Wellness

After 2 years of virtual-only programming, The Society’s 59th Annual Meeting, January 21 – 23 in San Diego, California, promises an in-person experience that’s better than ever—with late-breaking abstracts, challenging case presentations, immersive experiences, and never-before-seen scientific discoveries and surgical techniques.  “The ability for colleagues and friends to gather in person for the first time in several years will be a palpable opportunity to not only share intellectual knowledge but also—perhaps more importantly—reconnect on a personal level,” said S. Adil Husain, MD, chair of the STS Workforce on Annual Meeting. “We have each experienced many unique challenges since our last in-person meeting and this reunion of sorts will be a valuable elixir for us all.”  The program planning committee received a record number of exciting abstract submissions in all subspecialty areas, Dr. Husain said. They designed the program with a focus on blending top-scoring science with highly respected invited speakers, with an emphasis on interaction and discussion time.  Adult Cardiac Offerings Target Optimal Outcomes  Parallel sessions in adult cardiac surgical topics explore why cardiac surgeons should be involved in pulmonary embolism response teams, the management of severe aortic stenosis in young adult patients, optimizing care for infective endocarditis, the heart team approach to complex tricuspid valve disease, and much more.   Hands-on courses cover annular enlargement and mitral valve repair, while “In the OR with” videos take attendees on an immersive journey as world-class surgeons demonstrate complex aortic arch reconstruction, minimally invasive mitral valve repair, and the Ross procedure. The J. Maxwell Chamberlain Memorial Paper and Richard E. Clark Memorial Paper will unveil outcomes data in large patient groups—the former on coronary artery bypass grafting versus multivessel percutaneous intervention, and the latter on the effect of surgical strategy in isolated tricuspid valve procedures.  Congenital Program Is Dynamic with Data  Data-driven outcomes, evidence-based guidelines, and optimizing the landscape for the current and future congenital surgery workforces feature prominently in the congenital surgery curriculum. “To Train or Not to Train?” will include a debate on the regulation of fellowship positions, and “Leveling the Playing Field” will explore whether it’s useful for lower-volume centers to partner with high-volume centers to deliver best results.  Engaging video and abstract presentations will demonstrate single leaflet neocuspidization with autologous pericardium, position of the autograft and homograft in the Ross-Konno procedure, neonatal palliation for high-risk single ventricle heterotaxy, and a novel hybrid palliation technique for a premature newborn prior to Norwood single ventricle palliation. The inaugural James S. Tweddell Paper investigates the creation of an STS adult congenital heart surgery risk model, and the Clark paper analyzes the STS National Database for patterns in the management of tetralogy of Fallot.   General Thoracic Sessions Showcase Next-Gen Techniques  Parallel sessions in the general thoracic program highlight topics including controversies in transplant practices, immunotherapy and targeted molecular therapy, and challenging esophageal consults, while an Ask the Experts session titled “Elegant Solutions to Lung Disasters” will show attendees how to salvage pulmonary resections gone wrong. Attendees will gain hands-on expertise in complex central airway reconstruction, and an “In the OR with” video demonstrates uniport segmentectomy and left lower lobectomy.  