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Surgical Hot Topics

Updated 4 days ago

Science
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Listen to leaders in cardiothoracic surgery discuss hot topics in the field. Please note: The comments included in these episodes are that of the individuals involved and not necessarily that of The Society of Thoracic Surgeons.

Read more

Listen to leaders in cardiothoracic surgery discuss hot topics in the field. Please note: The comments included in these episodes are that of the individuals involved and not necessarily that of The Society of Thoracic Surgeons.

iTunes Ratings

14 Ratings
Average Ratings
10
1
2
0
1

iTunes Ratings

14 Ratings
Average Ratings
10
1
2
0
1
Cover image of Surgical Hot Topics

Surgical Hot Topics

Latest release on Mar 31, 2020

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Listen to leaders in cardiothoracic surgery discuss hot topics in the field. Please note: The comments included in these episodes are that of the individuals involved and not necessarily that of The Society of Thoracic Surgeons.

Rank #1: Anticoagulation During Cardiopulmonary Bypass

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In January, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of ExtraCorporeal Technology released a clinical practice guideline on the use of blood thinning medication (anticoagulants) during heart surgery. In this episode, guideline coauthor John Hammon, MD speaks with two cardiothoracic surgeons (Gaetano Paone, MD and Richard Engelman, MD) and a perfusionist (Theron Paugh, CCP) about how the guideline will change clinical practice.

Feb 21 2018

9mins

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Rank #2: Beyond the Abstract: The Resilience Bank Account

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The numerous professional and personal stressors experienced by cardiothoracic surgeons can—if not well managed—lead to errors in clinical judgment, burnout, early departure from practice, health issues, and substance abuse. In the latest episode of “Beyond the Abstract,” a program that explores the “whys” behind an article in The Annals of Thoracic Surgery, Dr. Michael Maddaus joins host Dr. Tom Varghese to discuss six habits that can make a significant difference in managing stress when proactively integrated into a daily routine. Read the related Annals article, “The Resilience Bank Account: Skills for Optimal Performance” at http://bit.ly/2q8XMFA.

Dec 02 2019

39mins

Play

Rank #3: The Surgical Challenges Involved with Treating Infective Endocarditis

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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.

Apr 01 2019

17mins

Play

Rank #4: What Is the Best Way to Treat Heart Disease?

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Cardiovascular disease is the #1 killer of people around the world, with approximately 18 million deaths annually, according to the World Health Organization. Treatment options for heart disease include lifestyle changes, stenting, and surgery. But which option is best and for which patients? Thomas E. MacGillivray, MD, moderates a panel discussion with Jennifer S. Lawton, MD, John D. Puskas, MD, Marc Ruel, MD, MPH, and Joseph F. Sabik III, MD. They explore recent results from the ISCHEMIA trial, implications for the heart team, and which patients benefit the most from percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or medical therapy.

Mar 02 2020

19mins

Play

Rank #5: Transcatheter-Based Mitral Valve Repair and Replacement

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The latest advances in mitral valve repair and replacement include a shift toward the transseptal platform. Gorav Ailawadi, Vinay Badhwar, Steven F. Bolling, and T. Sloan Guy discuss how catheter-based techniques will re-emulate the gold standard for mitral valve surgery, the important role of 3D Echo technology, the need for transseptal puncture skills, and navigating the local politics.

Mar 09 2018

17mins

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Rank #6: Mentorship in Cardiothoracic Surgery

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Mentorship is an important component to success for many up-and-coming cardiothoracic surgeons. For established surgeons, being a good mentor is equally as important. Vinay Badhwar, MD moderates a discussion that includes Shanda H. Blackmon, MD, MPH, Melanie A. Edwards, MD, and David D. Odell, MD, MMSc talking about how mentorship is critical to the future of the specialty and what STS is doing to promote mentorship for early career surgeons.

Apr 06 2018

17mins

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Rank #7: The Risks and Benefits of Media Exposure for Cardiothoracic Surgeons

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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.

Mar 25 2019

17mins

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Rank #8: Should Robotics Be Part of Cardiothoracic Surgery Training?

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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.

Apr 22 2019

19mins

Play

Rank #9: The Consequences of Refusing Surgery

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Two studies presented at the recent STS Annual Meeting showed that surgical therapy is superior to alternative treatment approaches for both esophageal cancer and coronary artery disease in younger patients. In light of these findings, Robbin G. Cohen, MD, MMM, Mark S. Allen, MD, Sebron W. Harrison, MD, and Alan M. Speir, MD discuss why patients refuse surgery, how they respond to patients who opt against surgery, and the obligations of surgeons in an age of patient autonomy.

