A Cut Above: Cardiothoracic insights from EACTS

Recorded at the AATS annual meeting in Seattle, our hosts are joined by Dr. El-Hamamsy & Dr. Ouzounian to explore the resurgence of the Ross procedure. The discussion covers the evolving evidence base, training requirements, and technical considerations surrounding this increasingly prevalent operation. Dr. El-Hamamsy and Dr. Ouzounian share their own learning curves, views on centralising care, and the importance of surgical volume for patient outcomes. Listeners will also hear about best practices in patient selection, graft support strategies, and the future of Ross—including potential innovations to expand access globally.

In this thought-provoking discussion, our hosts explore the multifaceted world of leadership in cardiac surgery. Joined by Shirin Bemelmans-Lalezari and Volkmar Falk, we delve into how leadership styles evolve, the balance between authority and empathy, and the importance of team dynamics. Learn of the real-life challenges in managing surgical teams and navigating hierarchy. With insights from both clinical and coaching perspectives, this episode offers valuable reflections for anyone considering or currently in a leadership role within cardiothoracic surgery.

We are pleased to announce the first of a new series of upcoming episodes, titled ‘Pulse Check – Key Papers at a Glance'. Our host Can discuss two recent and impactful EJCTS articles on infective endocarditis. Joined by the renowned, Michael Borger and Torsten Doenst, we explore firstly the implications of preoperative septic cerebral embolism for patients undergoing valve surgery. Then followed by an exploration into the use of haemoadsorption therapy, addressing the key issue of controlling inflammation during cardiac surgery for endocarditis. Listen to gain rapid insight into the associated articles: Effect of haemoadsorption during cardiac surgery for Staphylococcus aureus endocarditis: a REMOVE trial post hoc analysis Outcomes following heart valve surgery in patients with infective endocarditis and preoperative septic cerebral embolism: insights from the CAMPAIGN study group'

Are you curious about the origins and future of aortic root enlargement surgery? In this episode, our hosts discuss the surgical horizons of this underutilised technique. Featuring the well-respected Bo Yang, Can Gollmann-Tepeköylü and Miia L Lehtinen explore the creation of this innovative technique, as well as its reputation and utility in the surgical community. Listeners can expect to hear firsthand how Dr Yang discovered his esteemed procedure, as well as detailed comparisons to similar interventions and how patient suitability is assessed.

Are you looking to deepen your understanding of perioperative medication? Join us for the first episode of 2025, where we offer listeners an author insight into the recently published ‘2024 EACTS Guidelines on perioperative medication in adult cardiac surgery'. With working group members Anders Jeppsson and Emma Hansson, our host Miia L Lehtinen explores the fundamental intricacies considered to ensure these diverse guidelines are current and clinically applicable. Discussions include how the varied specialities of clinical intervention contribute to individual patient needs, including indication specific medication schedules, and the nuanced effects these bring to patients. We also encourage our listeners to view the recently published perioperative guidelines here: https://academic.oup.com/ejcts/advance-article/doi/10.1093/ejcts/ezae355/7815986?searchresult=1&login=false

In our final episode of the year, our hosts discuss the notorious complexities of the tricuspid valve, joined by specialists Nikos Bonaros and Victoria Delgado. Join Miia L Lehtinen and Can Gollmann-Tepeköylü in their exploration of the increasing relevance of tricuspid valve interventions, analysing the dynamic considerations of diagnostics, imaging, anatomy, cardiology and surgical interventions. Listeners can expect to learn of the fundamental principles of tricuspid disease, as well as how experts navigate nuanced challenges faced in challenging cases.

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen for their late-breaking trials highlights presented at the 38th EACTS Annual Meeting in Lisbon, including: (0:39 - 4:31) Long-term mortality after PCI or CABG in patients with diabetes and multivessel coronary artery disease: A SWEDEHEART study by Dr Emma C Hansson (4:32 - 8:33) Long-term (>10 years) results of transcatheter Mitral valve-in-valve implantation for degenerated surgical mitral bioprosthesis: Italian MItral VIV registry (MIVIV registry) by Dr Edoardo Zancanaro  (8:34 - 11:55) Personalized multimodal teleprehabilitation in elective cardiac surgery: results from the Digital Cardiac Counselling multicentered randomized Controlled Trial (ClinicalTrials.gov number, NCT04393636.) by Dr Bart Scheenstra   (11:55 - 16:15) 5-Year Results on Aortic Remodeling in the Dissected Aorta Repair Through Stent (DARTS) Implantation Trial by Dr Ryaan EL-Andari (16:16 - 19:49) Clinical impact of continuous postoperative pericardial flushing on bleeding-related complications after cardiac surgery by Dr Robert Klautz

Following the European Society of Cardiology's (ESC) guidelines publication in collaboration with EACTS, Miia L Lehtinen and Can Gollmann-Tepeköylü host the esteemed Atrial Fibrillation experts, Manuel Castella and Niv Ad. In this month's episode, our guests explore the nuances of how a surgical approach might be used to treat Atrial Fibrillation and why cardiac surgeons are increasingly interested in this complex electrophysiological condition. In light of the developing accepted practices, listeners can expect comparisons between the Maze procedure and non-surgical approaches, as well as an exploration of the endpoints used to determine patient outcomes.