Among the abstracts are a 20-year experience with salvage esophageal reconstruction with colon interposition, a one-step classifier for molecular differential diagnosis between multiple primary lung cancer and intrapulmonary metastasis, the evolution of pain control for adult pectus excavatum repair, and how the number of involved structures affects outcomes in thymic epithelial tumors. The Chamberlain Paper examines racial disparities in patients awaiting lung transplant, and the Clark Paper pinpoints how urgent paraesophageal hernia repair in elderly patients is associated with worse outcomes. Perioperative, Critical Care Topics Bring Results into Practice  An array of offerings in perioperative and critical care includes controversies in perioperative blood management, building an ERAS cardiac program without added cost, contemporary approaches to pain management, phenotypes and unique characteristics of cardiogenic and postcardiotomy shock, and new regulatory standards for resuscitation. A hands-on course covers the V3 exam—volume status, venous access, ventricular function—for CT surgery.   The Clark Paper, “The Price of Delay: RV Failure and Biventricular Support” utilizes relevant findings from the Intermacs database, and the Chamberlain Paper demonstrates that the COVID-19 pandemic is associated with increased mortality, failure to rescue, and cost across all socioeconomic statuses.   Equity Is Paramount in Wellness, Education, Quality  Surgeon wellness and career advancement take center stage at STS 2023. A “Surgical Families” session explores unique situations including adoptive parents, parents of children with special needs, surgical trainees and parents, two-surgeon households, and single-parent surgeons. A session on ergonomics helps surgeons avoid injuries that can curtail a career, and Annals Academy provides tips on publishing impactful research.   In the quality and education realms are sessions on the preoperative assessment of frailty beyond the “eyeball test” and making sense of hospital star ratings, while intriguing abstracts investigate how communication patterns in the OR are affected by task difficulty, how male versus female candidates regard diversity in selecting jobs and training programs, and harnessing natural language processing to evaluate gender bias in letters of recommendation for cardiothoracic surgery applicants. “The plenary session invited speakers will offer a unique opportunity for attendees to self-reflect both personally and professionally,” added Dr. Husain. The Vivien T. Thomas Lecture will be delivered by Francisco G. Cigarroa, MD, who directs the transplant center at the University of Texas Health Science Center San Antonio. Bestselling author Max Lucado will present the Thomas B. Ferguson Lecture, and Peter K. Smith, MD, principal investigator for the Duke University site in the Cardiothoracic Surgery Clinical Trials Network, is this year’s C. Walton Lillehei Lecturer.   The Presidents Reception—at a bayfront restaurant and cocktail venue featuring a floating reception hall and a skyline lounge—will celebrate not only the term of current STS President John H. Calhoon, MD, but also the legacies of Past Presidents Sean C. Grondin, MD, MPH, FRCSC and Joseph A. Dearani, MD, who oversaw the Society’s governance with innovation and grace during the peak of the COVID-19 pandemic. Space is limited for the reception, and attendees must add it to their cart during registration.   “We have lost several admired colleagues in recent times, Dr. Tweddell and Dr. Grondin in particular,” said Dr. Husain. “We will value our ability to celebrate their contributions to our subspecialty as well as to acknowledge the loss of other cherished members within our Society.”  STS 2023 also heralds the return of live product demonstrations, with 150 exhibitors showcasing the latest tools and technologies for surgical practice. Industry symposia—both offsite and at the convention center this year—afford rare opportunities to practice new techniques, and product theaters let attendees experience devices and software hands-on.  For those who can’t travel to San Diego—or for those who want to do more with their in-person registration—a new option, Plenary Livestream-Plus, will allow registrants to livestream the President’s Address and named lectures from anywhere onsite or across the globe.   STS Members enjoy significant discounts on STS 2023 registration, and Resident/Fellow and Medical Student Members register for free. There’s still time to register at sts.org/annualmeeting.

