Clinical Decision-Making

At the 2025 Society of Thoracic Surgeons Annual Meeting, researchers will unveil a late-breaking study exploring the long-term survival outcomes of different surgical approaches for early-stage non-small cell lung cancer (NSCLC). The analysis leveraged the robust STS General Thoracic Surgery Database (GTSD), combined with long-term follow-up data, to evaluate the effectiveness of anatomic lung resections versus alternative techniques.

The study, to be presented by Dr. Christopher Seder, Rush University Medical Center, examined data from more than 32,000 patients, provides valuable real-world insights that complement existing randomized controlled trials, offering a comprehensive perspective on how surgical decisions influence outcomes over time. With findings drawn from diverse healthcare settings, this research underscores the potential of leveraging large-scale databases to refine treatment strategies and optimize patient care.

The STS GTSD remains a leading resource for capturing detailed surgical and patient data, driving advancements in cardiothoracic surgery. This latest study adds to its legacy by highlighting the importance of integrating real-world evidence into clinical practice.

The Congenital Heart Surgery Clark Paper, Understanding Mortality Following Congenital Heart Surgery: What Do Procedure-Specific Factors (PSF) Add? will assess the contribution of PSFs beyond standard risk factors in estimating mortality in this population.

Meena Nathan, MD, a pediatric cardiac surgeon at Children’s Hospital Boston, will present this paper on Friday, Jan. 24, from 2:16 to 2:24 p.m. as part of the "The Tribulations of Trials: Challenges in CHD Clinical Studies" session. During her talk, she will discuss data from The Society of Thoracic Surgeons Congenital Heart Surgery Database, a crucial resource for enhancing the quality of congenital heart surgery. In 2013, the Database expanded to include 82 Patient Safety Factors (PSFs) for benchmark operations (BMOs), though the impact of these PSFs on mortality prediction has yet to be fully explored.

To address this knowledge gap, Dr. Nathan and her team analyzed the contribution of PSFs to mortality estimation beyond standard STS risk factors. The study included a large cohort of BMOs from 115 U.S. centers between 2017 and 2022.

Dr. Nathan will present study findings, which emphasize the complexity of mortality prediction in congenital heart surgery and highlight the need for continued research to identify the most relevant risk factors and PSFs for each procedure, with the goal of developing more accurate prediction models that enhance patient care and support informed decision-making.

In patients undergoing coronary artery bypass grafting (CABG), a novel analysis evaluating surgeon preference for multi- versus single-arterial grafting may help explain the differing results between prior retrospective analyses and randomized controlled trials regarding long-term survival.

A novel study to be presented on Friday, Jan. 24, at The Society of Thoracic Surgeons’ 61st Annual Meeting by lead author Justin Schaffer, MD, a cardiothoracic surgeon at Baylor Scott & White Health, offers fresh insights into the long-debated question of whether multi-arterial grafting (MAG) improves long-term survival compared to single-arterial grafting (SAG) in patients undergoing CABG. The analysis evaluates over one million Medicare beneficiaries and incorporates an innovative approach using surgeon preference as a tool to address unmeasured variables.

While the findings highlight nuances in interpreting retrospective and randomized trial data, they also underscore the need for future randomized studies, such as the forthcoming results of the ROMA trial, to definitively guide clinical decision-making.

The researchers emphasized that understanding the survival benefit of MAG over SAG requires randomized data, and it remains an important and open clinical question. 
 

In today’s presentation of the Clark Memorial Paper for General Thoracic Surgery, Lobectomy versus Sublobar Resection Among Lung Cancer Patients Understudied in Recent Clinical Trials, Gavitt Woodard, MD, a thoracic surgeon at Yale Medicine, will discuss the findings of a comprehensive evaluation of lung cancer surgery outcomes.

This study examined survival outcomes across groups to determine whether the trial’s results are widely applicable to a broader population, including older patients, those with reduced pulmonary function, and non-smokers.

Researchers analyzed data from the Society of Thoracic Surgeons General Thoracic Surgery Database, linking it with Medicare survival data to evaluate patient outcomes. The study included a diverse group of patients who underwent different surgical resections, including lobectomy, segmentectomy, and wedge resection.

“The study found that sublobar resection and lobectomy offer similar survival outcomes for many patients, including those over 75, with poor lung function, or who are lifelong nonsmokers,” said Dr. Woodard. "Inadequate lymph node evaluation during sublobar resection was associated with worse survival. These findings highlight the need for better nodal assessment, particularly for patients with compromised lungs or minimal lymph node spread."

On Thursday, Jan. 23, the Society of Thoracic Surgeons (STS) kicked off its pre-conference for STS 2025. The program featured three concurrent half-day symposia designed to enhance attendees' educational experience at this year's Annual Meeting.

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The symposium, Lung Cancer: Clinical Trials Meet Clinical Practice, explored the rapidly evolving landscape of early-stage and locally advanced non-small cell lung cancer. Through interactive formats, participants examined recent diagnostic breakthroughs and key clinical trials, gaining practical strategies to integrate this knowledge into their daily practice.

The STS APP Conference: Redesigning the Future Together marked the inaugural program dedicated to advanced practice providers (APPs) in cardiothoracic surgery. This event focused on innovative ways to enhance the role of APPs, strengthen clinical management, and present strategies for professional success and leadership. Expert-led sessions and collaborative discussions provided attendees with valuable insights into improving patient care, driving clinical excellence, and fostering career development.

The Aortic Universe: From Birth to Adulthood symposium provided a comprehensive overview of aortic disease across all age groups. Participants learned about diagnosing, treating, and managing the full spectrum of congenital and acquired aortic conditions. "Through videos, detailed case-based presentations, and surgical techniques, these courses helped strengthen our ability to provide the highest level of care to those affected by aortic disease," said course co-director Ibrahim Sultan, MD, a cardiothoracic surgeon at the University of Pittsburgh Medical Center.
 

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, Reilly Hobbs, MD, 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.

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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.”
 

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.