Podcasts about thoracic surgeons

In April, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the fiscal year 2026 Inpatient Prospective Payment System. This annual regulation introduces several initiatives that will have a direct impact on cardiothoracic surgery. The Society of Thoracic Surgeons is diligently reviewing all the proposed changes. They plan to submit their comments in the coming months to represent the interests of cardiothoracic surgeons and their patients effectively.

It's been one year since University Hospitals' cardiac surgeons began performing heart bypass surgeries with the assistance of a surgical robot known as Da Vinci.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the robotic market. He explores the new FDA approval for the Johnson & Johnson robotic surgical system for clinical trials, the background of Johnson & Johnson MedTech, and the location for this trial. He also discusses the details of TAVR, what we currently know about TAVR, and highlights an article by Steve Bell that discusses his own views on Johnson & Johnson and the robotic market.    Joel also reviews recent JANS articles on The Society of Thoracic Surgeons expert consensus on the multidisciplinary management and resectability of locally advanced non-small cell lung cancer, a European multicenter study evaluating the prognosis of peripheral early-stage lung adenocarcinoma patients operated on by segmentectomy or lobectomy, early intervention in patients with asymptomatic severe aortic stenosis and myocardial fibrosis, and the use of hybrid stage I to stratify between single ventricle palliation and biventricular repair.   In addition, Joel explores an off-pump ASD closure with a two-layer patch attached to the right atrium, a repair of Scimitar syndrome in a two-year-old via VRAT, and robotic-assisted carinal reconstruction using cross table ventilation. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) The Society of Thoracic Surgeons Expert Consensus on the Multidisciplinary Management and Resectability of Locally Advanced Non-small Cell Lung Cancer  2.) European Multicentre Study Evaluating the Prognosis of Peripheral Early-Stage Lung Adenocarcinoma Patients Operated on by Segmentectomy or Lobectomy  3.) Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis: The EVOLVED trial  4.) Use of Hybrid Stage I to Stratify Between Single Ventricle Palliation and Biventricular Repair  CTSNET Content Mentioned  1.) Off-Pump ASD Closure With a Two-Layer Patch Attached to the Right Atrium  2.) Repair of Scimitar Syndrome in a Two-Year-Old Via VRAT: Pitfalls of Intra-atrial Baffle  3.) Robotic-Assisted Carinal Reconstruction Using Cross Table Ventilation—A Novel Surgical Technique  Other Items Mentioned  Why am I so tough on Johnson & Johnson and Medtronic and their surgical robotic programs?  CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

For patients with AFib, left atrial appendage (LAA) occlusion should now be part of any non-emergency cardiac operation, and surgical ablation should also be considered. Panayotis Vardas, M.D., discusses how he and colleagues from the Society of Thoracic Surgeons arrived at stronger recommendations for these procedures in their 2023 guidelines. Learn more about related surgical procedures for AFib and the directions of future research.

In this episode of Lung Cancer Considered, host Dr. Stephen Liu and guests preview the publication of the Ninth Edition of Tumor, Node and Metastasis (TNM) Classification System for lung cancer. The new edition will be published in January 2025 and has some important changes that reflect an evolving understanding of the disease and more rigorous analysis of data from around the world. Guest: Dr. Valerie Rusch is a Thoracic Surgeon from Memorial Sloan Kettering Cancer CenterMSKCC where she is Vice Chair for Clinical Research in the Department of Surgery and the Miner Family Chair in Intrathoracic Cancers. She has held many leadership positions in the American College of Surgeons and other organizations and was part of the team to first described EGFR mutations. She has been chair of the Thoracic Committee for the American Joint Committee on Cancer 6th, 7th, 8th, and now 9th Editions of the Cancer Staging Handbook Guest: Dr. Hisao Asamura is a Professor of Surgery, Chief of Division of Thoracic Surgery at Keio University School of Medicine in Tokyo, Japan and Vice President of the Japan Lung Cancer Society. For IASLC, he is the Chair of the Staging and Prognostic Factors Committee, former Executive Board Director, and Congress President for the 18th World Conference on Lung Cancer. Guest: Dr. Enrico Ruffini is a Thoracic Surgeon and Professor of Thoracic Surgery from the University of Torino, Italy where he is the Chief of the Thoracic Surgery Unit and Director of the Thoracic Surgery Residency Program. He is heavily involved in the European Society of Thoracic Surgeons and Chair of the IASLC Staging and Prognostic Factors Committee – Thymic domain.

SEND US A TEXT MESSAGE!!! Let Drs. Nii & Renee know what you think about the show!SEND US A TEXT MESSAGE!!! Let Drs. Nii & Renee know what you think about the show!Drs. Nii and Renée come together to discuss a recent study published by Health Affairs that contrasts the lack of diversity among US physicians to the impact of debt on the populations that are underrepresented in medicine. The study asserts that understanding the differential burden of debt by race and ethnicity may help to determine strategies to address the lack of diversity, including scholarships, debt relief and financial guidance. Things to expect in this episode:Nii & Renee's micro and macro habits, plus motivation vs. systemsNii checks in with his mentee, and the role significant others play in career plans Outgoing surgeon from the Society of Thoracic Surgeons attacks affirmative action in presentationThe oftentimes prohibitive financial investment of going to medical school, including applying to and being dismissed fromMedical student, devastated by her total medical school debt, posts on InstagramInternational Healthcare Volunteers: ihcv.orgHealth Affairs article, Differences in Debt Among Postgraduate Medical Residents by Self-Designated Race and Ethnicity, 2014-2019WE WANT TO HEAR FROM YOU!!!!TELL US WHAT YOU WANT TO HEAR ON FUTURE EPISODES!!!!FILL OUT THE DOCS OUTSIDE THE BOX PODCAST SURVEY (in partnership w INCROWD)INCROWDMAKE EXTRA MONEY AS A RESIDENT OR ATTENDING - COMPLETE MEDICAL SURVEYS WITH INCROWDWATCH THIS EPISODE ON YOUTUBE!Join our communityText word PODCAST to 833-230-2860Twitter: @drniidarkoInstagram: @drniidarkoEmail: team@drniidarko.comPodcasting Course: www.docswhopodcast.comMerch: https://docs-outside-the-box.creator-spring.comThis episode is edited by:Your Podcast PalThis episode is sponsored byLocumstory. Learn how locum tenens helps doctors make more and have the lifestyle they deserve!. Check them out HERE!

Dr. Yugal K MISHRA is one of India's most well-known and skilled cardiac surgeon. He is Chief of Cardiac Services, Chairman & Chief Cardio Vascular Surgeon at Manipal Hospitals. He is also President of the Society of Minimally Invasive Cardiovascular Surgeons of India, President of the India Association of Cardiovascular & Thoracic Surgeons and Council Member of the Association of Thoracic & Cardiovascular Surgeons of Asia.  Dr Mishra is one of the renowned Robotic & Minimally Invasive Heart Surgeons in Asia. He has performed more than 500 robotic cases in India. Some facts about him : He has over 30 years of experience. He has done more than 20 000 successful procedures He has written more than 200 scientific research papers He has trained more than 100 cardiac surgeons  In this episode, Dr. Yugal Mishra explains the benefits and challenges of Minimally Invasive Cardiac Surgery (MICS) compared to traditional open-heart surgery in India. Dr. Mishra highlights that while MICS offers advantages and that MICS is more expensive due to the advanced equipment and expertise required, but it can ultimately be more cost-effective by reducing hospital stays and enabling patients to return to work sooner. Dr. Mishra discusses the technical challenges, including managing complications and the importance of advanced technology in improving surgical outcomes.  LinkedIn Profile : Yugal Mishra Dr. Mishra Website : https://dryugalmishra.com/   In this episode, Dr. Yugal Mishra explains the benefits and challenges of Minimally Invasive Cardiac Surgery (MICS) compared to traditional open-heart surgery. Dr. Mishra highlights that while MICS offers advantages and that MICS is more expensive due to the advanced equipment and expertise required, but it can ultimately be more cost-effective by reducing hospital stays and enabling patients to return to work sooner. Dr. Mishra discusses the technical challenges, including managing complications, and the importance of advanced technology in improving surgical outcomes.    About Behind the OR Behind the OR is the official podcast channel by Peters Surgical. Here, we invite you to step into the world of surgery, where we uncover what happens behind the closed doors of the operating room and beyond. Each episode features in-depth conversations with expert surgeons, providing insights into the latest surgical techniques, innovations, and the daily lives of those who dedicate themselves to saving lives. Founded in 1926, Peters Surgical is a French company with a global presence in over 90 countries. As a reference group for surgical practices worldwide, we are dedicated to improving surgical outcomes through innovative medical devices, including surgical sutures, hemostatic clips, and surgical glue. Our expertise lies in designing, manufacturing, and distributing these devices.  Visit our website here : https://peters-surgical.com/

Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief

As part of the May issue, the European Respiratory Journal presents the latest in its series of podcasts. Chief Editor James Chalmers interviews Steven Walker (Academic Respiratory Unit, Southmead Hospital, Bristol, UK) about the joint European Respiratory Society/European Association for Cardio-Thoracic Surgery/European Society of Thoracic Surgeons clinical practice guidelines on adults with spontaneous pneumothorax.

The Accelerators (Drs. Matt Spraker and Simul Parikh) host the lung cancer legend, Brendon Stiles, MD. He is a Professor of Oncology, Medicine, and Thoracic Surgery at Montfiore and Albert Einstein College of Medicine.We discuss all things lung cancer: early stage, locally advanced, staging, quality, and more.The episode is capped with Simul's Lighting Round. Good luck Brendon!We hope you enjoy this #MedEd instant classic!Here are (almost?) all the studies and materials we mentioned during the show:Brendon's "Old Slide" on patient selection and operabilityLobar or Sublobar Resection for Peripheral Stage IA Non–Small-Cell Lung Cancer (CALGB 140503)Stereotactic ablative radiotherapy with or without immunotherapy for early-stage or isolated lung parenchymal recurrent node-negative non-small-cell lung cancer (I-SABR)Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials (STARS-ROSEL)Measuring the Integration of Stereotactic Ablative Radiotherapy Plus Surgery for Early-Stage Non–Small Cell Lung Cancer (MISSILE)Stereotactic ABlative Radiotherapy Before Resection to AvoId Delay for Early-Stage LunG Cancer or OligomEts During the COVID-19 Pandemic (SABR-BRIDGE)Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non–Small-Cell Lung CancerPhase II Study of Accelerated High-Dose Radiation Therapy with Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer (RTOG 0239)Randomized Phase II Study of Preoperative Chemoradiotherapy ± Panitumumab Followed by Consolidation Chemotherapy in Potentially Operable Locally Advanced (Stage IIIa, N2+) Non-Small Cell Lung Cancer (RTOG 0839)Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer (CheckMate 816)Pacific-2 Press Release, AstraZenecaStudy of Durvalumab Given With Chemoradiation Therapy in Patients With Unresectable Non-small Cell Lung Cancer (MDT-BRIDGE, in progress)Society of Thoracic Surgeons quality initiativesThe Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