Dynamic Event Featured CVT Critical Care and ERAS Techniques, Strategies The multifaceted nature of cardiovascular and thoracic (CVT) critical care cases was the focus of the 19th Annual Perioperative and Critical Care Conference, held September 8–10, in Denver, Colorado. More than 150 cardiothoracic surgeons, cardiologists, anesthesiologists, nurses, perfusionists, and other medical professionals learned about new concepts, management protocols, and clinical experiences from a multidisciplinary faculty. In addition, Ronald M. Stewart, MD, from the University of Texas Health Science Center at San Antonio, delivered the special keynote address, “Team Management Through Crisis: Firearm Injury Prevention Initiative from the American College of Surgeons Committee on Trauma.” “For our first in-person meeting in 2 years, it was great to meet with a very engaged and interested group,” said Rakesh C. Arora, MD, PhD, one of the program directors. “Participation in every session was outstanding: the level of talks, the questions being asked, the conversations in-between. We had great science and breakout sessions, and meeting old friends again was a real treat.” Thomas Knapp, a third-year medical student from the University of Central Florida College of Medicine in Orlando, received the Best Overall Poster honor for his presentation, “Dexmedetomidine Withdrawal in Pediatric Cardiac ICU Patients: A Systematic Review and Meta-Analysis.” Thomas Knapp, from the University of Central Florida College of Medicine in Orlando, received the Best Overall Poster honor. He shared how much he enjoyed the hands-on sessions, especially the “ECMO 101” session. “I was really excited because it was smaller groups and very visual, which appealed to me. I appreciated the intimacy of the sessions and that the conference was niche.” The meeting content will be available for purchase this month through the STS Learning Center. More information is available at sts.org/criticalcare. New Award Will Honor Extraordinary Women in CT Surgery Nominations currently are being accepted for the inaugural Extraordinary Women in Cardiothoracic Surgery Award, which is co-sponsored by STS and Women in Thoracic Surgery. This honor will recognize outstanding women cardiothoracic surgeons who achieve excellence in clinical practice. Nominees also should exemplify one or more of the following characteristics: Selfless leadership in cardiothoracic surgery Mentorship/sponsorship of others in the specialty Exceptional advocacy on behalf of cardiothoracic surgery, the patient population, or fellow surgeons/trainees Integrity, innovation, creativity, and expertise in carrying out day-to-day professional responsibilities The Extraordinary Women in Cardiothoracic Surgery Award will be presented live during STS 2023 in January. Nominations are being accepted through October 21. For more information, visit sts.org/extraordinarywomen. STS 2023 Will Reconnect the CT Community in San Diego After 2 years of virtual-only Annual Meetings, STS is bringing the cardiothoracic surgery community back together for never-before-seen science, hands-on demonstrations, virtual OR experiences, industry showcases, and thought-provoking keynote lectures. STS 2023 will take place January 21–23, at the San Diego Convention Center. “There isn’t an STS Annual Meeting that I don’t walk away from having learned something new, thought about something differently, or gained a unique perspective about how another surgeon or institution is tackling a problem,” said S. Adil Husain, MD, Chair of the STS Workforce on Annual Meeting. “Being together face to face creates organic conversations and opportunities to learn from one another, as well as allows us to find joy, excitement, and commonalities in terms of challenges and successes we have as cardiothoracic surgeons.” For those who can’t travel to San Diego—or for those who want to do more with their in-person registration—a new option, Plenary Livestream-Plus, will allow registrants to livestream the President’s Address and the Thomas B. Ferguson, Vivien T. Thomas, and C. Walton Lillehei Lectures from anywhere onsite or across the globe. Plenary Livestream-Plus also gives participants access to all session recordings within 48 hours of presentation. Early registration guarantees a place—and the best choice of hotel rooms—at the most highly anticipated cardiothoracic surgery event in the world. Registration now is under way at sts.org/annualmeeting.   World-Class Faculty Will Headline Latin America Conference Featuring interactive panel discussions, original scientific abstracts, and hands-on courses, the 2022 STS/EACTS Latin America Cardiovascular Surgery Conference takes place December 1–3, in Cartagena, Colombia. The conference is an exceptional opportunity to explore the latest developments and best practices in coronary artery disease, congenital heart disease, thoracic aortic disease, atrial fibrillation, and the surgical management of heart failure. The final day of the conference will showcase industry-sponsored workshops that demonstrate mitral, tricuspid, and aortic valve repair, as well as valve sparing and the Ross procedure. “The Latin America Cardiovascular Surgery Conference this year will be a remarkable event as surgeons from South America, Europe, and North America come together to disseminate knowledge and learn from each other,” said program committee member Vinod H. Thourani, MD. “We will discuss cases, listen to didactic lectures, and watch videos about the best practices for adult cardiac, congenital, and heart failure surgery. I encourage you to attend this don’t-miss event.” For more information, visit sts.org/latam. 