January 23/24, 2016

Thank You!

The Society of Thoracic Surgeons gratefully acknowledges the following companies for providing educational grants for the STS 52nd Annual Meeting.

This list is accurate as of December 28, 2015.

STS Platinum Benefactors

Provided $50,000 or above
Abbott Vascular
Medtronic

STS Silver Benefactors

Provided $10,000-$24,999
Ethicon
HeartWare
Olympus America Inc.
St. Jude Medical

Get Free Tech Support at the Tech Bar

An exciting amenity at the 2016 Annual Meeting is the Tech Bar, which is located at Booth #639 in the Exhibit Hall. Stop by for answers to all of your technical questions—experts can help you with personal and professional tasks, such as downloading and using the STS Annual Meeting Mobile App, troubleshooting issues with your smartphone or tablet, and more. A complimentary charging station also is available, and you can attend these free demos on various technology topics of interest:

  • Twitter 101: Want to share your thoughts and links with the world? Get on Twitter. The Tech Bar team will get you set up and Tweeting in minutes. (Hands-on tutorial with your device.)
  • Note Taking and Capturing Data: Let’s Go Paperless!: Are you still taking notes by hand with pen and paper? The Tech Bar experts will share options for note taking on your mobile devices with speech and handwriting recognition features.
  • 5 Productivity Apps: How many days are you out of the office, yet you still need to function as if you are there? Learn about apps that will help you with everything from productivity to travel.
  • 5 Apps to Tame Your Inbox: Avoid an e-mail overload. These apps will help you deal with e-mail more effectively.
  • Wearables in the Medical World: You’ve seen the gadgets—Google Glass, smart watches, and many other devices that help track lifestyle improvements. Come hear how these technologies are changing the way health is monitored.

Sunday

4:30 p.m.-5:10 p.m.
Note Taking and Capturing Data: Let’s Go Paperless!

5:15 p.m.-5:55 p.m.
Twitter 101

6:00 p.m.-6:30 p.m.
5 Apps to Tame Your Inbox

Monday

10:50 a.m.-11:30 a.m.
Twitter 101

12:30 p.m.-1:15 p.m.
5 Productivity Apps

3:30 p.m.-4:15 p.m.
5 Apps to Tame Your Inbox

Tuesday

10:00 a.m.-10:45 a.m.
Note Taking and Capturing Data: Let’s Go Paperless!

12:00 p.m-1:00 p.m.
Wearables in the Medical World

3:00 p.m.-3:30 p.m.
5 Productivity Apps

Hear from Experts at Industry-Sponsored Satellite Activities

Satellite activities are programs offered by industry and held in conjunction with the STS 52nd Annual Meeting. They are not developed or sponsored by STS. This list is accurate as of December 22, 2015.

Saturday

Abbott Vascular
The New Mitral Valve Surgeon
7:00 p.m.-8:30 p.m.
Phoenix Ballroom A, Sheraton Grand Phoenix, 340 N. Third Street

CMEology/Baxter Healthcare Corporation
Advanced Strategies for Preventing Bleeding-Related Complications: Patient-Centered Approaches
7:00 p.m.-9:15 p.m.
Valley of the Sun Ballroom D, Sheraton Grand Phoenix, 340 N. Third Street

Sunday

Atricure & MediaSphere Medical, LLC
Why the LAA Matters: The Role of LAA Occlusion for Stroke Management
7:00 p.m.-9:00 p.m.
Regency Ballroom A, Hyatt Regency Phoenix, 122 N. Second Street

Baxter Healthcare Corporation
Guideline Based Approach to Blood Management
7:00 p.m.-10:00 p.m.
Curtis B, Hyatt Regency Phoenix, 122 N. Second Street

CorMatrix Cardiovascular
CorMatrix Conversation & Comedy
7:00 p.m.-10:00 p.m.
Copper Blues, 50 W. Jefferson Street #200

Tuesday

Medtronic
Electromagnetic Navigation Bronchoscopy: Expanding Options in Thoracic Oncology
6:00 p.m.-8:00 p.m.
Paradise Valley, Sheraton Grand Phoenix, 340 N. Third Street

Medtronic
Complex Endovascular Aortic Repair: The Role of the CT Surgeon Today and Tomorrow
6:00 p.m.-9:00 p.m.
North Mountain, Sheraton Grand Phoenix, 340 N. Third Street

Learning Opportunities Available in the Exhibit Hall

Exhibiting companies and others will present talks and demonstrations in the new Learning Labs in the Exhibit Hall. The Large Theater is located to the far left of the 100 Aisle and the Small Theater is located toward the back of the 900 Aisle.