In this episode of Run with Fitpage, we have one of the top Heart Surgeons in the country, Dr Adil Sadiq. Vikas and Dr Adil dive deep into some of the most prominent reasons behind Coronary Artery Disease and ways to prevention.Dr Adil Sadiq is a renowned cardiac surgeon in Bangalore with over 4500 cardiac surgeries, 1600 thoracic procedures, and 65 heart and lung transplants under his belt. He is one of the few surgeons in India who is trained in robotic cardiac surgery and has extensive experience in minimally invasive cardiac surgery. He is currently the Senior Consultant and Head of Cardiothoracic and Vascular Surgery at Sakra World Hospital in Bangalore.Dr Sadiq completed his undergraduate medical degree from Bangalore Medical College and his master's degree in general surgery from Kasturba Medical College, Manipal. He then went on to pursue his super-specialty training in cardiothoracic and vascular surgery at the prestigious Sree Chitra Institute. Dr Sadiq is a highly skilled and experienced cardiac surgeon who is passionate about providing his patients with the best possible care. He is a member of several professional organizations, including the American College of Surgeons and the Society of Thoracic Surgeons. He is also a recipient of several awards, including the "Service Excellence in Cardiovascular Surgery" award from the Times Health Excellence 2018 event.Reach out Dr Adil here: sakraworldhospital.com/doctors/dr-adil-sadiq-institute-of-cardiac-sciences/11About the hostVikas hosts this weekly podcast and enjoys nerding over-exercise physiology, nutrition, and endurance sport in general.  He aims to get people to get out and 'move'.  When he is not working, he is found running, almost always.  He can be found on nearly all social media channels but Instagram is preferred:)Reach out to Vikas:Instagram: @vikas_singhhLinkedIn: Vikas SinghTwitter: @vikashsingh1010Download Fitpage App: fitpage.in/the-all-new-fitpage-app/Subscribe To Our Newsletter For Weekly Nuggets of Knowledge!

In this episode of CTSNet's flagship podcast, editor in chief Joel Dunning is joined by new senior editor of congenital content, Dr. Sameh Said. Together, they run through the latest, most popular content on ctsnet.org—the largest online community of CT surgeons and source of CT surgery information—and breaking cardiothoracic surgery news and research from around the world. After a short introduction, Joel and Sameh begin their discussion on outcomes of pulmonary atresia in neonates, surgical outcomes for type A thoracic aorta dissection, and disparities in access to thoracic surgeons for esophagectomy. They also talk about a new method for VSD closure without ventriculotomy, a double valve replacement from Medtronic, and an anomalous origin of the coronary artery repair from Dr. Said himself. After discussing upcoming events in the CT surgery world, they close with a shoutout to Patrick Myers. JANS Items Mentioned Procedural Outcomes of Pulmonary Atresia with Intact Ventricular Septum in Neonates: A Multicenter Study    Surgical Outcomes of Thoracic Endovascular Aortic Repair for Retrograde Stanford Type A Dissection   Racial, Socioeconomic Disparities Affect Access to Thoracic Surgeons for Esophagectomy  CTSNet Content Mentioned Postinfarction Ventricular Septal Defect Closure Without Ventriculotomy—A Novel Method Medtronic Sponsored Content: Double Valve Replacement—How I Do It Anomalous Aortic Origin of the Right Coronary Artery from the Wrong Sinus of Valsalva (AAORCA): Two Surgical Strategies Other Items Mentioned Uniportal VATS-RATS Training Program at Shanghai Pulmonary Hospital CTSNet Events Calendar

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Go online to PeerView.com/GQW860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Patients with early-stage lung cancer frequently experience disease recurrence within 1 year of receiving curative-intent surgery, representing a significant unmet medical need. Individualized management of patients with NSCLC is based on a number of considerations, including the molecular profile of the patient's tumor and the benefits and limitations of therapeutic options in the context of the latest evidence. Continued advances with targeted therapies have sparked substantial interest in expanding their use into earlier disease settings, and adjuvant EGFR-targeted therapy has demonstrated remarkable efficacy in early-stage NSCLC, leading to the first regulatory approval of osimertinib as adjuvant therapy after resection in patients with NSCLC whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. In addition, results from studies in the neoadjuvant setting are emerging now, as perioperative use of EGFR-targeted therapy continues to demonstrate improved outcomes. Thoracic surgeons are key members of the multidisciplinary care team, playing an essential role in collaborating and coordinating with other specialists to determine the best treatment plan, including incorporating EGFR-targeted therapy into multimodal management strategies. This PeerView educational activity, based on a recent live symposium, focuses on the latest clinical evidence supporting the use of EGFR-targeted therapy in perioperative settings and provides practical guidance for optimally integrating targeted therapies in practice or clinical trials. Multidisciplinary discussions on the latest practice-changing data highlight important implications of utilizing EGFR-targeted therapy as part of multimodal treatment for surgeons and the broader lung cancer care team. Upon completion of this activity, participants should be better able to: Discuss the role of EGFR mutations in NSCLC, advances in EGFR-targeted therapy in earlier disease settings, and the importance of identifying patients who might benefit from these therapies in perioperative settings; Identify patients with early-stage resectable NSCLC who are candidates for adjuvant EGFR-targeted therapy or investigational targeted approaches according to the latest evidence and guidelines; and Implement multidisciplinary and patient-centric strategies to integrate EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage resectable NSCLC

Drs. Nii and Renée come together to discuss a recent study published by Health Affairs that contrasts the lack of diversity among US physicians to the impact of debt on the populations that are underrepresented in medicine. The study asserts that understanding the differential burden of debt by race and ethnicity may help to determine strategies to address the lack of diversity, including scholarships, debt relief and financial guidance. Things to expect in this episode:Nii & Renee's micro and macro habits, plus motivation vs. systemsNii checks in with his mentee, and the role significant others play in career plans Outgoing surgeon from the Society of Thoracic Surgeons attacks affirmative action in presentationThe oftentimes prohibitive financial investment of going to medical school, including applying to and being dismissed fromMedical student, devastated by her total medical school debt, posts on InstagramInternational Healthcare Volunteers: ihcv.orgHealth Affairs article, Differences in Debt Among Postgraduate Medical Residents by Self-Designated Race and Ethnicity, 2014-2019WE WANT TO HEAR FROM YOU!!!! TELL US WHAT YOU WANT TO HEAR ON FUTURE EPISODES!!!!FILL OUT THE DOCS OUTSIDE THE BOX PODCAST SURVEY (in partnership w INCROWD)INCROWDMAKE EXTRA MONEY AS A RESIDENT OR ATTENDING - COMPLETE MEDICAL SURVEYS WITH INCROWDWATCH THIS EPISODE ON YOUTUBE!Join our communityText word PODCAST to 833-230-2860Twitter: @drniidarkoInstagram: @drniidarkoEmail: team@drniidarko.comPodcasting Course: www.docswhopodcast.comMerch: https://docs-outside-the-box.creator-spring.comThis episode is edited by:Your Podcast PalThis episode is sponsored by Locumstory. Learn how locum tenens helps doctors make more and have the lifestyle they deserve!. Check them out HERE!

David Tom Cooke, MD, Founding Chief of the Division of General Thoracic Surgery at UC Davis, joins the first episode of 2023 to discuss his colleague's specific role in lung cancer screening and intervention, advances to minimally invasive, robotic and bronchoscopic techniques, and evolving strategies in individualized patient care. Episode Highlights 0:14 Intro 1:52 Introducing David T. Cooke, MD 3:23 The role of thoracic surgeons in improving lung cancer screening rates 6:22 Shared decision making in thoracic surgery 8:16 Lobar, wedge resection or segmentectomy? Plus, robotic techniques? 12:22 PET/CT scans in the staging process 13:52 The surgeon approach to stage IV lung cancer 16:02 Patient follow-up—improved mortality and longer life expectancy 18:50 Prioritizing surgery and neoadjuvant therapy regimens 20:48 Thoracic surgeon role in palliative care 22:57 What's on the horizon in the field: robotic surgery 24:17 Outro Check out other lung cancer episodes of Lungcast: Innovations in Interventional Pulmonology with Dr. Carla Lamb  Lung Cancer Screening: Trials, Tribulations & Triumphs with Dr. James Mulshine Future of Lung Cancer Precision Medicine with Andrea Mazzochi Get More From Lungcast Lungcast on HCPLive: https://www.hcplive.com/podcasts/lungcast Lungcast on American Lung Association: https://www.lung.org/professional-education/lungcast Spotify: https://spoti.fi/3YEDxKw Apple Podcasts: http://bit.ly/3jCVevq YouTube: https://www.youtube.com/@Lungcast/videos

What are warning signs a doctor may be experiencing doctor burnout? How are some nonprofits affected by doctor burnout? What can members of the CHD community do to try to reduce doctor burnout? Today's program is 'Dr. John Calhoon on Doctor Burnout in the CHD Community' and our Guest is Dr. John Calhoon.Dr. Calhoon is both a congenital and adult cardiac surgeon and was my Heart Warrior's surgeon. He also wrote the Foreword for my first book: “Hypoplastic Left Heart Syndrome: A Parent's Handbook.”Dr. Calhoon is the Professor and Founding Chair of the Department of Cardiothoracic Surgery at the University of Texas Health Science Center and also is the Director of the Congenital Heart Center in San Antonio, a partnership of UHS and UTH. Over the years, his interests and expertise have included complex congenital heart surgery; heart and lung transplantation; less invasive cardiac surgery, and improving education and patient care.He has served as the President of many national cardiac associations and is currently President of the Society of Thoracic Surgeons – the largest heart and lung specialty organization in the world., He helped found HeartGift San Antonio, an organization that sponsors charitable lifesaving congenital heart repairs on kids from around the globe. Dr. Calhoon is married to his wife Sarah, and together they have four children: Satchel, Stetson, Seve, and James.Today we'll learn about Dr. Calhoon's views on doctor burnout, some of the causes of doctor burnout, and what the CHD community can do to help prevent or curb doctor burnout.Here's a link to an article about Chip Oswalt – the surgeon who founded HeartGift - Austin: https://ctvstexas.com/a-doctor/Support the showAnna's Buzzsprout Affiliate LinkBaby Blue Sound CollectiveSocial Media Pages:Apple PodcastsFacebookInstagramMeWeTwit...

