Surgical Hot Topics

Beyond the Abstract: Reporting on the STS Intermacs and Pedimacs Databases

Hosted by Thomas K. Varghese Jr., MD, MS, Annals Deputy Editor, Digital Media and Digital Scholarship, the “Beyond the Abstract” program explores the “whys” behind an article in The Annals of Thoracic Surgery and discusses next steps with authors and thought leaders. In the latest episode, Drs. Robert Kormos and David Morales join host Dr. Thomas K. Varghese Jr. to explore the motivation for developing registries that examine clinical outcomes and quality-of-life metrics for patients who received FDA-approved durable mechanical circulatory support devices. They also discuss how these data will impact future devices, patient selection, and outcomes. Read the related Annals articles online:

• “The Society of Thoracic Surgeons Intermacs Database Annual Report: Evolving Indications, Outcomes, and Scientific Partnerships” (http://bit.ly/2NmLNPs)
• “Third Annual Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) Report: Preimplant Characteristics and Outcomes” (http://bit.ly/2J5vSzY)    

Finding Your First Job in Cardiothoracic Surgery

The job market for cardiothoracic surgeons is more promising now than it has been in decades. So how can residents and fellows be successful in finding that first job? Vinay Badhwar, MD asks seasoned and early career colleagues for tips on making a good impression during an interview, making sure that the job is a great fit, how to find the best career resources, and how to engage and maintain good mentors.

Should Robotics Be Part of Cardiothoracic Surgery Training?

More cardiothoracic surgery programs are incorporating robotics training for residents and fellows. But should robotics be a standard part of the curriculum and have a presence on the in-training and board exams? Dr. Rishinda M. Reddy moderates a discussion with colleagues about the principles of robotics training, how they obtained funding for their robotics programs, and the importance having expanded minimally invasive skills.

The Value of the STS National Database—It’s Much More than Star Ratings

The STS National Database is known worldwide as the “gold standard” for quality improvement and patient safety in cardiothoracic surgery. Launched in 1989, the Database includes approximately 8 million patient records. In this roundtable discussion, Drs. Dave Shahian, Felix Fernandez, Jeff Jacobs, and Vinod Thourani explain how they’ve used data from the Database for making improvements at their own hospitals, for research projects, to understand the cost-effectiveness of various procedures, and to demonstrate the importance of the care that cardiothoracic surgeons provide.

Breaking the Demographic and Cultural Barriers to Patient Enrollment in Clinical Trials

Despite mandates that determinants of health and differences in sex be incorporated into clinical trials, some groups—such as minorities, women, and those of lower socioeconomic status—are still underrepresented. Drs. David T. Cooke, Loretta Erhunmwunsee, and Linda W. Martin discuss why diverse groups are important, how to improve clinical trial design, and strategies to enroll more broadly representative groups into clinical trials.

The Surgical Challenges Involved with Treating Infective Endocarditis

Endocarditis is one of the most challenging infections to treat for cardiothoracic surgeons, and the opioid epidemic has led to a staggering increase in the number of infective endocarditis cases seen in the United States. Dr. Robbin G. Cohen talks with some of the world’s leading experts in treating valve disease and endocarditis—Drs. Joseph E. Bavaria, Eric E. Roselli, and Scott Goldman—about when surgeons should get involved in the treatment process, when and how long to treat with antibiotics, the best candidates for surgery, and the ethics surrounding treating IV drug abusers.

The Risks and Benefits of Media Exposure for Cardiothoracic Surgeons

Media coverage can be a powerful way for cardiothoracic surgeons to help more patients and their families understand important health care information. But how can you handle a reporter’s tough questions and still get your message across? Todd K. Rosengart, MD leads a panel discussion with cardiothoracic surgeons who have had experience with handling awkward media situations, connecting with a lay audience, and helping to change the course of a conversation when a reporter has incorrect information.

STS Provides Personal Performance Data to Cardiac Surgeons

The Society is offering a new opportunity for self-assessment and quality improvement in cardiothoracic surgery—surgeon-specific outcomes reports from the Adult Cardiac Surgery Database (ACSD). For those who affirmatively opt in, these feedback reports will be available beginning in fall 2019 and will include data on coronary artery bypass grafting (CABG), aortic valve replacement (AVR), CABG+AVR, mitral valve repair and replacement (MVRR), and CABG+MVRR. Four STS leaders, Drs. Richard Prager, David M. Shahian, Alan M. Speir, and Domenico Pagano, recently discussed the importance of this initiative and how it will lead to better patient care.

How to Develop a Productive Mentor/Mentee Relationship

Some of the most successful cardiothoracic surgeons credit mentors for part of their achievements. Whether you are still in training, an early careerist, or a senior surgeon, taking part in a productive mentor/mentee arrangement has long-term benefits. But how do you identify a good mentor or mentee and cultivate that relationship? Drs. Mara B. Antonoff, Vinod H. Thourani, John D. Mitchell, and Elizabeth A. David describe the qualities to look for in a mentor, the importance of communication, setting realistic expectations, avoiding “mentor malpractice,” and why mentees should under promise and over deliver.

 

Preparing for AI and New Cyber Threats in Cardiothoracic Surgery

Artificial intelligence and electronic health technologies are changing how physicians conceptualize and treat diseases. Although these futuristic advancements are leading to improvements in quality, safety, and patient outcomes, these technologies also are dramatically changing the cyber threat landscape. Kevin W. Lobdell, MD talks with colleagues in cardiothoracic surgery, cardiology, and anesthesiology about embracing virtual reality, augmented reality, and machine learning, while also finding ways to protect against cyberattacks.