Sunday

Medistim
A Practical Introduction to Graft Assessment and Intraoperative Guidance
4:30 p.m.-5:00 p.m.
Small Theater

Joint Council on Thoracic Surgery Education, Inc.
Jeopardy Championship—Round 1
5:10 p.m.-5:40 p.m.
Large Theater

Monday

MAQUET
Preventing POAF by Reducing Retained Blood
10:50 a.m.-11:20 a.m.
Small Theater

Cook Medical
Lunch & Learn: Hands-On and Didactics of the New Low-Profile Zenith Alpha Thoracic Device
12:30 p.m.-1:00 p.m.
Small Theater

Ethicon
Practical Skills in Cardiothoracic Surgery
3:30 p.m.-4:00 p.m.
Small Theater

Joint Council on Thoracic Surgery Education, Inc.
Jeopardy Championship—Round 2
3:30 p.m.-4:00 p.m.
Large Theater

Opportunities Abound for Annals Education

Meeting attendees interested in improving their scholarly research abilities have a number of opportunities at the Annual Meeting to learn more about publishing in The Annals of Thoracic Surgery.

A Tuesday morning Early Riser session, The Annals Academy, will provide authors with the necessary tools to turn their data into interesting and potentially practice-improving scholarly articles. The session will be held from 7:30 a.m. to 8:30 a.m. in Room 222A; unlike in previous years, you do not need to purchase a separate ticket to attend.

Annals editorial staff also will be available to assist attendees with new submissions, figure editing, journal CME, mailing address changes, and other questions in Room 121C from 1:00 p.m. to 4:00 p.m. on Sunday, 8:00 a.m. to 5:00 p.m. on Monday, 9:00 a.m. to 5:00 p.m. on Tuesday, and 8:00 a.m. to 12:00 p.m. on Wednesday.

Finally, Annals editorial staff will host several tutorials in the Exhibit Hall. Visit Booth #938 to participate in any of the following sessions:

  • New Submissions—Staff will help meeting presenters and other authors navigate the online process to submit their manuscripts.
  • Journal CME—Learn how to access CME content on the Annals website and how these activities are developed.
  • Figure Clinic—Authors can bring their figure files and learn how to optimally display images, including how to identify image resolution and font size, as well as how to submit files for Annals peer review.

Sunday

4:30 p.m.-6:30 p.m.
Figure Clinic, Journal CME, New Submissions

Monday

10:50 a.m.-11:30 a.m.
Figure Clinic

12:30 p.m.-1:15 p.m.
Journal CME

3:30 p.m.-4:15 p.m.
New Submissions

Tuesday

10:00 a.m.-10:45 a.m.
Figure Clinic

12:00 p.m.-1:00 p.m.
Journal CME

3:00 p.m.-3:30 p.m.
New Submissions

LDCT Screening Detects High Lung Cancer Rates in Underserved Area

Carsten Schroeder, MD, PhD

free program to screen high-risk individuals for lung cancer showed triple the number of overall cancer incidence than reported in the National Lung Screening Trial (NLST).

Carsten Schroeder, MD, PhD, Director of the Cancer Center Thoracic Surgery Service and Associate Professor of Surgery, and resident Erika Simmerman, MD, both at the Medical College of Georgia at Augusta University, will report on the findings during Monday’s General Thoracic Session: Lung Cancer I—Diagnosis and Staging, which will be held from 1:30 p.m. to 3:30 p.m. in Room 120A.

“In the NLST, they found 1 in 100 cancers. We found 1 in 32 cancers,” said Dr. Schroeder, adding that the NLST was done throughout the United States, while the Augusta trial was conducted in an underserved area in the Southeast.

The NLST randomly assigned participants to undergo three annual screenings with either low-dose computed tomography (LDCT) (26,722 participants) or single-view chest X-ray (26,732).

The men and women were ages 55 to 74 with at least 30 pack-years of smoking and were either current smokers or had quit within the past 15 years.

Results from the NLST, which were published in 2011, found a 20% reduction in lung cancer mortality among patients screened with LDCT, compared to patients screened with plain chest radiography.

As a result of the NLST findings, the National Comprehensive Cancer Network recommended that high-risk individuals undergo annual LDCT screenings.

In February 2015, the Centers for Medicare & Medicaid Services released a final National Coverage Determination that provides coverage of LDCT lung cancer screening in certain high-risk patients.

Georgia Screening

The researchers conducted their thoracic surgery-driven 1-year LDCT trial beginning in June 2014 at the major academic hospital in Augusta, Georgia. The trial had two screening groups of people ages 55 to 80. (See modified screening criteria below.)