Patient acuity is a critical benchmark for ensuring the patient has a proper care plan – it essentially saves lives. On MedAxiom HeartTalk, host Melanie Lawson talks with Amy Simone, PA-C, FACC, director of the Marcus Heart Valve Center at Piedmont Heart Institute, and Vinod Thourani, MD, FACC, professor of Cardiac Surgery and chief of Cardiovascular Surgery at Piedmont Healthcare at the Marcus Heart Valve Center. They discuss the challenges of accurately capturing patient acuity in heart failure patients and share innovative solutions to this problem. Guest BiosVinod Thourani, MD, FACC, Professor of Cardiac Surgery, Chief of Cardiovascular Surgery, Piedmont Healthcare at the Marcus Heart Valve Center - Dr. Thourani is board certified in surgery and cardiothoracic surgery. He earned his medical degree from Emory University School of Medicine. Dr. Thourani completed a general surgery internship at Emory University, followed by a residency and fellowship at Emory University. He also completed visiting fellowships for minimally invasive and transcatheter valve surgery at Fuwai Hospital in Beijing, China, and a fellowship with Prof Fred Mohr in Leipzig, Germany. Dr. Thourani is a member of the American Association for Thoracic Surgery, American Board of Thoracic Surgery, American College of Cardiology, American Heart Association, the Heart Valve Society, the International Society of Minimally Invasive Cardiothoracic Surgery, the South Atlantic Cardiovascular Society, and the Society of Thoracic Surgeons. He serves as the President of the Southern Thoracic Surgical Association (2019-2020) and the President-elect for the Heart Valve Society (2019-2020). Dr. Thourani specializes in valve surgery, specifically in minimally invasive and transcatheter aortic and mitral valve surgery. He is passionate about working with a multi-disciplinary team in providing the patient with options for traditional, minimally invasive, and transcatheter surgical options. In his spare time, Dr. Thourani enjoys spending time with his family, traveling, tennis, and going to sporting events and concerts. Amy Simone, PA-C, FACC, Director of the Marcus Heart Valve Center, Piedmont Heart Institute - Amy Simone is a Physician Assistant who received her training in Boston, MA at Massachusetts College of Pharmacy and Health Sciences. She is entering her seventeenth year of practice as a PA, and has spent over a decade in the Structural Heart arena. She served as the Structural Heart and Valve Coordinator at Emory University Midtown Hospital for over 6 years before transitioning to the Piedmont Heart Institute as the Director of the Marcus Heart Valve Center in 2017. She is a Past President of the Academy of Physician Associates in Cardiology (APAC) and in 2022 was appointed the APAC Structural Heart Disease Committee Chair. She is a Fellow of the American College of Cardiology (FACC) and serves on the ACC Cardiovascular Team Section Leadership Council, the ACC Physician Assistant Committee and the ACC Georgia Chapter Program Committee. In 2019 she co-published a textbook entitled Transcatheter Aortic Valve Replacement Program Development – A Guide for the Heart Team. She is passionate about patient advocacy and experience, program optimization, and addressing disparities in care. She lives in Atlanta, GA with her husband Michael and daughter Ivy.

Intro: Dr. Thomas Varghese Jr. is the Associate Chief Medical Quality Officer and Chief Value Officer at the Huntsman Cancer Institute, and Chief of General Thoracic Surgery at the University of Utah. Dr. Varghese is a national leader in minimally invasive applications for general thoracic surgery, recognized by Castle Connolly as one of America's “Top Docs”, and is ranked in the top 10% of the nation by Press Ganey for patient satisfaction scores. His research interests bridge the world of Educational Research and Health Services Research, specifically in the arena of optimizing performance at the patient, surgeon and system levels. He created the Strong for Surgery program, which is now a formal Quality Improvement program of the American College of Surgeons, and active at 331 clinical sites across the nation and 3 state surgical collaboratives.Dr. Varghese holds national leadership positions in the Society of Thoracic Surgeons, Thoracic Surgery Directors Association, American College of Surgeons, and the Society of University Surgeons. Dr. Varghese is active on social media and is the Deputy Editor of Digital Media and Digital Scholarship for the Annals of Thoracic Surgery.Questions We Asked: Where did your passion for leadership come from? Who were your mentors and what made that relationship special? Have you found your mentors formally or informally? How can you create a good formalized mentorship program? How do mentors effectively help their mentees find their career path? How do you create a good mentor/mentee relationship? How can those in the majority be allies to minority groups in medicine and science? How do you be comfortable saying “I don't know”? Quotes & Ideas: “Never stop looking for best practices” You can and should have different mentors for the various areas of your life (academic, career, social, spiritual, etc.) “Mentorship is someone with a particular knowledge or skills that shares them with someone else who does not have it on their own.” “A mentor does not always have to be older than you.” Identify OKR (objectives and key results) and set a time deadline for it “An ally is someone who builds a culture of inclusion” and “A leader is someone who betters the culture of those they lead”. Leaders need to be allies. “Are we better today than we were yesterday, and are we going to be better tomorrow than we were today and how do we achieve that.” “Diversity doesn't end because you hire the next diverse faculty. You have to make sure they thrive in their position.” “You don't know, doesn't necessarily mean you don't act.” “MD means make decisions.” “We are living in the greatest time in history.” “Seek your tribe members” Books Suggestions: The 4 Disciplines of Execution by Sean Covey Peter Drucker Start With Why by Simon Sinek Adam Grant 

This is another episode in our AI is Here series, and today, we're focusing on AI in the hospital setting. In this episode, we discuss patient data and being able to guide a patient's treatment journey with artificial intelligence. Our guest is Dr. Kostas Papagiannopoulos. Kostas is an Honorary Senior Lecturer at Leeds University and serves as Thoracic Surgeon for Leeds Teaching Hospitals. He is also a Medical Advisor to several substantial medical device companies and, until recently, was President of the European Society for Thoracic Surgeons. In today's episode, Kostas discusses where he's seeing AI make its way into the hospital setting and some of the critical barriers to adoption, and how leaders should overcome them. This series is brought you to by SambaNova Systems. SambaNova believes that AI is here, and we've partnered with them to bring you leading experts across industries to discuss where AI is making an impact today.

In this episode of Season 2, Dr. David Tom Cooke interviews Dr. Cherie Erkmen, from Temple University in Philadelphia, PA. Dr. Erkmen grew up in Colorado with devoted parents who encouraged and inspired her to consider a career in medicine. Interestingly, her mom was unofficially a “storm chaser;” officially, she was an atmospheric researcher for National Oceanic and Atmospheric Administration who studied how pollution impacts storm patterns and the connection between air pollution and lung cancer. Through her mom, Dr. Erkmen “gained a lot of courage and vicarious experience.” She remembers having only a “vague” idea of being a doctor when she was growing up. However, along with a cheering section of parents and siblings, Dr. Erkmen had the support to “think big.” In this fascinating conversation, she also shares that her dad's battle with lung cancer motivated her to become a cardiothoracic surgeon. An active member of the STS Workforce on Diversity, Equity, and Inclusion, Dr. Erkmen discusses the importance of listening to what the community needs and creative initiatives that she leads through Temple University. “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity.

In this episode, Dr. Tom Varghese interviews Dr. Allan Pickens, a leading thoracic surgeon from Emory University in Atlanta. Listeners will discover interesting personal details such as Dr. Pickens, along with his five siblings, grew up on a farm in a rural Alabama town. That farm is where he began shaping his extraordinary work ethic. With parents who strongly encouraged good grades and required college after high school, Dr. Pickens always made schoolwork a priority. A high performing student, he was recruited in 6th grade to participate in a special program through the Macy Foundation. This is when Dr. Pickens was first inspired to pursue a career in medicine. Eventually he decided on cardiothoracic surgery. “I enjoy the technical components of surgery and the immediate impact on patient care, and I'm fascinated by chest physiology.” Dr. Pickens shares that growing up in rural Alabama did not provide much opportunity for physician mentorship, especially for minorities. “Finding mentors took some work,” he says. Dr. Pickens discusses some of the challenges he's faced, and how these personal experiences motivated him to “want to give back” and “be involved in the educational process” for underrepresented individuals. “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity. Patients can learn more about cardiothoracic diseases and their treatments at ctsurgerypatients.org.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

Go online to PeerView.com/FYQ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. How have the best practices for multidisciplinary management of patients with stage I-III lung cancer changed now that adjuvant EGFR-targeted therapy has become the new standard of care in resected early-stage EGFR-mutated NSCLC, and what are the implications for thoracic surgeons and other key members of the lung cancer care team?, This PeerView Candid Conversations & Clinical Consults educational activity, based on a recent live broadcast, answers these and other burning questions. Experts in thoracic surgery and medical oncology come together to discuss recent advances and provide practical, case-based guidance on the importance of biomarker testing in early-stage settings. In addition, they provide direction on how to determine which patients are appropriate candidates for adjuvant EGFR-targeted therapy, if adjuvant chemotherapy is still needed, which considerations should be discussed with patients, and how thoracic surgeons, medical oncologists, pathologists, and other relevant specialists can effectively work together to determine the best multimodal treatment approach for each patient with stage I-III NSCLC. Upon completion of this CE activity, participants will be able to: Discuss the role of EGFR mutations in NSCLC, importance of identifying patients with EGFR mutations in earlier disease settings, and role of thoracic surgeons in biomarker testing and treatment selection in the era of precision oncology, Apply the latest evidence and recommendations to identify patients with early-stage NSCLC who would benefit from adjuvant EGFR-targeted therapy, Implement multidisciplinary strategies and shared decision-making to optimize biomarker testing and integration of adjuvant EGFR-targeted therapy into multimodal treatment plans for eligible patients with early-stage NSCLC.

This week we were joined by Dr. Bill Kent, a cardiac surgeon at the University of Calgary, to talk about minimally invasive techniques in cardiac surgery. We were curious to learn from him where MIS techniques fit in an era of rapid evolution in cardiac surgery and particularly with the advent of new catheter based techniques. Dr. Kent had a number of important insights into the introduction of new technologies in surgery and the challenges associated with trying something new. Links: 1. Minimally invasive cardiac surgery and the importance of qualitative patient-centered metrics to guide innovations. https://www.sciencedirect.com/science/article/pii/S0022522319304507?via%3Dihub Bio: Dr. William Kent is a cardiac surgeon whose practice focuses on valve surgery and mechanical circulatory support. A Fellow of the Royal College of Surgeons of Canada and a member of the International Society for Minimally Invasive Cardiothoracic Surgery, the Society of Thoracic Surgeons, the Canadian Society of Cardiac Surgeons and the American College of Surgeons, Dr. Kent is particularly interested in minimally invasive mitral valve repair and aortic valve surgery, including aortic valve and root repair as well as the Ross procedure. Dr. Kent completed his undergraduate BA and MSc degrees in Neuroscience at Western University before obtaining his MD and FRCSC in General Surgery at Queen's University. He began his Cardiac Surgery training at the University of Alberta and then continued his residency training at the University of Calgary. Dr. Kent then completed a Fellowship in complex valve surgery, transplant and mechanical circulatory support at Northwestern University in Chicago, before joining the Libin Cardiovascular Institute in 2013. His current position is Clinical Assistant Professor in the Section of Cardiac Surgery. He leads the Minimally Invasive Valve Surgery Program and is Surgical Director of the Mechanical Circulatory Support Program.

