) in the US. In this presentation, Dr. Hayanga and his research team will share new, risk-adjusted study results that provide fresh insights into treatments for severe emphysema.

Recent findings suggest that as surgical practices evolve, LVRS may offer better long-term results for patients with advanced emphysema compared to EBV therapy. Although EBV patients had shorter hospital stays, lower charges, and fewer pre-existing conditions, the study revealed they experienced more complications and a higher risk of death over time than those who underwent LVRS.

To be held Sunday, Jan. 25, at 8 a.m. during the larger “Modernized Solutions for Lung Failure, From Bench to Bedside” session, Dr. Hayanga will also discuss the limitations of lung transplantation as a solution for severe emphysema due to the shortage of donor organs. 

“Surgical lung volume reduction, explored in the late 1990s, did not gain widespread acceptance due to its associated risks and the small pool of patients who were thought to benefit,” says Dr. Hayanga. “However, with advancements in surgical techniques and risk management, LVRS has seen improved outcomes, offering hope for patients who are not candidates for lung transplants.”

During the Saturday, Jan. 25 presentation of the James S. Tweddell Memorial Paper for Congenital Heart Surgery, Dr. Reilly Hobbs from the University of Utah Medical Center will explore the relationship between the volume of Norwood procedures performed at a center and patient outcomes based on findings from the National Pediatric Cardiology – Quality Improvement Collaborative Database study.

The Norwood procedure, a critical surgery for infants with single ventricle defects, has been extensively studied, but findings on how case volume affects outcomes have been inconsistent. This study examines data that clarifies the relationship between center case volume and survival and morbidity in patients undergoing this complex surgery.

In presenting the findings of the study, Congenital Heart Surgery, Volume-Outcome Relationship of Norwood Procedures: Insights from the National Pediatric Cardiology – Quality Improvement Collaborative Database, Dr. Hobbs will explain how centers were grouped based on their annual case volume—low, medium, and high—and how preoperative risk factors, complications, and survival outcomes were compared. He will also highlight how patients at high-volume centers had better outcomes than those at low-volume centers, including higher survival rates and lower mortality, particularly among patients with additional high-risk features. 

“The findings indicate that the number of Norwood procedures performed at a center significantly impacts patient outcomes with high-volume centers consistently achieving better results than low-volume centers,” says Dr. Hobbs. “It’s essential to emphasize the role of case volume in complex congenital heart surgeries and explore the potential benefits of directing high-risk patients to more experienced centers. Further research is needed to identify the key factors that contribute to improved outcomes at high-volume centers, ultimately enhancing care for single ventricle patients.”
 

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. 

The 2024 Latin American Cardiovascular Surgery Conference, held over three days in Buenos Aires, Argentina, attracted leading experts from Europe, Latin America, and North America to address topics in cardiovascular medicine, including coronary artery disease, congenital heart disease, atrial fibrillation, and heart failure.

"The conference provided a diverse range of sessions to accommodate surgeons at all stages of their careers," explained Program Chair Rafael Sadaba, MD, Navarra University Hospital, Pamplona, Spain. “Residents and early career surgeons benefited from dedicated sessions, while experienced surgeons had the opportunity to delve into complex procedures and cutting-edge techniques.”

The program offered a comprehensive overview of the latest advancements in cardiac surgery. It featured scientific abstracts, technical videos, and interactive discussions on a variety of topics, including the current state of heart transplantation in Latin America, the use of mechanical circulatory support devices, the role of ECMO in treating cardiogenic shock, and advanced surgical techniques for mitral and aortic valve repair.

“This year, I was particularly interested in the session on the Ross Procedure, an operation that has been around for a long time but has experienced renewed interest over the past few years," said EACTS Secretary General Patrick Meyers, MD, Lausanne University Hospital, Switzerland. 

The three-day event highlighted women's cardiac health, particularly tailored approaches and complex treatments for women of reproductive age.  Other sessions focused on managing aortic dissection, advancing transcatheter valve therapies, and providing lifelong care for patients with conditions such as aortic stenosis.

The conference concluded with hands-on workshops that allowed participants to practice skills such as mitral valve repair and ECMO cannulation, making it an essential platform for advancing cardiac care in Latin America.

Check out our event photo gallery. 

The Society of Thoracic Surgeons (STS) and the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS) recently co-hosted the inaugural Aortic Summit 2024 in Tokyo, Japan. This international event brought together leading experts in the field to discuss advancements in the diagnosis and treatment of thoracic aortic lesions, including endovascular approaches.

The summit was designed to cater to a diverse audience, including cardiothoracic surgeons, cardiac anesthesiologists, CT residents, perfusionists, and ICU and OR nurses. 

The comprehensive three-day program covered a wide range of topics, including root, arch, descending aorta, TEVAR, dissection, and hybrid procedures. Participants had the opportunity to learn from experts, network with colleagues, and gain valuable insights into the latest techniques and technologies.

"The sessions delved into the latest developments through a series of presentations, panel discussions, and hands-on workshops," said Yutaka Okita, MD, Congress President for the STS-ASCVTS Aortic Summit 2024. "The event featured a number of eminent speakers from all over the world, who shared their expertise and achievements with attendees.”

On October 25-26, 2024, more than 230 members of perioperative and critical care teams from around the world gathered in Philadelphia for the 2024 Perioperative & Critical Care Conference. The conference focused on the latest techniques and management strategies in cardiovascular and thoracic critical care, as well as enhanced recovery after surgery. Participants gained valuable insights and practical strategies aimed at optimizing patient care and improving outcomes. 

The two-day event covered a wide range of topics, including fundamentals of waveforms and monitoring, goal-directed hemodynamic therapy and AKI prevention, ECMO fundamentals, improving communication in the cardiothoracic intensive care unit, and vasoplegia management. 

Here's what a few attendees said about the Perioperative & Critical Care Conference:

•  "In the ECMO session, we not only saw the latest in technology and innovation, but also learned techniques that will help us treat our patients and get them out of the hospital in better condition,” Dr. Jeremiah Hayanga, West Virginia University Health System
• "The conference was well-paced and engaging. The speakers were captivating, and the discussions were thought-provoking. The two days flew by!"
• "The STS team did a fantastic job with the logistics of this large-scale conference. The recordings and slides will be a great way to review the material and share it with colleagues.”
• "The conference was informative and highlighted areas where we can improve our practices. I appreciate the multidisciplinary focus, which is essential for optimal patient care."
•  "As an APP, I truly enjoyed the conference and felt that the presentation and topics aligned well with my role. I look forward to attending again next year."

Check out our event photo gallery.