Augusta, a 2-hour drive from Atlanta, has about 200,000 residents, with the metro area totaling about 545,000. A 2014 Brookings Institution report found that between 2008 and 2012, 63.9% of Augusta’s poor lived in the suburbs.

Of the 255 patients screened, four had pathologically proven malignancies, four had a clinical diagnosis of cancer, seven had equivocal findings for workups, four were false positives, and four chose to avoid intervention and instead underwent serial imaging surveillance.

“Early detection of lung cancer is important because if we don’t detect it early, it is not operable,” Dr. Schroeder said. “Once an individual starts coughing up blood or has pain, it’s normally too late because you are already in stage 3 or 4. If we can detect lung cancer early, we can offer patients longer survival, if not a cure.”

Screening Criteria

Group 1

  • 55−80 years old
  • Currently a smoker or have quit within the past 15 years
  • Smoked at least a pack of cigarettes a day for 30-plus years

Group 2

  • 50−80 years old
  • Smoked at least a pack of cigarettes a day for 20-plus years
  • Have at least one of the following additional lung cancer risks:
    • Personal cancer history (lung, head and neck, and/or lymphoma)
    • Family history of lung cancer (parent, sibling, or child)
    • Emphysema or chronic bronchitis
    • Chronic obstructive pulmonary disease
    • Long-term exposure to asbestos
    • Asbestos-related lung disease or pulmonary asbestosis
    • Long-term exposure to silica, cadmium, arsenic, beryllium, chromium, diesel fumes, nickel, radon, uranium, or coal smoke and soot

Study Examines Impact of Specialty and Trainee Involvement on Esophagectomy Outcomes

A study being presented Tuesday has found that allowing trainees to participate in esophagectomies does not influence patient outcomes. And while the specialty of the surgeon performing the procedure doesn’t affect mortality, it may have an impact on other outcomes.

Zeyad Khoushhal, MD, MPH

Senior author Daniela Molena, MD and her colleagues conducted a retrospective analysis using the American College of Surgeons National Surgical Quality Improvement Program databases (2005-2013). Zeyad Khoushhal, MD, MPH will report on the findings during Tuesday’s General Thoracic Session: Esophageal, which will be held from 1:00 p.m. to 3:00 p.m. in Room 125AB.

More than 15,000 esophagectomy patients, who were 18 years and older, were divided into two groups, those with surgeries performed by general surgeons (69.8%) and those with surgeries performed by cardiothoracic surgeons (30.2%). Dr. Khoushhal and his colleagues compared intraoperative and postoperative outcomes.

They found that while patients treated by cardiothoracic surgeons had significantly higher comorbidities, cancer rates, and trainee involvement with their surgeries, there was no significant difference in mortality.

Daniela Molena, MD

However, they found that in those procedures performed by general surgeons, patients experienced an increase in serious morbidity, longer hospital stay, and decreased odds for home discharge.

When researchers evaluated trainee involvement as an independent factor, no significant differences were seen in patient outcomes.

Dr. Khoushhal conducted the study while working on his master’s degree in public health at Johns Hopkins Bloomberg School of Public Health in Baltimore. He is now a Postdoctoral Research Fellow at St. Michael’s Hospital in Toronto. Dr. Molena was his mentor.

“As academic surgeons, it’s our responsibility to train residents and students. I am happy to see there was really no difference in the outcomes when there was trainee involvement,” Dr. Molena said. “At the end of the day, the responsibility of the case is on the attending. It is important that the operation is done in a way that is safe for the patient and provides an optimal outcome, but, at the same time, it allows trainees to learn how to become good surgeons. These data are important because they show that the outcome doesn’t change whether the trainee is involved or not.”

She noted that patients who seek treatment from cardiothoracic surgeons typically are sicker.

“I’m not surprised to see more cancer, more COPD, and more congestive heart failure. Patients who are sicker are going to see specialists for care,” said Dr. Molena, who is now an Associate Attending and Director of the Esophageal Surgery Program at Memorial Sloan Kettering Cancer Center and an Associate Professor at Weill Cornell Medical College, New York.

STS Staff Welcomes You to Phoenix!

Rob Wynbrandt

On behalf of the Society’s staff, I join STS President Mark Allen in welcoming you to The Society of Thoracic Surgeons 52nd Annual Meeting and Exhibition in Phoenix, Arizona. As in the past, the Annual Meeting will provide you with a wide range of educational, networking, and social offerings.

Because there is so much to experience between Saturday and Wednesday, this STS Meeting Bulletin will help you keep track of what’s happening and provide up-to-date information about new sessions, meeting room locations, exhibitor descriptions, and much more.