Apr 27 2018

16mins

Play

Rank #10: Which Low-Risk Patients Should Receive TAVR?

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The FDA recently expanded the indications for transcatheter aortic valve replacement (TAVR) to include patients at low surgical risk, but experts are urging caution about which low-risk patients should undergo TAVR until more information is gathered. In this episode, Joseph E. Bavaria, MD, explored recent clinical trials with Tsuyoshi Kaneko, MD, Michael J. Reardon, MD, and Vinod Thourani, MD. They discussed what these trials mean for cardiac surgeons, interventional cardiologists, and the heart team, as well as knowledge gaps about age, bicuspid patients, SYNTAX score, pacemakers, and mechanical valve durability.

Feb 10 2020

20mins

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Rank #11: Evolving Trends in TAVR

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The volumes of two aortic valve replacements (AVR) procedures have changed dramatically over the past few years, with more transcatheter procedures now being performed than open surgical procedures. Four cardiac surgeons discuss the evolving trends in TAVR, why the changes are occurring, and what’s ahead for TAVR and SAVR. Wilson Y. Szeto, MD moderates the discussion that also features Michael J. Mack, MD, John V. Conte, MD, and Thomas E. MacGillivray, MD.

Apr 13 2018

16mins

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Rank #12: STS Provides Personal Performance Data to Cardiac Surgeons

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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.

Mar 15 2019

25mins

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Rank #13: Take It to the Limit

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Taking it to the limit is what cardiothoracic surgery has done for the past 50 years and what STS has done on behalf of the specialty for that same half century; however, some things that once made CT surgery successful may now be counterproductive. In his Presidential Address at the 2014 STS Annual Meeting in Orlando, Florida, Douglas E. Wood, MD challenged his colleagues in the male-dominated profession to welcome in more women and transition away from a masculine, autocratic leadership style.

May 11 2018

44mins

Play

Rank #14: Strategies for Surgeons to Prevent Burnout

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Cardiothoracic surgeons are at significant risk of burnout because of long work hours, delayed career gratification, complex health care, intense personality, and poor work-life balance. In fact, recent data show that more than half of cardiothoracic surgeons reported feeling burned out. In this important roundtable discussion, Thomas K. Varghese Jr., MD, MS, gathers tips to avoid burnout from Oliver S. Chow, MD, Michal Hubka, MD, and Susan D. Moffat-Bruce, MD, PhD, MBA. Strategies include building strong networks, bonding with family and friends, meditation, spending time outdoors, and making wellness a goal of the entire health care team.

Feb 24 2020

15mins

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Rank #15: Addressing the Impending Shortage of Cardiothoracic Surgeons

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Numerous studies predict growing shortages in the physician workforce in the United States, especially among cardiothoracic surgeons. Five cardiothoracic surgeons and a fourth-year medical student discuss ways to address this impending shortage, including increasing the cap on residency slots, reducing the burden of training costs, and improving work-life balance.

Mar 02 2018

19mins

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Rank #16: A New Global Health Crisis

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Over the last several decades, deaths from noncommunicable diseases—including cardiovascular disease and lung and esophageal cancer—have increased in the developing world. In his Presidential Address at the 2015 STS Annual Meeting in San Diego, California, David A. Fullerton, MD outlined the problem, the Society’s efforts to fund charitable surgical missions in developing nations, and STS members who are making a difference.

May 18 2018

31mins

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Rank #17: How to Develop a Productive Mentor/Mentee Relationship

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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.

Mar 08 2019

16mins

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Rank #18: Innovation for Life

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Even though an operation or a process has been around for a long time and may seem "normal," an innovative idea can change it all. In his Presidential Address at the 2016 STS Annual Meeting in Phoenix, Arizona, Mark S. Allen, MD described five common characteristics shared by innovators inside and outside of medicine and urged cardiothoracic surgeons to embrace innovation and ultimately make the specialty better for themselves and their patients.

May 25 2018

39mins

Play

Rank #19: The Value of the STS National Database—It’s Much More than Star Ratings

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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.

Apr 12 2019

18mins

Play

Rank #20: The Debate Over Exercise Restrictions in Cardiac Surgery

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Should patients remain active before, during, and after cardiac surgery? Some surgeons have opposing views. Thomas G. Gleason, MD, from the University of Pittsburgh, and Edward P. Chen, MD, from Emory University, discuss the role of exercise in the treatment and recovery process following surgery for various forms of heart disease, especially among active patients.

Mar 30 2018

14mins

Play

STS Responds to the COVID 19 Crisis

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STS President Joseph A. Dearani, MD, updates members on the COVID-19 pandemic and explains how the Society is supporting cardiothoracic surgeons and patients.

