Chamberlain Papers Will Examine Timely Topics at Monday Plenary

The Chamberlain Paper for General Thoracic Surgery describes new molecular imaging technology that may improve surgical outcomes for non-small cell lung cancer. Here, a tumor on the pleural surface of the lung is lit up by OTL38. CREDIT: On Target Laboratories, Inc.

The Chamberlain Paper for General Thoracic Surgery describes new molecular imaging technology that may improve surgical outcomes for non-small cell lung cancer. Here, a tumor on the pleural surface of the lung is lit up by OTL38. Photo credit: On Target Laboratories, Inc.

Failure to rescue after cardiac surgery, real-time molecular imaging of lung nodules, and the role of transcatheter aortic valve replacement (TAVR) in young and middle-aged adults are the focuses of this year’s prestigious J. Maxwell Chamberlain Memorial Papers, which will be presented during Monday’s plenary session.

Mortality Rates after Cardiac Surgery Tied to a Hospital’s Ability to Rescue
Mortality rates after cardiac surgery varied significantly across 90 hospitals, according to a study that analyzed data from the STS Adult Cardiac Surgery Database (ACSD) to evaluate the role of failure to rescue (FTR) in operative mortality. 

Donald S. Likosky, PhD

Donald S. Likosky, PhD

“The variation in mortality rates after cardiac surgery is driven in large part by a hospital’s failure to rescue rate, rather than its complication rate,” said Donald S. Likosky, PhD, from the Institute for Healthcare Policy & Innovation at the University of Michigan in Ann Arbor. Dr. Likosky will present the Chamberlain Paper for Adult Cardiac Surgery. 

The study drew from the results of six physician-led quality improvement collaboratives and is one of the largest experiences to date concerning FTR in the setting of coronary artery bypass grafting and/or valve surgery. 

J. Maxwell Chamberlain Memorial Papers

9:30 a.m. – 10:30 a.m.
Great Hall A

“Our findings further establish the importance of identifying and disseminating optimal complication recovery approaches across cardiac surgical hospitals and practices,” Dr. Likosky said. 

New Molecular Imaging Technology May Improve NSCLC Surgical Outcomes
Intraoperative molecular imaging using a drug that targets folate receptors within cancer cells improved outcomes for 26% of patients undergoing pulmonary resection for non-small cell lung cancer (NSCLC). 

Inderpal S. Sarkaria, MD

Inderpal S. Sarkaria, MD

Specific to adenocarcinoma, “this new technology involves an IV injection of OTL38, a drug that directly localizes to the tumor, and an imaging system specifically developed to target the wavelength for which the drug fluoresces,” said Inderpal S. Sarkaria, MD, from the UPMC Hillman Cancer Center in Pittsburgh. Dr. Sarkaria will present the Chamberlain Paper for General Thoracic Surgery.

Identifying nodules during thoracic surgery is becoming an increasing challenge in the era of minimally invasive surgery. “We no longer have the facility of our hands to palpate the lung and identify nodules,” Dr. Sarkaria said. In order to accurately stage patients and provide appropriate treatment, better technology is needed to identify nodules and occult cancers within the lung that aren’t seen in preoperative imaging or felt by palpitation, he added. 

“We’re emerging into an era of non-invasive technologies for localization of tumors, assessment of tumor margin, and better identification of occult cancers during minimally invasive operations using more imaging technologies,” Dr. Sarkaria said. 

Should TAVR Be Considered for Young and Middle-Aged Patients?
The use of TAVR has become more widespread, yet it is still relatively uncommon in adult patients younger than 55 years old. 

Jennifer S. Nelson, MD, MS

Jennifer S. Nelson, MD, MS

To understand contemporary national practice patterns of surgical aortic valve replacement (SAVR) and TAVR in young and middle-aged adults, researchers combined data available for adults age 18 to 54 years in the ACSD and the STS Congenital Heart Surgery Database. 

“Approximately one-sixth of the young and middle-aged adults who undergo aortic valve replacement have congenital heart disease other than an isolated bicuspid aortic valve. In the growing group of adults with congenital heart disease, anatomical considerations could present challenges for current TAVR devices. However, because adults with congenital heart disease often require repeated valve interventions over a lifetime, it is our responsibility to explore new therapies that could help patients avoid sternotomies,” said Jennifer S. Nelson, MD, MS, from Nemours Children’s Hospital in Orlando, who will present the Chamberlain Paper for Congenital Heart Surgery. 

“We were able to provide a description of SAVR/TAVR use and early outcomes,” Dr. Nelson said. “These data help us better understand the risks and complications associated with TAVR versus SAVR in this age group, but it is obvious that new collaborations between adult and congenital heart teams will be paramount.”