Watch for the Monday and Tuesday/Wednesday editions of the Bulletin; the newspapers will be placed in bins throughout the Phoenix Convention Center during the Annual Meeting. Check the front-page left-hand column in each issue for a quick summary and update of the day’s activities.

The Bulletin also provides a handy reference to the Exhibit Hall, which is an important component of the meeting experience. The Exhibit Hall is a great place to learn about new and improved technology and products, and it offers the perfect opportunity to see and meet with colleagues and friends. Surveys from past meetings show that the majority of attendees make a point of visiting with the exhibitors at least three times over the course of the meeting. The STS Exhibit Hall opens its doors at 4:30 p.m. on Sunday, with a reception that runs through 6:30 p.m. Snacks and refreshments will be served throughout the Exhibit Hall.

While you’re there, take advantage of the free services offered at the Tech Bar. Experts can help you with both personal and professional tasks, such as downloading and using the STS Annual Meeting Mobile App, utilizing social media, improving your work productivity, troubleshooting issues with your smartphone or tablet, and more—all as a benefit of meeting registration.

I hope you also will stop by the STS booth (#523) in the Exhibit Hall. Staff members will be there, eager to talk with you about—and provide updates on—all things STS. Be sure to ask about the first outcomes report from the STS/ACC TVT RegistryTM, plans to upgrade and expand the STS National Database, our public reporting initiatives, exciting developments from the STS Research Center (now in its fifth year), and upcoming educational programs, such as the STS ECMO Symposium that will be held in March 2016.

You also will want to take a moment and talk with the STS Government Relations staff, who can bring you up to date on the Society’s many efforts on Capitol Hill. From coding and reimbursement issues to the implications of health care reform to important legislation relevant to cardiothoracic surgeons, STS continues to champion the specialty in Washington. Stop by and learn more. There’s a lot going on—and you’ll want to understand the implications for your practice.

If you are not already an STS member, please stop by the STS booth and learn about the many membership benefits we have to offer, including a complimentary subscription to The Annals of Thoracic Surgery. Those attendees who are not cardiothoracic surgeons—i.e., other physicians, CT surgery and general surgery residents, medical students, and all allied health care professionals—should especially note that our rolling admission process for Candidate, Pre-Candidate, and Associate Membership allows for the prompt disposition of their STS membership applications, typically within a week or two, so that they can start enjoying the benefits of STS membership almost immediately. And if you are an STS member, please pick up a membership packet to take home to a colleague; you will be helping both your colleague and your Society.

All the scientific sessions at this 52nd Annual Meeting, including the symposia, early riser sessions, breakout sessions, hands-on sessions, and invited talks, create a vast array of educational opportunities—more than any one person could ever attend onsite. Fortunately, the STS 52nd Annual Meeting Online now is included free with your Annual Meeting registration. This online product will allow you to catch those sessions you weren’t able to attend—and review all the sessions you did attend—in the comfort of your home or office throughout the year ahead.

In closing, please know that all of us on the staff are here to serve you. Look for the distinctive green STAFF ribbon on our name badges, and please don’t hesitate to let us know if there’s anything we can do to help.

Thank you for attending, and enjoy the meeting!

Rob Wynbrandt

STS Executive Director & General Counsel 

Symposium Preps Residents for Practice

Ara A. Vaporciyan, MD

Making the move from completing medical training to starting a practice can seem like a road with endless choices.

“From when cardiothoracic surgery residents first apply to medical school to completing their residencies, they move from one job to the next without a lot of input. They go through clear processes for getting into medical school, residency, and fellowship. It’s all orchestrated for them,” said Ara A. Vaporciyan, MD, Professor and Chair of Thoracic and Cardiovascular Surgery at The University of Texas MD Anderson Cancer Center in Houston.

Dr. Vaporciyan is a co-moderator of the Residents Symposium, which will provide residents with practical information to help them transition from residency to a successful practice. The symposium will be from 1:00 p.m. to 4:00 p.m. Sunday in Room 231ABC. All residents, no matter their year, are encouraged to attend the program.

“The first time they have a choice and have to make deep decisions is when they complete their residency. The ones who don’t think about it and only focus on superficial issues, such as location and salary, have the worst outcomes with the jobs they choose,” said Dr. Vaporciyan.