Mar 31 2020

6mins

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Young Professors: Insights and Tips for Early and Mid-Career Faculty

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For cardiothoracic surgeons who are hoping to advance in their careers, it’s often difficult to balance clinical work with the scholarly activities that are necessary for promotion in a modern academic medicine environment. Ourania A. Preventza, MD, and colleagues including Himanshu J. Patel, MD, Elaine E. Tsang, MD, and Sunil Singhal, MD, provide insight on the processes required and tips to help young surgeons successfully get to the next step.

Mar 29 2020

21mins

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Artificial Intelligence and Machine Learning in Cardiothoracic Surgery

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Cardiothoracic surgeons are studying the use of artificial intelligence (AI) and machine learning (ML) to improve risk prediction in the hopes that patient outcomes also will improve. Arman Kilic, MD, and Ara A. Vaporciyan, MD, along with medical student Brian Ayers, discuss what AI and ML mean, how it can uncover previously unknown relationships in medical data, and how it can be used to assist the surgeon in the operating room.

Mar 23 2020

14mins

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Expanding the Pool of Heart and Lungs for Organ Donors

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More than 100,000 people in the United States currently are waiting for a lifesaving organ transplant, including 5,000 people on the transplant list for a heart and/or lungs, according to the United Network for Organ Sharing. Although some will die before they receive a transplant, surgeons and research teams are making great strides in expanding the pool of viable organs. Zachary N. Kon, MD, moderates a discussion with Ashish S. Shah, MD, Matthew G. Hartwig, MD, and Varun Puri, MD, MSCI, about new ways to assess organ quality, technologies to increase their viability, and ways to better match donors and recipients.

Mar 16 2020

23mins

Play

Recognizing and Treating the Frail Cardiothoracic Surgery Patient

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Understanding a patient’s frailty index is an important part of assessing the risks and benefits of a surgical procedure for a cardiothoracic surgery patient. Frailty sometimes is measured by a patient’s grip strength, weight, and walking test results, but standards for evaluating and treating frailty before surgery do not exist. Mark K. Ferguson, MD (The University of Chicago), moderates a panel discussion with Nimesh Desai, MD (University of Pennsylvania), Linda W. Martin, MD, MPH (University of Virginia), and Betty C. Tong, MD (Duke University Medical Center), about how to screen for frailty, interventions to help patients prepare for surgery, and optimizing post-operative treatment protocols for the frail patient.

Mar 09 2020

19mins

Play

What Is the Best Way to Treat Heart Disease?

Podcast cover
Read more

Cardiovascular disease is the #1 killer of people around the world, with approximately 18 million deaths annually, according to the World Health Organization. Treatment options for heart disease include lifestyle changes, stenting, and surgery. But which option is best and for which patients? Thomas E. MacGillivray, MD, moderates a panel discussion with Jennifer S. Lawton, MD, John D. Puskas, MD, Marc Ruel, MD, MPH, and Joseph F. Sabik III, MD. They explore recent results from the ISCHEMIA trial, implications for the heart team, and which patients benefit the most from percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or medical therapy.

Mar 02 2020

19mins

Play

Strategies for Surgeons to Prevent Burnout

Podcast cover
Read more

Cardiothoracic surgeons are at significant risk of burnout because of long work hours, delayed career gratification, complex health care, intense personality, and poor work-life balance. In fact, recent data show that more than half of cardiothoracic surgeons reported feeling burned out. In this important roundtable discussion, Thomas K. Varghese Jr., MD, MS, gathers tips to avoid burnout from Oliver S. Chow, MD, Michal Hubka, MD, and Susan D. Moffat-Bruce, MD, PhD, MBA. Strategies include building strong networks, bonding with family and friends, meditation, spending time outdoors, and making wellness a goal of the entire health care team.

Feb 24 2020

15mins

Play

The Changing Landscape of Tobacco Use

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The biggest threat to lung health in the current era is vaping. Shanda H. Blackmon, MD, MPH, moderates a discussion about the changing landscape of tobacco use, which includes vaping as the new gateway to smoking. She and colleagues, J. Robert Headrick, MD, MBA, Matthew A. Steliga, MD, and Keith S. Naunheim, MD, describe the “terrifying” statistics about vaping, why patients are oftentimes afraid to seek help, the use of graphics warnings, and why bringing smoking cessation resources to patients may become more necessary.

Feb 18 2020

15mins

Play

Which Low-Risk Patients Should Receive TAVR?