This month's episode is hosted by Miia L Lehtinen and Can Gollmann-Tepeköylü, who are joined by Wouter Oosterlinck, exploring his experience and expertise in the field of robotic cardiac surgery. Although already popular amongst thoracic surgeons, Wouter discusses the creation of his fast growing minimally invasive programme, which has been influential in this emerging field. Listen in for insight into the ever-developing applications of robotic cardiac surgery as well as the challenges being faced, such as nuanced medical device regulations.

In this Episode, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen speak with Karl-Henrik Grinnemo on the provocative subject of scientific misconduct. Listeners can expect to hear a firsthand experience of his notorious experience with Paolo Macchiarini, exploring insights into the high-profile case discrediting the use of dangerous artificial tracheae. Karl describes his team's journey from reporting poor patient outcomes in 2013, to being wrongfully accused of misconduct, and to finally being exonerated in 2016. Tune in to hear this unique story of courage, controversy, and vindication.

Joining our hosts this month are the esteemed ‘Ex Vivo Organ Perfusion' experts, Edris Mahtab Leiden University Medical Center, The Netherlands) and Andreas Zuckermann (Medical University of Vienna, Austria). In this episode, Can Gollmann-Tepeköylü and Miia L Lehtinen discuss how these guests have influenced the developing field of heart and lung transplantation. Listeners can gain an understanding of the evolving difficulties associated with transplantation, and how innovative techniques are improving organ preservation.   Listeners are also encouraged to take a look at a related MMCTS article demonstrating relevant techniques.

This month, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen explore the future of coronary surgery with renowned experts: Sigrid Sandner, Anders Jeppsson and Torsten Doenst. This discussion addresses the evolving utility of CABG following the introduction of PCI, involving evidence-based comparisons between these approaches. Listen for a detailed analysis of how patient risk versus benefit is understood, and the diverse nuances available between clinical outcomes and patient groups. 

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen at the second EACTS innovation summit in Paris, an international event gathering diverse specialists and innovative ideas.     (00:53 – 11:29) Paul Rulkens, a renowned expert in high performance, discusses how to courageously innovate and think beyond the limitations of preconceived notions. Rulkens also creatively advises how to approach failure and think differently when developing novel ideas.     (11:30 – 25:17) Our hosts meet with Shaf Keshavjee, the highly influential thoracic surgeon, director and chief of innovation. Keshavjee talks of their innovation in the field of transplantation, strategically transforming the capabilities of ex-vivo lung perfusion.    (25:28 -  38:38) The paediatric cardiac surgeon, Pedro del Nido, expresses the value of focussed collaborative innovation in medical device development. Del Nido also discusses how unique approaches are used to address unmet need, for example in paediatric valvular disease.

This month's episode features Sam Heuts, the first author of a recent Editor's Choice article published in ICVTS entitled ‘TAVR vs. SAVR – A Bayesian interpretation'. Our hosts, Can Gollmann-Tepeköylü and Miia L Lehtinen, find out more about the analysis of trials comparing transcatheter valve replacement and surgical aortic valve replacement. Including discussions of the fundamental statistics used and the effect upon 5-year all-cause mortality. 

Following our joint publication of the highly anticipated Aortic Disease Guidelines, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen speak with Martin Czerny (University Clinic Freiburg, Germany) and Martin Grabenwöger (Clinic Floridsdorf, Vienna, Austria). This episode covers both the people involved in creating this influential document, as well as engaging detail regarding our current understanding of this fascinating organ. 

This month, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen are joined by the esteemed Dr. Filip Casselman (of the OLV Clinic, Belgium) and Dr. Sabine Bleiziffer (of the Herz- und Diabeteszentrum NRW, Germany). Listen for an in-depth discussion on the often controversial, aortic valve, including key insight into current clinical practices as well as how these approaches are developing.

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen for the first episode of 2024. In this episode, our hosts chat to Dr. Patrick Myers, leading cardiothoracic surgeon and EACTS Secretary General (2022 – Present). Dr Myers talks about his journey to becoming the EACTS Secretary General and his experiences within the role including the merits and challenges. 

In this episode, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, chat to Prof. Dr. Matthias Siepe, leading cardiothoracic surgeon and EACTS Editor-in-Chief (2021 – Present). Prof. Siepe talks about his journey to becoming the Editor-in-Chief for the European Journal of Cardio-Thoracic Surgery and his experiences within the role. He provides an overview of the journal team structure and processes and shares tips for submitting to EJCTS. 