To wrap up our “Power of Partnerships” series, Dr. Douglas Wood has a conversation about the thoracic surgeon's role in lung cancer with fellow thoracic surgeons Dr. Leah Backhus, Dr. Tom Varghese, and Dr. Farhood Farjah. They discuss the surgeon's role in screening programs, evaluating nodules from a surgical perspective, and how to avoid harm and minimize unnecessary surgery for patients without cancer. Douglas E. Wood, MD, FACS, FRCSEd is the Chair of Surgery at the University of Washington School of Medicine in Seattle, and a physician with the Seattle Care Alliance. Dr. Wood has previously served as president of the Society of Thoracic Surgeons and director of the American Board of Thoracic Surgery. Leah Backhus, MD, MPH, FACS is an Associate Professor of Cardiothoracic Surgery at Stanford University. Dr. Backhus is the Co-Director of the Thoracic Surgery Clinical Research Program and Associate Program Director of the Thoracic CT Surgery Residency Training Program at Stanford. Thomas K. Varghese Jr., MD, MS is an Associate Professor of Surgery and the Head of Thoracic Surgery at the University of Utah. Dr. Varghese has also previously served as the Interim Executive Medical Director at the Huntsman Cancer Institute. Farhood Farjah, MD, MPH, FACS is an Associate Professor of Surgery and an Endowed Chair of Lung Cancer Research at the University of Washington. Dr. Farjah is a physician with the Seattle Cancer Care Alliance. As a follow-up to the National Lung Cancer Roundtable and American College of Radiology's 2021 webinar series, the “Power of Partnerships” limited podcast series will feature conversations currently happening in the world of lung cancer with the people pushing the field into the future. Additional information on this topic, as well as the resources mentioned during the episode, can be found at https://www.acr.org/Clinical-Resources/Lung-Cancer-Screening-Resources.

In this episode, Dr. David Tom Cooke interviews Dr. Raja Flores, from Mount Sinai in New York City (NYC). With generous detail, Dr. Flores describes his “jagged line” to cardiothoracic surgery, while crediting luck and his supportive mom for much of his success. He shares how he “grew up poor” in NYC with neighborhood friends who turned to drugs and often ended up in jail. For Dr. Flores, though, personal experiences during repeated trips to the emergency room as a kid sparked his interest in medicine. He opens up about his passion for improving lung cancer survival—an area that has “a lot of room for improvement.” Dr. Flores explains that 80% of people living in NYC public housing are living with serious health hazards and exposures, but there is no “political activity” to improve the conditions. This reality fueled Dr. Flores's motivation to launch a run for NYC mayor in 2021. “I wanted to bring awareness and effect change on a greater scale,” he shares. While unsuccessful, his campaign as “a son of New York City and mayor for all people” was organized and run by four medical students. Hear, too, what Dr. Flores says about the cardiothoracic surgery specialty “exploding” in years to come. “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity. Patients can learn more about cardiothoracic diseases and their treatments at ctsurgerypatients.org.

In this episode—which does not disappoint—Dr. Tom Varghese interviews Dr. Gail Darling, head of surgery at Dalhousie University in Nova Scotia, Canada. Dr. Darling reveals an “ordinary upbringing,” growing up in Canada with an accountant dad and a stay-at-home mom. Interestingly, her 12th grade English teacher was the person who recommended that Dr. Darling think about medicine as a career; before that, she was going to study English. She went on to become the first person in her family to attend university. The original plan was family medicine, but during the surgery rotation, Dr. Darling realized there was more opportunity to “make a difference and make things happen” in surgery. She liked “the pace and the people—birds of a feather.” This “giant” in cardiothoracic surgery shares her perspectives and thoughts about overcoming challenges associated with shattering glass ceilings, constant changes in cardiothoracic surgery, and the need to adopt a growth mindset in the quest for excellence. In reflecting on her career so far, Dr. Darling offers some wise words and sage advice for listeners: “Never give in; Don't be limited by what other people tell you; Think about what drives you, what motivates you, what gets you up in the morning; Don't let anything stand in your way.” “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity. Patients can learn more about cardiothoracic diseases and their treatments at ctsurgerypatients.org.

Welcome to the first episode of “All Things AFib.” I am your host, Dr. Armin Kiankhooy. As a board-certified cardiothoracic surgeon, my focus is on advanced treatments for heart and lung failure and minimally-invasive surgical treatments for atrial fibrillation such as the Hybrid Maze procedure. You can find me on staff at Adventist Health Heart and Vascular Institute in St. Helena California. For our inaugural episode, I'm thrilled to welcome Dr. James Cox, a legend in the field of cardiothoracic surgery, and inventor of the Cox maze surgery. The world is lucky that Dr. Cox decided to become a surgeon because he also had an offer to play professional baseball with the LA Dodgers. Dr. Cox was the Evarts A. Graham Professor of Surgery, vice-chairman of the department of surgery, and chief of the division of cardiothoracic surgery at Washington University School of Medicine and Barnes Hospital in St. Louis, MO. It was here in 1987 that he developed the eponymous “maze” procedure, which is still the gold standard in the world today. Dr. Cox was the 81st (and youngest) president of the American Association for Thoracic Surgery (AATS), a member of the editorial board of more than 20 scientific journals, and editor-in-chief of two AATS journals. Among the numerous awards and honors he has received throughout his illustrious career, Dr. Cox is the only surgeon to receive the Distinguished Scientist Award from the AATS, the Society of Thoracic Surgeons, and the Heart Rhythm Society. He is the only U.S. cardiac surgeon in the Russian Academy of Medical Sciences. Cox is dedicated to clinical excellence, the development of new techniques, and the training of the next generation of surgeons. Discussion points:What is Atrial Fibrillation (AFib)?The AFib word origins actually meant the appearance of a “sack of worms”The two types of Macro Re-Entry– Automaticity and micro/macro re-entryTreatment methods– Cardiothoracic Surgeons vs. ElectrophysiologistsThe technicalities of terms Maze III vs. Maze IV, the confusion, and even a lawsuitWhat are the confusing statistics around pacemaker implantation and the Cox maze procedure?Post-operative and medicinal damage to the sinus nodeAround 5% of patients may need pacemakers due to “sick” sinus nodes, not AFib surgeryA discussion of Left Atrial Appendage managementIs there a percentage of AFib patients that should have more than the Left Atrial closure procedure?Do we need to get more surgeons to do Left Atrial closure?Discussion of hybrid maze proceduresWill we still be doing maze procedures in 30 years?Imagining tools we may be using in the futureResources:Dr. James Cox Original Papers: The surgical treatment of atrial fibrillation. I. Summary of the current concepts of the mechanisms of atrial flutter and atrial fibrillation. The surgical treatment of atrial fibrillation. II. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation. The surgical treatment of atrial fibrillation. III. Development of a definitive surgical procedure. Modification of the maze procedure for atrial flutter and atrial fibrillation. I. Rationale and surgical results. Modification of the maze procedure for atrial flutter and atrial fibrillation. II. Surgical technique of the maze III procedure.Dr. James Cox LinkedInDr. James Cox Receives Jacobson Innovation Award Dr. Kiankhooy LinkedInAll Things AFib WebsiteAll Things AFib TwitterAll Things AFib YouTube Channel

In this episode, Dr. David Tom Cooke interviews Dr. Jacques Kpodonu, from Harvard Medical School and Beth Israel Deaconess Medical Center in Boston. Listeners will discover fascinating personal details, like why Dr. Kpodonu considers himself an “international gentleman.” He was born in Paris, France—his mom's home city, but at 8 years old, moved to his dad's country of Ghana. Throughout his childhood years, the family moved back and forth between the two countries several times. In Ghana, Dr. Kpodonu's dad served as the country's first cardiologist, and today, at 84 years old, he is still practicing medicine—"as active as ever.” After attending medical school at the University of Ghana, Dr. Kpodonu felt a “pull” to complete his training in the US. Why cardiothoracic surgery? His dad's influence pushed him to “do something with the heart.” From an early age, he was reading EKGs for his dad—“making some money on the side.” A staunch advocate for global health equity, Dr. Kpodonu details his work with health care disparities in underserved communities. He also illustrates an exciting future for the specialty and advises young cardiothoracic surgeons to “keep an open mind.” “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity. Patients can learn more about cardiothoracic diseases and their treatments at ctsurgerypatients.org.

In this episode of Season 2, Dr. Tom Varghese interviews Dr. Joseph Dearani, from the Mayo Clinic in Rochester, MN. Described as a leader extraordinaire, Dr. Dearani reflects on his STS presidency and shares the most challenging aspects of leading the organization during the first 10 months of the COVID-19 pandemic. He says adapting, rebounding, and refocusing were key. Dr. Dearani details captivating personal stories such as how his father's family—who were silk weavers—emigrated from Syria; how his father, as a young boy, shined shoes on a street corner in Patterson, New Jersey, and then used his earnings to buy bread for dinner on the way home; and what it was like growing up with eight younger sisters. His father, who went on the become a family physician, inspired Dr. Dearani to pursue a career in medicine. The decision to specialize in cardiothoracic surgery, though, was a little less straightforward. In fact, surgery wasn't even one of his initial interests. Instead, he considered emergency medicine and primary care. It was when Dr. Dearani rotated onto cardiac surgery toward the end of medical school that he decided he wanted to be heart surgeon. In addition to medicine, Dr. Dearani has a love for music. Listeners will hear how a nun visiting on Thanksgiving convinced him to take saxophone lessons. He continued playing throughout college and eventually the saxophone became a “religious part of my everyday life,” he says. “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity. Patients can learn more about cardiothoracic diseases and their treatments at ctsurgerypatients.org.

In the first episode of Season 2, Dr. David Tom Cooke interviews Dr. Valerie Rusch, esteemed medical researcher and thoracic surgeon from Memorial Sloan-Kettering Cancer Center in New York City. Dr. Rusch reveals fascinating details about her storied career, excitedly sharing that cardiothoracic surgery is “in a time of wonderful transformation.” She describes growing up in Manhattan with powerful lessons from her mother about being a strong woman. This counsel—along with a summer job as a surgical scrub tech—motivated Dr. Rusch to pursue a career in medicine. She knew it wouldn't be easy, but with persistence and resilience, she carried on and became one of the world's top experts in the management of lung cancer and mesothelioma. Throughout the episode, Dr. Rusch offers valuable advice for young surgeons. “Be nimble and flexible,” she says. In addition, Dr. Rusch explains the importance of being open to new ideas and thoughtful about acquiring new skills to take care of patients. The faces of cardiothoracic surgery are different than they were 30 years ago, which she says, is "a benefit to the specialty, surgery in general, and especially to our patients.” Is the thoracic surgeon of tomorrow different than the thoracic surgeon of today? According to Dr. Rusch, “absolutely.” “Same Surgeon, Different Light” is a program from The Society of Thoracic Surgeons designed to demystify cardiothoracic surgery, revealing the men and women behind their surgical masks. Learn more about STS diversity and inclusion efforts at sts.org/diversity. Patients can learn more about cardiothoracic diseases and their treatments at ctsurgerypatients.org.