8 in 8s Provide Quick Tips for Hypoxemia, Reimbursement, Epicardial Pacing, and More The STS 8 in 8 Series is a collection of expert-presented videos that offer clear, concise explanations of cardiothoracic surgery topics—each features just 8 slides and is approximately 8 minutes long.  The newest videos cover hypoxemia during VV ECMO, academic promotion for advanced practice providers, post-cardiotomy temporary epicardial pacing in the ICU, surgeon reimbursement, and tracheostomy techniques.  The series is available at sts.org/8in8 and on the STS YouTube channel, ThoracicSurgeons. This 8 in 8 video identifies contributors to hypoxemia during VV-ECMO support, including cannula recirculation. Now Is the Time to Send Data Managers to AQO Surgeons are encouraged to register their data management teams for the 2022 Advances in Quality Outcomes (AQO): A Data Managers Meeting, October 26–28 in Providence, Rhode Island. Registrants can choose one or multiple in-person tracks—for the Adult Cardiac, Congenital, General Thoracic, and/or Intermacs/Pedimacs Databases—or choose a virtual pass to get access to digital content. STS members, including non-physician associate members, save even more. Details are available at sts.org/aqo. Blog Curates Conversations for Aspiring Surgeons The Aspiring CT Surgeons Blog launched to much celebration, providing a space for trainees to openly reflect on their experiences and share ideas to help each other navigate the troubles and triumphs of medical school, residency, fellowship, and beyond. New articles—which offer viewpoints from a diverse range of backgrounds and stages of training—are added regularly. The first few articles detail coping with complications, feeding the joy, and finding your own way to the operating room. Coping with Complications in Cardiothoracic Surgery: How Do We Grow as Trainees? by Linda Schulte, MD   The Scenic Route to Cardiothoracic Surgery by Mahnoor Imran, MD   Feed the Joy by Anna Olds, MD   Visit sts.org/aspiringctsurgeons, and carry on the discussion via social media with #aspiringctsurgeons. Webinar Challenges Teams to Prepare for Post-Surgical Arrest In the event of a sudden cardiac arrest after surgery, everyone on the perioperative team needs to know their roles and act fast. A recent installment of the STS Webinar Series teaches teams to establish a protocol that everyone can follow. In “Arrest after Cardiac Surgery: Is Your Team Ready?,” an expert panel demonstrates how to implement Cardiac Surgery Advanced Life Support protocols and their utility in failure-to-rescue algorithms. The free webinar is available to watch now at sts.org/videos. STS Traveled to Milan for EACTS Meeting The Society had an important presence at the European Association for Cardio-Thoracic Surgery (EACTS) Annual Meeting in Milan, Italy, in October. STS President John H. Calhoon, MD, met with colleagues from around the world, while other surgeon leaders gave presentations during the meeting. STS staff also promoted the benefits of STS membership at a booth in the Exhibit Hall.

John H. Calhoon, MD STS News, Fall 2022 — As we emerge from the pandemic, it is fascinating to see how much has changed. Expectations of a return to normal just don’t seem possible. Although some things may be better, other daily experiences clearly are not. To me, one thing has become much worse: the relentless barrage of trivial and misleading information and negative news and commentary. The endless accusations of one faction’s bias or maltreatment of the other are difficult to reconcile. Without self-control, this societal noise could wear one out. To avoid these traps, we can remind ourselves how fortunate we are to be cardiothoracic surgeons with the opportunity to make a difference each day in the lives of our patients and their families. Gratitude for my family and friends, and for the many gifts offered by this world, this country, and my community, are a great comfort to me. Nonetheless, the seemingly ever-increasing loss of stability and predictability impacts our ability to effectively manage our lives, both at work and at home. It is all too easy as a surgeon to thrive on the illusion of stability, predictably, and control. With time, I have come to realize the significance of this illusion. The only thing we can control is our response to the noise. Reminding myself of this has helped me be less stressed and more relaxed. Have I experienced burnout? Yes. However, taking the time to occasionally relax and recharge is the best way to manage stress and aim for a bit of balance. Throughout my career, I have turned to senior surgeons—all of whom