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The FDA recently expanded the indications for transcatheter aortic valve replacement (TAVR) to include patients at low surgical risk, but experts are urging caution about which low-risk patients should undergo TAVR until more information is gathered. In this episode, Joseph E. Bavaria, MD, explored recent clinical trials with Tsuyoshi Kaneko, MD, Michael J. Reardon, MD, and Vinod Thourani, MD. They discussed what these trials mean for cardiac surgeons, interventional cardiologists, and the heart team, as well as knowledge gaps about age, bicuspid patients, SYNTAX score, pacemakers, and mechanical valve durability.

Feb 10 2020

20mins

Play

The NextGen STS National Database Is Finally Here

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More than 2 years in the making, the first phase of the next generation STS National Database launched during the STS Annual Meeting in New Orleans (January 2020). The phase 1 rollout includes a data uploader, missing variable report, interactive dashboard, and a data quality report that will provide feedback within minutes after upload. Vinay Badhwar, MD, leads a discussion about what this innovative new clinical data registry means for cardiothoracic surgeons, their data managers, hospitals, and patients. He is joined by Joseph A. Dearani, MD, Felix G. Fernandez, MD, MSc, Jonathan Morris, MD, and Diane E. Alejo.

For the latest updates on the next generation Database, visit www.sts.org/database.

Feb 03 2020

18mins

Play

Beyond the Abstract: The Future is Now

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Hosted by Thomas K. Varghese Jr., MD, MS, the “Beyond the Abstract” program explores the “whys” behind articles in The Annals of Thoracic Surgery and discusses next steps with authors and thought leaders. In the latest episode, Dr. Felix Fernandez joins Dr. Varghese to reflect on the accomplishments of the STS National Database over the last 30 years and discuss the early 2020 transition to a user-friendly, cloud-based, real-time platform that will accelerate practice improvement and lead to better patient outcomes. Read the related Annals Article, "The Future is Now: The 2020 Evolution of The Society of Thoracic Surgeons National Database" at http://bit.ly/3afTrmj

Jan 16 2020

20mins

Play

Beyond the Abstract: Understanding and remediating lapses in professionalism

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When physicians regularly exhibit a lack of civility and respect, patient safety and quality of care are compromised. The latest episode of “Beyond the Abstract,” from The Annals of Thoracic Surgery and part of the Society’s Surgical Hot Topics podcast, covers a paper that explores unprofessional behavior in the workplace and recommends a new framework for the assessment, treatment, and remediation of physicians with professionalism transgressions. Lead author Dr. Betsy Williams joins host Dr. Tom Varghese to discuss why this article was written and next steps. Read the related Annals article, “Understanding and remediating lapses in professionalism: Lessons from the island of last resort,” at http://bit.ly/2spz457

Jan 14 2020

18mins

Play

Beyond the Abstract: The Resilience Bank Account

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The numerous professional and personal stressors experienced by cardiothoracic surgeons can—if not well managed—lead to errors in clinical judgment, burnout, early departure from practice, health issues, and substance abuse. In the latest episode of “Beyond the Abstract,” a program that explores the “whys” behind an article in The Annals of Thoracic Surgery, Dr. Michael Maddaus joins host Dr. Tom Varghese to discuss six habits that can make a significant difference in managing stress when proactively integrated into a daily routine. Read the related Annals article, “The Resilience Bank Account: Skills for Optimal Performance” at http://bit.ly/2q8XMFA.

Dec 02 2019

39mins

Play

Beyond the Abstract: Attrition of the Cardiothoracic Surgeon-Scientist

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Are surgeon-scientists a dying breed? Dr. John Ikonomidis is the lead author of a new paper that explores the decline of surgeons who are applying for and receiving grants, publishing less, and feeling that research is not a part of their role. He joins host Dr. Tom Varghese in the latest episode of “Beyond the Abstract,” a program that explores the “whys” behind an article in The Annals of Thoracic Surgery and discusses next steps with authors and thought leaders. Read The Annals article, “Attrition of the Cardiothoracic Surgeon-Scientist: Definition of the Problem and Remedial Strategies,” at  http://bit.ly/2ZLg8ZR

Aug 09 2019

27mins

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

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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)    

Jun 25 2019

37mins

Play

Finding Your First Job in Cardiothoracic Surgery

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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.

Apr 29 2019

21mins

Play

Should Robotics Be Part of Cardiothoracic Surgery Training?

Podcast cover
Read more

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.

Apr 22 2019

19mins

Play

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

Podcast cover
Read more

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.

Apr 12 2019

18mins

Play

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

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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.

Apr 08 2019

19mins

Play

The Surgical Challenges Involved with Treating Infective Endocarditis

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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.

Apr 01 2019

17mins

Play

iTunes Ratings

14 Ratings
Average Ratings
10
1
2
0
1