Go online to PeerView.com/KZR860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you integrating the latest optimal treatments into the management plans for your patients with esophageal/gastroesophageal junction (GEJ) cancer? The approval of the PD-1 inhibitor nivolumab in the adjuvant setting has provided a new opportunity for patients to achieve longer disease-free survival, a goal that had not been attainable with conventional modalities. Despite guideline recommendations and clinical evidence demonstrating the role of immunotherapy in esophageal/GEJ cancer, many eligible patients are not receiving this game-changing treatment, and patients in other settings are not being enrolled in clinical trials of immune checkpoint inhibitors. By combining in-depth discussions on the latest data and key clinical issues with expert guidance on integrating immunotherapy into multimodal practice, PeerView's Candid Conversations & Clinical Consults event is designed to help clinicians incorporate new standards of care into the treatment of their patients with esophageal/GEJ cancer. Don't miss this opportunity to learn how thoracic surgeons, oncologists, and other oncology team members can collaborate to bring practice-changing science into the clinic. Upon completion of this CE activity, participants will be able to: Identify appropriate patients with resectable esophageal/GEJ cancer who are candidates for adjuvant therapy with an immune checkpoint inhibitor, Apply multimodal treatment protocols for locally advanced or earlier-stage esophageal/GEJ cancer to incorporate novel immunotherapy options for eligible patients, either in the context of clinical practice or through clinical trial participation, based on the latest evidence, indications, guideline recommendations, and patient-centered factors, Collaborate with the broader multidisciplinary team to optimally integrate novel immunotherapy options into individualized treatment plans, including strategies to promptly recognize and manage potential immune-related adverse events, for patients with locally advanced or early-stage esophageal/GEJ cancer.

Go online to PeerView.com/KZR860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you integrating the latest optimal treatments into the management plans for your patients with esophageal/gastroesophageal junction (GEJ) cancer? The approval of the PD-1 inhibitor nivolumab in the adjuvant setting has provided a new opportunity for patients to achieve longer disease-free survival, a goal that had not been attainable with conventional modalities. Despite guideline recommendations and clinical evidence demonstrating the role of immunotherapy in esophageal/GEJ cancer, many eligible patients are not receiving this game-changing treatment, and patients in other settings are not being enrolled in clinical trials of immune checkpoint inhibitors. By combining in-depth discussions on the latest data and key clinical issues with expert guidance on integrating immunotherapy into multimodal practice, PeerView's Candid Conversations & Clinical Consults event is designed to help clinicians incorporate new standards of care into the treatment of their patients with esophageal/GEJ cancer. Don't miss this opportunity to learn how thoracic surgeons, oncologists, and other oncology team members can collaborate to bring practice-changing science into the clinic. Upon completion of this CE activity, participants will be able to: Identify appropriate patients with resectable esophageal/GEJ cancer who are candidates for adjuvant therapy with an immune checkpoint inhibitor, Apply multimodal treatment protocols for locally advanced or earlier-stage esophageal/GEJ cancer to incorporate novel immunotherapy options for eligible patients, either in the context of clinical practice or through clinical trial participation, based on the latest evidence, indications, guideline recommendations, and patient-centered factors, Collaborate with the broader multidisciplinary team to optimally integrate novel immunotherapy options into individualized treatment plans, including strategies to promptly recognize and manage potential immune-related adverse events, for patients with locally advanced or early-stage esophageal/GEJ cancer.

Go online to PeerView.com/KZR860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you integrating the latest optimal treatments into the management plans for your patients with esophageal/gastroesophageal junction (GEJ) cancer? The approval of the PD-1 inhibitor nivolumab in the adjuvant setting has provided a new opportunity for patients to achieve longer disease-free survival, a goal that had not been attainable with conventional modalities. Despite guideline recommendations and clinical evidence demonstrating the role of immunotherapy in esophageal/GEJ cancer, many eligible patients are not receiving this game-changing treatment, and patients in other settings are not being enrolled in clinical trials of immune checkpoint inhibitors. By combining in-depth discussions on the latest data and key clinical issues with expert guidance on integrating immunotherapy into multimodal practice, PeerView's Candid Conversations & Clinical Consults event is designed to help clinicians incorporate new standards of care into the treatment of their patients with esophageal/GEJ cancer. Don't miss this opportunity to learn how thoracic surgeons, oncologists, and other oncology team members can collaborate to bring practice-changing science into the clinic. Upon completion of this CE activity, participants will be able to: Identify appropriate patients with resectable esophageal/GEJ cancer who are candidates for adjuvant therapy with an immune checkpoint inhibitor, Apply multimodal treatment protocols for locally advanced or earlier-stage esophageal/GEJ cancer to incorporate novel immunotherapy options for eligible patients, either in the context of clinical practice or through clinical trial participation, based on the latest evidence, indications, guideline recommendations, and patient-centered factors, Collaborate with the broader multidisciplinary team to optimally integrate novel immunotherapy options into individualized treatment plans, including strategies to promptly recognize and manage potential immune-related adverse events, for patients with locally advanced or early-stage esophageal/GEJ cancer.

Go online to PeerView.com/KZR860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you integrating the latest optimal treatments into the management plans for your patients with esophageal/gastroesophageal junction (GEJ) cancer? The approval of the PD-1 inhibitor nivolumab in the adjuvant setting has provided a new opportunity for patients to achieve longer disease-free survival, a goal that had not been attainable with conventional modalities. Despite guideline recommendations and clinical evidence demonstrating the role of immunotherapy in esophageal/GEJ cancer, many eligible patients are not receiving this game-changing treatment, and patients in other settings are not being enrolled in clinical trials of immune checkpoint inhibitors. By combining in-depth discussions on the latest data and key clinical issues with expert guidance on integrating immunotherapy into multimodal practice, PeerView's Candid Conversations & Clinical Consults event is designed to help clinicians incorporate new standards of care into the treatment of their patients with esophageal/GEJ cancer. Don't miss this opportunity to learn how thoracic surgeons, oncologists, and other oncology team members can collaborate to bring practice-changing science into the clinic. Upon completion of this CE activity, participants will be able to: Identify appropriate patients with resectable esophageal/GEJ cancer who are candidates for adjuvant therapy with an immune checkpoint inhibitor, Apply multimodal treatment protocols for locally advanced or earlier-stage esophageal/GEJ cancer to incorporate novel immunotherapy options for eligible patients, either in the context of clinical practice or through clinical trial participation, based on the latest evidence, indications, guideline recommendations, and patient-centered factors, Collaborate with the broader multidisciplinary team to optimally integrate novel immunotherapy options into individualized treatment plans, including strategies to promptly recognize and manage potential immune-related adverse events, for patients with locally advanced or early-stage esophageal/GEJ cancer.

Go online to PeerView.com/KZR860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you integrating the latest optimal treatments into the management plans for your patients with esophageal/gastroesophageal junction (GEJ) cancer? The approval of the PD-1 inhibitor nivolumab in the adjuvant setting has provided a new opportunity for patients to achieve longer disease-free survival, a goal that had not been attainable with conventional modalities. Despite guideline recommendations and clinical evidence demonstrating the role of immunotherapy in esophageal/GEJ cancer, many eligible patients are not receiving this game-changing treatment, and patients in other settings are not being enrolled in clinical trials of immune checkpoint inhibitors. By combining in-depth discussions on the latest data and key clinical issues with expert guidance on integrating immunotherapy into multimodal practice, PeerView's Candid Conversations & Clinical Consults event is designed to help clinicians incorporate new standards of care into the treatment of their patients with esophageal/GEJ cancer. Don't miss this opportunity to learn how thoracic surgeons, oncologists, and other oncology team members can collaborate to bring practice-changing science into the clinic. Upon completion of this CE activity, participants will be able to: Identify appropriate patients with resectable esophageal/GEJ cancer who are candidates for adjuvant therapy with an immune checkpoint inhibitor, Apply multimodal treatment protocols for locally advanced or earlier-stage esophageal/GEJ cancer to incorporate novel immunotherapy options for eligible patients, either in the context of clinical practice or through clinical trial participation, based on the latest evidence, indications, guideline recommendations, and patient-centered factors, Collaborate with the broader multidisciplinary team to optimally integrate novel immunotherapy options into individualized treatment plans, including strategies to promptly recognize and manage potential immune-related adverse events, for patients with locally advanced or early-stage esophageal/GEJ cancer.

Go online to PeerView.com/KZR860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Are you integrating the latest optimal treatments into the management plans for your patients with esophageal/gastroesophageal junction (GEJ) cancer? The approval of the PD-1 inhibitor nivolumab in the adjuvant setting has provided a new opportunity for patients to achieve longer disease-free survival, a goal that had not been attainable with conventional modalities. Despite guideline recommendations and clinical evidence demonstrating the role of immunotherapy in esophageal/GEJ cancer, many eligible patients are not receiving this game-changing treatment, and patients in other settings are not being enrolled in clinical trials of immune checkpoint inhibitors. By combining in-depth discussions on the latest data and key clinical issues with expert guidance on integrating immunotherapy into multimodal practice, PeerView's Candid Conversations & Clinical Consults event is designed to help clinicians incorporate new standards of care into the treatment of their patients with esophageal/GEJ cancer. Don't miss this opportunity to learn how thoracic surgeons, oncologists, and other oncology team members can collaborate to bring practice-changing science into the clinic. Upon completion of this CE activity, participants will be able to: Identify appropriate patients with resectable esophageal/GEJ cancer who are candidates for adjuvant therapy with an immune checkpoint inhibitor, Apply multimodal treatment protocols for locally advanced or earlier-stage esophageal/GEJ cancer to incorporate novel immunotherapy options for eligible patients, either in the context of clinical practice or through clinical trial participation, based on the latest evidence, indications, guideline recommendations, and patient-centered factors, Collaborate with the broader multidisciplinary team to optimally integrate novel immunotherapy options into individualized treatment plans, including strategies to promptly recognize and manage potential immune-related adverse events, for patients with locally advanced or early-stage esophageal/GEJ cancer.