gave back to our specialty via volunteer work with STS and other organizations—for support and guidance. It is those surgeons and STS that have helped our specialty evolve tremendously since my days as a resident and early career surgeon. Many technologies and techniques that are common today did not exist then. STS has been and continues to be steadfast as a leader in providing hands-on education for thoracoscopic techniques, mitral valve knowledge, TAVR, and so much more. For many of us, STS has played an important role in strengthening our skills and abilities as surgeons and leaders. "We can remind ourselves how fortunate we are to be cardiothoracic surgeons with the opportunity to make a difference each day. John H. Calhoon, MD An array of STS education programs and services—including in-person meetings, webinars, on-demand content, and the STS Cardiothoracic Surgery E-Book—provide members access to the latest science and best practices. The Society also provides special opportunities for residents and early career surgeons to connect with peers and mentors, participate in hands-on training, develop leadership skills with renowned faculty, and participate in STS governance to advance the interests of the specialty. But STS is so much more. It is a catalyst for advances in CT surgery that help surgeons provide the highest quality care and deliver the best patient outcomes. The STS National Database and accompanying research and quality initiatives help drive cardiothoracic surgery innovation and safety. Hospitals and health systems depend on our data to strengthen their performance. Industry uses them to design and improve next generation devices and therapeutics. Data-driven research powers The Annals of Thoracic Surgery, the largest and most read journal in our specialty (congratulations to Dr. Jo Chikwe and her editorial and administrative teams!). And research is the basis for STS’s leadership in guideline development. Most importantly, STS is the only organization engaged in public policy advocacy for cardiothoracic surgeons and the patients, institutions, and communities we serve. STS-PAC is a political action committee in Washington, DC, that exclusively represents the specialty. Let me close by asking each of you: Are you unlocking the full value of your STS membership? Here are five things you can do to become more engaged and give back to the profession: Attend—in person—STS 2023, our 59th Annual Meeting in San Diego (see page 11) Submit an abstract for a presentation at an upcoming STS meeting Contribute an article to The Annals or Annals Short Reports Donate to STS-PAC and develop a relationship with your member of Congress Volunteer to serve as a mentor for a younger surgeon or join an STS Workforce or Task Force Details about these opportunities can be found at sts.org. More to come, John

STS News, Fall 2022 — The highly anticipated new season of The Resilient Surgeon is underway, featuring game changers in the high-performance and wellness space, including a professor of leadership at Harvard Business School, a performance coach, and a psychiatrist. This provocative STS podcast series aims to help surgeons be their best selves inside and outside of the operating room. “The choice of guests featured this season parallels a paradigm I developed called ‘Best Self Pie,’” said Michael A. Maddaus, MD, host of The Resilient Surgeon. “I prefer the term ‘best self’ to the word wellness because it is an intuitive and personal reference point that we all have, if we are aware enough." The first piece of the “pie”—individual habits and activities such as sleep, diet, exercise, gratitude, and connection with others—were covered in the first season of the podcast; whereas the additional pieces—self-awareness, purpose, and connection at work and home—will be tackled in Season 2 of The Resilient Surgeon, which began airing in late August. The episodes will be released biweekly with a lineup that includes: Brad Stulberg: author of The Practice of Groundedness discusses being successful without crushing the soul (self-awareness and habits) Marcus Buckingham: world expert on engagement at work and the author of Love + Work provides a master class on finding purpose by embracing our "wyrd" (self-awareness and purpose) Amy C. Edmondson, PhD: professor of leadership at Harvard Business School and author of seven books discusses psychological safety and its crucial role in performance, creativity, and wellbeing (all four) Paul M. Conti, MD: psychiatrist who specializes in mental illness and the impact of life stressors breaks down the epidemic of trauma and how it impacts lives in ways that people may not even realize (self-awareness) Christine Porath, PhD: professor at Georgetown University and author of Mastering Community offers insights on the critical role of being valued and respected in the workplace (connection) Additional guests will include Rich Diviney, Brian R. Little, PhD, and Steve Magness. Subscribe to Surgical Hot Topics via your favorite podcast app, or find the episodes at sts.org/podcast. Social media postings about the series will include the hashtag #BeYourBestSelf.