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen for their late-breaking trials highlights presented at the 37th EACTS Annual Meeting in Vienna, including:  (2:40 - 8:53) Subannular Repair for Secondary Mitral Regurgitation with restricted systolic leaflet Motion (type IIIb): 2-year results from REFORM-MR registry by Dr Jonas Pausch   (8.53 - 13:47) Mechanistic insights from the CAST-HF trial: Transcriptomic analysis of human myocardial biopsies reveal biglycan as crucial mediator of angiogenesis by Dr Johannes Holfeld   (13.47 - 20:55) First-in-human experience with a novel custom-made double branch stent graft for aortic arch repair – The NEXUS DUO by Prof Mario Louis Lachat & Dr P Buyl   (20:56 - 25:28) Real World Experience of 510 On-X Aortic Valve Replacement Patients Treated with Low Dose Warfarin by Prof Aungye OO   (25:28 - 32:1) CEASE-AF: Effectiveness and safety of hybrid epicardial and endocardial ablation in patients with persistent and longstanding persistent atrial fibrillation by Dr Piotr Suwalski.

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, as they discuss where and how to train congenital cardiac surgeons with Prof. Mark Hazekamp, Prof. Jürgen Hörer and Dr Nabil Hussein. The speakers share their invaluable insights and experiences gained during their careers.

This month's episode features Prof. Klautz and Dr. Arabkhani, the first authors of a recent Editor's Choice article published in EJCTS entitled 'A multicentre, propensity score matched analysis comparing a valve-sparing approach to valve replacement in aortic root aneurysm: Insight from the AVIATOR database'. Our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, find out more about the AVIATOR Registry and the key findings of their research. 

In this episode, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, chat with leading female surgeons, Dr Ourania Preventza, Dr Daniela Molena and Dr Joanna Chikwe, about their career journeys, what took them to the United States, and the difference in working cultures and practices between the US and Europe.  

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, as they discuss the importance of driving innovation within cardiothoracic surgery to improve patient outcomes. Prof. Friedhelm Beyersdorf and Prof. Mark Hazekamp share some of their highlights from the EACTS Innovation Summit held in April 2023 and how EACTS is exploring ways to support innovation in the field. 

Join our host, Miia L Lehtinen, as she speaks to Stephen Clark (Chairman of The European Board of Cardiothoracic Surgery (EBCTS)), Edu Quintana (Secretary, EBCTS) & Yvonne Hurst (Expert in examination science/educational advisor to EBCTS) about the history of the EBCTS, what the exam is like, why it's important and how it supports the mission to ensure high standards for cardiothoracic surgeons. 

In this episode, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen discuss the use of Artificial Intelligence (AI) within cardiothoracic surgery (CTS) with Sandy Engelhardt, Simo Syrjälä and Volkmar Falk. From whether there is a clinical need for AI, to the role of AI in the future of CTS, and its potential pitfalls. Join us in the latest episode to find out more.

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, as they discuss the future of mitral valve (MV) therapy with Nikolaos Bonaros and Patrick Perier. In this episode, Nikolaos and Patrick share their expertise and advice on valve preferences; the evolution of MV surgery, how young surgeons can develop their skills to perform complex MV surgical techniques; and much more.  

In this episode, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen, chat to Prof. Dr. Friedhelm Beyersdorf, eminent cardiothoracic surgeon and past-President of the EACTS (2021 – 2022), about his career - how he got to where is today, the challenges he faced along the way, and his thoughts on the future of cardiothoracic surgery.  Guest Speaker:  Prof. Dr. Friedhelm Beyersdorf was born in Bochum, Germany and is a graduate from the Wolfgang-Goethe-University in Frankfurt/M. with clinical clerkship at Johns-Hopkins in Baltimore and Thomas Jefferson Medical College in Philadelphia. His residency was at Johann Wolfgang Goethe-University Frankfurt and University of California Los Angeles. From 1994 - 2022 he was Professor and Chairman of the Dept. of Cardiovascular Surgery in Freiburg, Germany.

The inaugural episode of A Cut Above features guest speakers, Dr Igor Mokryk and Dr Ihor Stetsyuk, describing the impacts of the war in Ukraine on their day-to-day practice as a cardiothoracic surgeon and resident. Dr Mokryk and Dr Stetsyuk talk to our hosts, Can Gollmann-Tepeköylü and Miia L Lehtinen, about the challenges they face as a result of this unimaginable situation and how we can support them during this difficult time.     Guest Speakers: Dr Igor Mokryk has been Chief of the Department of Adult Cardiac Surgery at the Heart Institute in Kyiv since 2017. He has worked in both adult and paediatric cardiothoracic surgery for more than 20 years. Dr Ihor Stetsyuk is a  4-th year resident of the department of adult cardiac surgery at Heart Institute, Kyiv. He specialises at miniinvasive AVR, MVR and CABG off-pump.