Sidharta P. Gangadharan, MD

His co-moderators will be Sidharta P. Gangadharan, MD, Associate Professor of Surgery at Harvard Medical School and Chief of the Division of Thoracic Surgery at Beth Israel Deaconess Medical Center, Boston, and Sandra L. Starnes, MD, the Dr. John B. Flege, Jr. Chair in Cardiothoracic Surgery, Associate Professor of Surgery, and Director of the Division of Thoracic Surgery at the University of Cincinnati. All are members of the Society’s Workforce on Thoracic Surgery Resident Issues, with Dr. Vaporciyan as Chair.

The program will feature five 15-minute talks on how to find the right position, interviewing tips, contract negotiation, how to be successful in developing a clinical practice, and early career development, which will be followed by group breakout sessions and discussions with experienced surgeons.

Sandra L. Starnes, MD

“To make the discussions more useful, they will not concentrate on broad concepts, but rather, specifics about the best way to find your first job, key points of a successful interview, the nuts and bolts of your contract, and so on,” Dr. Starnes said. “Most residents have never seen a contract, so they’ll learn how to break down the specifics of what is a typical contract and what things to avoid.”

Feedback from last year’s participants has brought a new format to the group discussions. Previously, each table discussion was dedicated to a specific topic from the symposium; this year, the format allows residents to pose questions related to any of the symposium topics at any table.

“Each table will have three faculty members from a variety of academic and private practices,” Dr. Starnes said. “Over the years, they have done a great job and have been committed to helping engage the residents.“

Beyond attending the symposium, Dr. Vaporciyan recommends that residents become STS members and get involved with the Society’s leadership opportunities.

“Getting involved in the STS Workforces is a great way to give back, network, and meet mentors,” he said. “Yes, it’s a little work, but it’s rewarding. I’ve met many people, and I clearly get more out of it than I think I put into it.”

Symposium Looks at Options for Common Congenital Problems

Andrew C. Fiore, MD

Some of the most common congenital cardiac conditions do not have a single specific treatment of choice. During the Parallel Surgical Symposium: Congenital, from 1:15 p.m. to 4:30 p.m. Sunday in Room 126ABC, speakers will discuss alternative surgical techniques for treating neonates, infants, children, and young adults with commonly encountered congenital cardiac conditions.

The talks will focus on three atrioventricular septal defect (AVSD) repair options, the closed versus open arterial switch technique, three repairs for tetralogy of Fallot, management of hypoplastic left heart syndrome, medical or surgical treatment of the borderline ventricular septal defect (VSD), and valve repair or replacement for aortic valve disease.

“These are common problems that congenital heart surgeons deal with on a regular basis,” said co-moderator Andrew C. Fiore, MD, adding that he hopes the program will appeal to surgeons at all stages of their careers.

The two-part program will kick off with video-based presentations for AVSD treatment, the switch technique for transposition of the great arteries, and treatment of tetralogy of Fallot.

“These well-respected surgeons are experienced at doing their chosen operation. Each technique is effective, but there are pros and cons to each one,” said Dr. Fiore, Professor of Surgery at St. Louis University.

The second part of the symposium will examine whether new data should spur surgeons to change the way they manage common congenital cardiac pathologies. For example, most surgeons initially perform reconstructive operations for patients with hypoplastic left heart syndrome, but some surgeons believe these patients initially should undergo transplantation.

“We tend to favor reconstructive techniques as the first operation, but there may be a role for transplantation in the treatment of certain high-risk patient subgroups at various stages of their palliation for hypoplastic left heart syndrome,”said Dr. Fiore, adding that attendees will hear data on the pros and cons of reconstruction versus transplantation.

Next up, a cardiologist and a cardiothoracic surgeon will look at indications for closure of the restrictive VSD. Controversy surrounds the low but potential risk associated with surgical VSD closure versus the potential complications of continued observations, such as aortic valve incompetence, endocarditis at the VSD site, and the potential difficulty of obtaining health insurance in adulthood.

The third area, aortic valve disease, brings its own controversy with respect to valve repair or replacement. “Aortic valve repair is technically more challenging, but has become more refined, more popular, and with acceptable early durability,” Dr. Fiore said. “On the other hand, mechanical aortic valve replacement adds the important burden of lifelong anticoagulation, but greater long-term structural integrity.”

The Ross procedure, usually recommended for the growing child, avoids anticoagulation, but late complications of autograft dilatation, aortic insufficiency, and pulmonary homograft structural failure can emerge with now two valves, aortic and pulmonary, placed at continued lifelong risk.

“While we will not completely resolve these complex controversial issues, we hope that with an open exchange of new ideas and knowledge between surgeons and cardiologists at all levels of experience, we can better serve the neonates, infants, children, and adults with congenital heart disease that we are so privileged to care for every day,” Dr. Fiore said.

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