This episode features Dr. Abe DeAnda, MD, FACS. He attended medical school, residency, and fellowship training at Stanford University in California. He currently serves as a professor and chief of cardiovascular and thoracic surgery at UTMB.In this episode, we get a look at the first fellowship to be featured on the show! Tune in to learn all the ways to become a cardiac surgeon as well as tips on how to do so!RESOURCES:American Board of Thoracic Surgery (https://www.abts.org/)CTSNet (https://www.ctsnet.org/)American Association for Thoracic Surgeons (https://www.aats.org/aatsimis/AATSWeb)Society of Thoracic Surgeons (https://www.sts.org/)Western Thoracic Surgical Association (https://westernthoracic.org/)Southern Thoracic Surgical Association (https://stsa.org/)Dr. DeAnda: abdeanda@utmb.eduMe: atmeffor@utmb.edu

This week's episode features special Guest Host Mercedes Carnethon, as she interviews author Sung-Min Cho and Associate Editor Marc Ruel as they discuss the article "Cerebrovascular Events in Patients with Centrifugal-Flow Left Ventricular Assist Devices: A Propensity Score Matched Analysis from the Intermacs Registry." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature, we're going to look at centrifugal flow, left ventricular assist devices and cerebrovascular events. But before we get to the feature, how about we grab a cup of coffee and jump into some of the other articles in the issue? And maybe how about I go first? Dr. Carolyn Lam: All right. I got my coffee. Dr. Greg Hundley: So my first paper comes from Professor Dali Luo from Capital Medical University. And it's pertaining to calsequestrin-1. So calsequestrin-1, and calsequestrin-2 isoforms buffer calcium and regulate its release from the sarcoplasmic reticulum of skeletal and cardiac muscle. Human inherited diseases associated with mutations of calsequestrin-1 or 2 include malignant hyperthermia and environmental heat stroke and catecholamingergic polymorphic ventricular tachycardia. However, patients with hypothermia, environmental heat stroke events often suffer from an arrhythmia for which the underlying mechanism remains unknown. Dr. Carolyn Lam: Wow. Okay. And what did the current paper do and find? Dr. Greg Hundley: Great, Carolyn. So what the authors found, calsequestrin-1, the skeletal isoform of it is indeed expressed in cardiomyocyte sarcoplasmic reticulum for mirroring in human hearts, mostly presenting as a polymeric form and interacting with the ryanodine 2 receptor in ventricles. Second, calsequestrin-1 deficiency cause sinus tachycardia in basal conditions. And this is a novel finding which may be associated with sinus beat regulation and ventricular arrhythmia as an independent arrhythmogenesis if a high concentration of volatile anesthetics are used. Next, these volatile anesthetics and heating to 41 degrees C can directly induce calsequestrin-1 oligomerization, thereby causing enhancement of diastolic calcium leak and premature calcium transience through a reduced regulatory effect of calsequestrin-1 on ryanodine 2 activity. And so Carolyn, this novel mechanism underlying the arrhythmia occurring in patients with malignant hypothermia or environmental heatstroke episodes may provide different strategies for heart disorders as an independent profile in these syndromes. And finally, the finding of calsequestrin-1 confirmational change induced by triggers in those with malignant hyperthermia and environmental heatstroke could lead to novel therapeutic approaches to prevent these types of episodes. And that may also very, very useful in treatment of heatstroke.   Dr. Carolyn Lam: Wow. Thanks Greg. Well, moving from this preclinical world to a very common clinical question of the diagnosis of acute myocardial infarction. Now we know that in patients presenting to the emergency department with symptoms suggestive of an MI, the European Society of Cardiology zero and one hour algorithm is recommended by current ESC NSTEMI guidelines with a class one recommendation. Now, what this does is it combines a very high safety for early rule-out and high accuracy for rule-in allowing a definite triage of about 70 to 75% of patients using the zero in one hour sample. Dr. Carolyn Lam: However, what is the most appropriate management of the 25 to 30% of patients who remain in the gray observed zone? So this is the question that the current paper addresses. Now to answer this, we also need some more background that a single center pilot study previously of patients in the observed zone had derived a cutoff of seven nanograms per liter for a zero and three hour high sensitivity cardiac troponin T change to identify patients also eligible for early rule-out or rule-in of NSTEMI. So the current study that we're talking about in today's issue from Dr. Christian Mueller from Cardiovascular Research Institute in Basil, Switzerland, and colleagues, really aimed to externally validate that previously proposed seven nanogram per liter change cutoff, and if necessary derive and internally as well as externally validate some new criteria for these patients in the observed zone of the ESC zero in one hour algorithm. Dr. Greg Hundley: Wow, Carolyn, so we're learning a lot about cutoff values and also algorithms here with high sensitivity cardiac troponin T. So what did they find here? Very interested to hear. Dr. Carolyn Lam: So in two large prospective multicenter diagnostic studies, they found that the proposed zero and three hour high sensitivity cardiac troponin T change of seven nanogram criteria, unfortunately provided suboptimal safety for ruling out NSTEMI in patients remaining in the observed zone of the ESC zero and one hour algorithm. So this had a sensitivity of only 33% and missed 80 patients with NSTEMI. So they derived their own novel criteria based on zero and three hour samples. And these novel criteria combined a three hour high sensitivity cardiac troponin T concentration of less than 15 nanograms per liter and a zero and three hour absolute change cutoff of four nanograms per liter. Dr. Carolyn Lam: And that combination provided a high safety for ruling out NSTEMI in these patients in the observed zone and with a sensitivity of 99% missing only one patient with NSTEMI. Another further thing they found was at a zero and three hour cardiac troponin T absolute change of greater or equal to six nanograms per liter triage, 63 patients, or 11% towards rule-in thus resulting in a specificity of 98%. So in summary, this novel criteria based on zero and three hour sample seemed to balance safety and efficacy well for the further decision making in patients who are remaining in the observed zone after the zero and one hour cardiac troponin T algorithm. Internal validation of these novel criteria and external validation in an independent international cohort showed robustness of performance metrics and further strengthen its possible clinical use.   Dr. Greg Hundley: Very nice, Carolyn. Lots of data there, and hopefully very important clarification on both the zones as well as the cutoff values for using cardiac troponin T. Well, Carolyn, my next paper again comes from the preclinical science world and it's from Dr. Anne Eichmann at Yale University School of Medicine, and it pertains to activin receptor-like kinase 1. And we're going to call that ALK1.   Dr. Greg Hundley: Kinase 1 and we're going to call that ALK1. And it's an endothelial transmenbrane serine threonine kinase receptor for BMP family ligands that plays a critical role in cardiovascular development and pathology. And loss of function mutations of the ALK1 gene cause type 2 hereditary hemorrhagic telangiectasias, a devastating disorder that leads to arteriovenous malformations. Dr. Carolyn Lam: Oh, okay. And what did the authors find? Dr. Greg Hundley: Dr. Carolyn Lam, ALK1 mutants displayed defective polarization against the direction of blood flow in capillary and venous endothelium as well as increased integran VEGF receptor 2 mediated P13K activation of YAP/TAZ signaling. Dr Carolyn Lam: Okay, Greg, that was super summarized but what are the clinical implications? Dr. Greg Hundley: Carolyn, pharmacological integrin inhibition using cilengitide or ATN-161, or YAP/TAZ inhibition using verteporfin, prevented AVM malformation in ALK1 mutant mice. And therefore for this study, the authors revealed that integrin and YAP/TAZ were novel affectors of ALK1 signaling in AVM pathogenesis that might be targeted for AVM treatment in patients with hemorrhagic telangiectasias. Dr. Carolyn Lam: Thank you, Greg. Well, let's review what else is in today's issue. There's an exchange of letters between Doctors Amadio and Valentine on cell-free DNA to detect heart allograph acute rejection. There's an AHA Update paper by Dr. Churchwell on preemption, a threat to building healthy, equitable communities. There's a Research Letter by Dr. Merkler on the association between cervical artery dissection and aortic dissection. Dr. Greg Hundley: And Carolyn, I've got a paper from Professor Daniels regarding the Clinical Implications of Basic Research getting inside the engine, the myosin modulation of hypertrophic cardiomyopathy and systolic heart failure. And then finally, there's an In Depth piece from Dr. Viskin entitled, “Polymorphic Ventricular Tachycardia: The Terminology, mechanism, diagnosis and Emergency Therapy.”   Dr. Carolyn Lam: Nice. Well, let's go on to our feature discussion. Can't wait. Dr. Greg Hundley: You bet.   Dr. Mercedes Carnethon: Welcome to this episode of Circulation on the Run, our podcast where we have an opportunity to talk with the authors of some of the top articles within our journal for a given week. And we've chosen today to focus on a set of articles, one of which is led by Dr. Sung-Min Cho from the Johns Hopkins University. And I'm really excited to have you with us today, Dr. Cho and joining us as well as the associate editor, Dr. Marc Ruel who handled the paper. And my name is Mercedes Carnethon from the Northwestern University's Feinberg School of Medicine. I guess without further ado, welcome to you both and we'll just jump right into it. Dr. Mercedes Carnethon: Dr. Cho, I'd love to hear a little bit more about your paper today. What made you choose to pursue this particular topic and what really inspired you? Dr. Sung-Min Cho: Thank you so much for the invitation and opportunity to talk today. During my training as a neuro person, I'm a neurointensivist by training and neurologist. I noticed that we are getting a lot of consults for LVAD associated strokes. When I took a closer look at the ENDURANCE trial, very showed really 29.7% stroke rate at two years and a few years later, we had this MOMENTUM 3 trial, which showed HeartMate 3 device had 10% stroke rate at two years. And we realized that a stroke is a major issue in this population and I wanted to study the incidence respecters and outcome of this strokes in LVAD population. However, despite the many observational studies in the past, we were really interested in looking at device specific stroke risk for current continuous flow LVADs and we wanted to look at the device specific risk and prevalence of these patients balancing co-morbidities each cohort. And that's why we conducted this study. Dr. Mercedes Carnethon: Great, well Sung-Min, it's not often that as an epidemiologist and cardiovascular epidemiologist that I actually get to talk with neurointensivists and get their insights on the importance of their work. Can you tell me a little bit about what you found and whether it surprised you? Dr. Sung-Min Cho: Population, we used the Intermacs registry database. This is well established database as all cardiologists and cardiothoracic surgeons know, and we defined a neurologic adverse event as stroke plus TIA, transient ischemic attack. We used a propensity score matching analysis to assess the association of HVAD with stroke risk, to balance for pre-implant risk factors. And basically after performing propensity score matching, we found that hazard of stroke was higher for patients with HVAD device compared to HeartMate 3. We kind of expected this based on the randomized control trials in the past but there was no head to head comparison between these two cohorts. This study really confirmed our suspicion that HeartMate 3 actually had lower hazard of a stroke compared to HeartMate 3. Dr. Mercedes Carnethon: Well, thank you so much. It's a really great explanation. And for those who haven't had a chance to dig into the issue yet, I really encourage you to read the piece. I found it to be very instructive. And I'm interested as well, Mark in your take about what excited you about this piece. Dr. Marc Ruel: Well, thank you very much Mercedes and Sung-Min it's really a pleasure to have you with us today. As you know, this has been a very impactful paper and you were very kind to share with us the study around your idea as to why you wanted to evaluate this question but even more than your idea and what led to the completion of the paper are the implications of your paper. And I think it would be great if you shared with us a little bit, what has been the path that your paper has led to and including amongst others, very likely a decision by the Medtronic to pull the HVAD out of market. It's interesting that your data, to my knowledge, correct me if I'm wrong, were presented first at the annual meeting of the Society of Thoracic Surgeons in January, 2021. And again, I want to reiterate that Circulation's very thankful that you chose to send your paper to our journal and we feel that it will give it full justice, like many other journals of would have had but we're really excited to have received your paper and give it the fullest consideration. Dr. Marc Ruel: Can you tell us a little bit about the implications and for lack of a better word, the storm that your paper has created in the field and your take on it? Dr. Sung-Min Cho: Right. That's a great question. Thank you for that. Like I said, as a neurologist, we see these patients after complication, patients having stroke and then we see these patients and we always wanted, cardiologists and cardiothoracic surgeons and neurologists, we always wondered which device carried more risk for stroke and TIA. And really our group actually worked on many papers in the past looking at single institutional data and also systematic review meta-analysis looking at this topic, but really HeartMate 3 came along a couple years ago, more recent device so we didn't have a lot of data. Dr. Sung-Min Cho: So intermex registry really helped since we didn't have a lot of data. So, INTERMACS Registry really provided opportunity for us to look at this specific question, really balancing those two chords to look at the risk of stroke in this HeartMate 3 and HVAD. And when we did that two years ago, we submitted a proposal to INTERMACS, and Dr. Kirklin from UAB, he really helped us to look at this data closely with his statistical team. And we had really a thorough statistical method to perform a propensity matching analysis. And we finally finished the analysis and presented in annual STS meeting in January, and it did really trigger a lot of attention to a lot of academic institutions and people who are practicing LVAD, and after that, when we finally submitted this paper to Circulation, we had to have a lot of discussion in between FDA and the Medtronic and discussing this implication of this paper. When it was finally published in Circulation, we are happy that there's a lot of attention and we made it through. Dr. Marc Ruel: Well, thank you, Dr. Cho, and maybe for the listener of this podcast, I would like to reiterate some of the salient points of your paper essentially, and correct me if I'm wrong, over 6,200 patients were included, about roughly 3,000 patients per group comparing the HeartMate 3 versus the HVAD. Dr. Marc Ruel: Now, as you alluded to the HVAD is the more ancient device, if you will. So there's a slightly longer follow-up, around 12 months on median, versus nine months with the HeartMate 3. And there's adjustment that has been made for this. And I think to me, really the key finding is that in the early acute phase around implantation, there is no real difference with regards to the risk adjusted incidents of neuro adverse events. However, once you pass the early implantation acute phase, in the chronic stable phase, there starts being really a signal that is detrimental to the performance of the HVAD versus the HeartMate 3. And I think your hazard ratio, correct me if I'm wrong, it's around 5.7 for neuro adverse events. Dr. Marc Ruel: So this is a very compelling hazard ratio, even coming out of an observational study with all the careful attention that you provided to adjust for residual confounding, et cetera. Dr. Marc Ruel: So obviously this is a very strong finding, but I would like you to perhaps comment on this, the patients are not the same. There's some indication that the HVAD patients may have been a little sicker, more RV dysfunction, more tricuspid regurgitation, higher INTERMACS-1 incidents more often on ECMO prior to an implant. What are your thoughts about this? Dr. Marc Ruel: Obviously, you've been very careful and the reader will note in the paper that many attempts have been made to account for those. But please give us your take around that 5.7 hazard ratio for neuro adverse event that you found. Dr. Sung-Min Cho: Right? In fact, we were really being careful adjusting those compounders. So we did a propensity matching has a primary analysis, but as you pointed out, as a secondary analysis, we wanted to look at multi-variable logistic regression analysis, looking at multi-hazard analytics. And when we did the secondary analysis, as you said, in the beginning early hazard period, the risk was similar, as time went on in the constant hazard period, the hazard ratio was 5.7 for HVAD compared to HeartMate 3, which gives a much higher risk of stroke and TIA for those patients with HVAD compared to HeartMate 3. Dr. Sung-Min Cho: So, that was really convincing to us. Confirming the findings from propensity matching analysis, showing that same findings were consistent throughout the different analysis. As we pointed out, HVAD patients actually were sicker, they had more ECMO, and they had more ventilation requirement or sicker patients INTERMACS level. Those are all carefully balanced in both propensity matching analysis and also multi-hazard analytics. And both of these analysis consistently showed that HVAD carried more risk of TIA and stroke compared to patients with HeartMate 3. Dr. Mercedes Carnethon: Thank you so much Sung-Min. You know what excites me as I think about choosing articles for journal clubs, when we're working with our trainees, the propensity matched approach and comparing it directly with what you're getting from multi-variable regression really provides an excellent methodological strategy to be able to generate results from these real world studies where it's not a randomized trial of who received which device, but we're able to yield practical conclusions that are actionable based on these findings when we have these well done analyses. And Marc alluded earlier to the actions that were taken in response to the findings from your study. Can you expand on those just a little bit more? Sung-Min Cho: Of course. So I guess, I don't know the real backstory, what was going on behind the scene, but I know for sure that STS leadership and INTERMACS leadership, they had a lot of discussion with the company who made HVAD device and also FDA, and I know that this study, the results of this study contributed to the decision they made back in June, pulling up HVAD device from the market. Sung-Min Cho: So I'm glad that this study could contribute to the science and hopefully this will help the patients in the future for device selection. So yeah. Dr. Marc Ruel: Sung-Min, I think it's fair to say that your study is probably, if not the most impactful in the field of ventricular assist devices, and I probably would personally think that it is, if not the single most impactful, certainly one of the two or three that are the most impactful. So congratulations to you and your team. Dr. Marc Ruel: If you still have a minute or two, I had a couple of more secondary questions? Dr. Marc Ruel In your analysis I noted that in the early acute phase, there are some protective predictors, such as performing the LVAD implant by sternotomy, which essentially results in about half of the neuro adverse events that you would otherwise observe. So I was a little intrigued by that. And high volume centers had about 1.8 hazard ratio. I suspect that's probably reflective of baseline risk and more acute illness in those patients coming. But if you have a chance, I'd love to hear your thoughts around this? Dr. Sung-Min Cho: Yeah, that's exactly what we thought actually is, initially we thought, hypothesized that surgical volume, the center volume will be associated with lower risk of stroke, but it was the other way around. But as you said, probably higher volume centers were getting sicker patients, so that's the association probably we were getting in the analysis. And we wanted to adjust for surgical techniques, sternotomy versus thoracotomy, and even after adjusting for that, HVAD remained a significant hazard per stroke, which showed in the table two and three, I think in the manuscript. Dr. Sung-Min Cho: And if I may, I want to say these couple of things. In the raw number, in the 6.4% of patients actually had TIA and strokes, neurological adverse events in HeartMate 3, at one year based on our study. And the risk goes up with a longer follow-up time of course. Moment3 trials had two-year follow-up, about 10% had stroke. And this is still, after HVAD is taken off the market, still there's a significant risk for stroke in these patients and based on autopsy and MRI studies although there is a very small studies--MRI studies, although they're a very small series, studies looking at MRI'd brains after explantation of LVAD. And it shows actually more than 95% of patients have cerebral micro bleeds, which is a marker for small vessel disease in the brain. I think this is an important issue, and although we show that one device had a lower risk of stroke, still question remains, are these patients have a high risk of stroke? And there is a need for improving biomedical engineering aspect, and I'm sure cardiologists and cardiothoracic surgeons know much better than I do regarding hemo-compatibility, especially for stroke. Dr. Sung-Min Cho: There is also a dire need for early detection and intervention for these events to improve the outcome for these patients, because once you have a stroke, the outcome is devastating, right? So I think there needs to be better medical management, neuroprotective agent, as well as neuro- monitoring methods, maybe biomarkers to predict stroke or TIA to come so we can intervene and prevent these really devastating complications. Dr. Marc Ruel: Mercedes, if I'm so allowed, I do have one final comment and question. Dr. Mercedes Carnethon: Most definitely. This has been delightful, so yes. Dr. Marc Ruel: Wonderful. So, first, Sung-Min, I want to thank you for working with us. We at Circulation were interested in your paper. You may recall you and I spoke on the phone offline when the decision to revise was made, and we went carefully over what the editors were anticipating would make your paper even better. And you were very responsive. You and your co-author's team were tremendous. And I think the paper that we have before us is absolutely very, very insightful and very important. And obviously tremendously impactful. So I want to thank you again for that. Dr. Marc Ruel: And my question is probably the very difficult question which is in everybody's mind at this point and I would like your take as a neurointensivist. You have someone who you have to care for who has a well-functioning HVAD, two years post implant. What would you recommend in terms of optimization for the prevention of neural adverse events? I realize we don't have all the information, but you are one of the few experts in the world who can probably provide us with a very valid take on this very difficult question. Dr. Sung-Min Cho: Yeah, it is indeed a difficult question. And that's what I am, including me a lot of neurointensivists, they are very interested in this topic. I think really, as I alluded before, only detection is really important, but it's really tough because either patients, they cannot get MRI. There's no way to know who's going to have stroke or not.   Dr. Sung-Min Cho: We know that a bacteremia is a huge risk factor for these patients. Whenever they have device infection, dry valve infection, bacteremia, their stroke risk goes up quite a bit. We have a lot of data on that. So we can carefully monitor these patients, follow these patients. There is some data that, within six days from infection, their stroke risk goes quite high up for these patients. Dr. Sung-Min Cho: But really, neuro-monitoring and biomarker study, there's so little data on this, but patients who are sick like this, not just LVAD patients but ECMO patients or ICU patients, are close neurologic monitoring and some markers to predict occurrence of a stroke or vascular event. I think that's something we really need to study and look into. Dr. Sung-Min Cho: Of course, we have a lot of biomarkers we can pick up from the brain, brain injury markers that we can study, and that has not been done in this space. And there are a lot of opportunities, I think, to look at that. And there's some signal based on Cleveland Clinic data that Randall Starling actually looked into, use of PDE5 inhibitor in this patient population, some protection against the ischemic stroke, and I think that's something also we should look into for neuroprotective agent. Dr. Mercedes Carnethon: Thank you so much! This has been such a delightful discussion this morning with Sung-Min Cho, the lead author of the study and the Associate Editor, Marc Ruel who handled it. Dr. Mercedes Carnethon: I really appreciate your attention. I hope the listeners enjoyed this episode of Circulation on the Run. Please join us again next time. Dr. Greg Hundley: This program is copyright of the American Heart Association, 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit ahajournals.org.  

What is congenitally corrected transposition of the great arteries or ccTGA? Historically, people born with ccTGA tended to do fairly well. Why is it today doctors are choosing to operate on the hearts of babies born with ccTGA? What does Dr. Edward Bove think about the future of babies born with ccTGA?Erin Beckemeier is mom to Conway, born in 2007 with ccTGA, a large ventricular septal defect or VSD, and sub-pulmonic stenosis. He was later diagnosed with an Ebsteinoid tricuspid valve. At six months of age, he had an arterial switch with a Senning (a double switch), VSD closure, and resection of the stenosis. Conway's recovery from these procedures was rocky, as he suffered a seizure and complete heart block, requiring a dual-chambered pacemaker. By two years of age, he was struggling with atrial flutter and underwent a mitral annuloplasty and ablation/Maze procedure. At five years, his RV-PA conduit was replaced and he was upgraded to a bi-ventricular or CRT pacing system. At 11 years old he needed a new atrial lead and generator replacement. The new atrial lead became infected and was removed the following month. At age 14 he received 2 new leads and his 4th pacemaker. Due to a significant growth spurt, his mitral valve, RV-PA homograft, and left ventricular function are being closely monitored. Erin lives with her husband Greg and their five children. She is a fourth-grade teacher and she is here today to share her story with Anna.Dr. Edward Bove is a cardiac surgeon at C.S. Mott Children's Hospital and chair of the Department of Cardiac Surgery at the University of Michigan Health System is an internationally acclaimed, board-certified pediatric cardiac and thoracic surgeon and the chair of the Hearts Unite the Globe Medical Advisory Board! Earlier this year, Dr. Bove was awarded the 2021 Earl Bakken Scientific Achievement Award by The Society of Thoracic Surgeons during the organization's virtual 57th Annual Meeting.My long-time Listeners will remember Dr. Edward Bove from Season 9. His show was entitled, “Advancements in Treatments for HLHS Heart Warriors.” We are thrilled Dr. Bove is returning to the program to talk to us about a very complicated ccTGA patient of his. He will also be sharing with us a bit about the history of the double-switch procedure and who would most benefit from that invasive surgery, as well as, predictions for the future of ccTGA Heart Warriors in the years to come.Anna's Buzzsprout Affiliate Link (if you'd like to try Buzzsprout for your podcast and get a bonus gift card -- and Anna will, too!) use this link: https://www.buzzsprout.com/?referrer_id=16817Links to 'Heart to Heart with Anna' Social Media and Podcast Pages:Apple Podcasts: https://itunes.apple.com/us/podcast/heart-to-heart-with-anna/id1132261435?mt=2MeWe: https://mewe.com/i/annajaworskiFacebook: https://www.facebook.com/HearttoHeartwithAnna/Instagram: https://www.instagram.com/hearttoheartwithanna/Twitter: https://twitter.com/AnnaJaworskiYouTube: https://www.youtube.com/channel/UCGPKwIU5M_YOxvtWepFR5ZwWebsite: https://www.hug-podcastnetwork.com/Support the show (https://www.patreon.com/HearttoHeart)

In this episode, Imani and Reginald discuss with Dr. Backhus and Dr. Goodney the historical implications of the longstanding poor relationship between the Black community and the medical community, and its effect on current practices and patient care in vascular surgery. They also explore the role of research in creating demonstrable changes in practice to aid in ameliorating this relationship. Leah Backhus, MD, MPH, FACS (@leahbackhusmd) practices at Stanford Hospital and is Chief of Thoracic Surgery at the VA Palo Alto, where she focuses on thoracic oncology and minimally invasive surgical techniques. She is also Co-Director of the Thoracic Surgery Clinical Research Program and has grant funding through the Veterans Affairs Administration and NIH. Her current research interests are in imaging surveillance following treatment for lung cancer and cancer survivorship. She is a member of the National Lung Cancer Roundtable of the American Cancer Society serving as Chair of the Task Group on Lung Cancer in Women. She also serves on the Board of Directors of the Society of Thoracic Surgeons. As an educator, Dr. Backhus is the Associate Program Director for the Thoracic Track Residency and is the Chair of the ACGME Residency Review Committee for Thoracic Surgery.  Phillip Goodney MD, MS (@DartmthSrgHSR) is a vascular surgeon, health services researcher, Vice-Chair of Research in the Department of Surgery, Director of the Center for the Evaluation of Surgical Care at Dartmouth (CESC), and Co-Director of the VA Outcomes Group at Veterans Affairs Medical Center in White River Junction, Vermont. His research interests include outcomes assessment using both quantitative and qualitative methods, clinical trials, patient preferences, and shared decision making. He received a Career Development Award from the National Heart, Lung, and Blood Institute in 2010, the Lifeline Research Award from the Society for Vascular Surgery (SVS), and research funding from VA HSR&D, PCORI, FDA, and others. He was elected to the American Surgical Association in 2016 and serves on multiple editorial boards of surgical, cardiovascular, and health services journals.  Background The U.S. Public Health Service Syphilis Study at Tuskegee American Eugenics and Forced Sterilization The Story of Henrietta Lacks Johns Hopkins NP Colonoscopy Training Additional Resources:  Warren et al. (2020) “Trustworthiness before Trust — Covid-19 Vaccine Trials and the Black Community.” NEJM, 383(22) Blanchard et al.(2020)  “A Sense of Belonging.” NEJM, 383(15): 1409–1411 Armstrong et al. (2007) “Racial/Ethnic Differences in Physician Distrust in the United States.” AJPH. 97(7): 1283–1289. DeShazo, Richard D. (2020) The Racial Divide in American Medicine: Black Physicians and the Struggle for Justice in Health Care. University Press of Mississippi.  Jacobs et al. (2006) “Understanding African Americans' Views of the Trustworthiness of Physicians.” JGIM. 21(6): 642–647 Frakt, Austin. (2020) “Bad Medicine: The Harm That Comes From Racism.” The New York Times. Tweedy, Damon. (2016) Black Man in a White Coat: a Doctor's Reflections on Race and Medicine. Picador, Armstrong et al. (2013) “Prior Experiences of Racial Discrimination and Racial Differences in Health Care System Distrust.” Medical Care. 51(2): 144–150 Greenwood et al. (2018) “Patient–physician gender concordance and increased mortality among female heart attack patients” PNAS. 115(34): 8569-8574. SVS Foundation VISTA Program Host Introductions Imani McElroy, MD, MPH (@IEMcElroy) is a general surgery resident at the Massachusetts General Hospital in Boston, MA. Reginald Nkansah, MD (@NkansahReginald) is a first-year vascular surgery resident at the University of Wahington in Seattle, WA. What other topics would you like to hear about? Let us know more about you and what you think of our podcast through our Listener Survey or email us at AudibleBleeding@vascularsociety.org. Follow us on Twitter @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and #jointheconversation.

Commentary by Dr. Valentin Fuster

Go online to PeerView.com/PSN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. As key members of the interdisciplinary care team, thoracic surgeons play an essential role in collaborating and coordinating with their colleagues from other specialties to assess and manage patients with esophageal/GEJ cancer and determine the most appropriate treatment plans based on new evidence inclusive of local and systemic treatment modalities. Thoracic surgeons must also engage patients in shared decision-making to select appropriate treatment according to stage, tumor characteristics, and patient values and preferences, among other key factors. This activity will provide a comprehensive, practically oriented, multidisciplinary overview on the expanding role of immunotherapy in esophageal and GEJ cancer. The experts discuss essential evidence supporting clinical decisions and offer practical guidance on key clinical issues concerning the continued integration of immunotherapy into individualized management plans for patients with esophageal/GEJ cancer. Upon completion of this accredited CE activity, participants should be better able to: Summarize the biologic rationale for the use of immune checkpoint inhibitors in the multimodal treatment of locally advanced and early-stage esophageal/GEJ cancer, Appraise the latest safety and efficacy evidence and guideline recommendations on the use of immune checkpoint inhibitors in patients with locally advanced or early-stage esophageal/GEJ cancer, Implement a collaborative care model among surgical, medical, and radiation oncology specialists and the greater multidisciplinary team to integrate immunotherapy into multimodal treatment plans for eligible patients with locally advanced or early-stage esophageal/GEJ cancer based on recent evidence, patient- and disease-related factors, and guideline recommendations.

Go online to PeerView.com/PSN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. As key members of the interdisciplinary care team, thoracic surgeons play an essential role in collaborating and coordinating with their colleagues from other specialties to assess and manage patients with esophageal/GEJ cancer and determine the most appropriate treatment plans based on new evidence inclusive of local and systemic treatment modalities. Thoracic surgeons must also engage patients in shared decision-making to select appropriate treatment according to stage, tumor characteristics, and patient values and preferences, among other key factors. This activity will provide a comprehensive, practically oriented, multidisciplinary overview on the expanding role of immunotherapy in esophageal and GEJ cancer. The experts discuss essential evidence supporting clinical decisions and offer practical guidance on key clinical issues concerning the continued integration of immunotherapy into individualized management plans for patients with esophageal/GEJ cancer. Upon completion of this accredited CE activity, participants should be better able to: Summarize the biologic rationale for the use of immune checkpoint inhibitors in the multimodal treatment of locally advanced and early-stage esophageal/GEJ cancer, Appraise the latest safety and efficacy evidence and guideline recommendations on the use of immune checkpoint inhibitors in patients with locally advanced or early-stage esophageal/GEJ cancer, Implement a collaborative care model among surgical, medical, and radiation oncology specialists and the greater multidisciplinary team to integrate immunotherapy into multimodal treatment plans for eligible patients with locally advanced or early-stage esophageal/GEJ cancer based on recent evidence, patient- and disease-related factors, and guideline recommendations.

Go online to PeerView.com/PSN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. As key members of the interdisciplinary care team, thoracic surgeons play an essential role in collaborating and coordinating with their colleagues from other specialties to assess and manage patients with esophageal/GEJ cancer and determine the most appropriate treatment plans based on new evidence inclusive of local and systemic treatment modalities. Thoracic surgeons must also engage patients in shared decision-making to select appropriate treatment according to stage, tumor characteristics, and patient values and preferences, among other key factors. This activity will provide a comprehensive, practically oriented, multidisciplinary overview on the expanding role of immunotherapy in esophageal and GEJ cancer. The experts discuss essential evidence supporting clinical decisions and offer practical guidance on key clinical issues concerning the continued integration of immunotherapy into individualized management plans for patients with esophageal/GEJ cancer. Upon completion of this accredited CE activity, participants should be better able to: Summarize the biologic rationale for the use of immune checkpoint inhibitors in the multimodal treatment of locally advanced and early-stage esophageal/GEJ cancer, Appraise the latest safety and efficacy evidence and guideline recommendations on the use of immune checkpoint inhibitors in patients with locally advanced or early-stage esophageal/GEJ cancer, Implement a collaborative care model among surgical, medical, and radiation oncology specialists and the greater multidisciplinary team to integrate immunotherapy into multimodal treatment plans for eligible patients with locally advanced or early-stage esophageal/GEJ cancer based on recent evidence, patient- and disease-related factors, and guideline recommendations.

Go online to PeerView.com/PSN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. As key members of the interdisciplinary care team, thoracic surgeons play an essential role in collaborating and coordinating with their colleagues from other specialties to assess and manage patients with esophageal/GEJ cancer and determine the most appropriate treatment plans based on new evidence inclusive of local and systemic treatment modalities. Thoracic surgeons must also engage patients in shared decision-making to select appropriate treatment according to stage, tumor characteristics, and patient values and preferences, among other key factors. This activity will provide a comprehensive, practically oriented, multidisciplinary overview on the expanding role of immunotherapy in esophageal and GEJ cancer. The experts discuss essential evidence supporting clinical decisions and offer practical guidance on key clinical issues concerning the continued integration of immunotherapy into individualized management plans for patients with esophageal/GEJ cancer. Upon completion of this accredited CE activity, participants should be better able to: Summarize the biologic rationale for the use of immune checkpoint inhibitors in the multimodal treatment of locally advanced and early-stage esophageal/GEJ cancer, Appraise the latest safety and efficacy evidence and guideline recommendations on the use of immune checkpoint inhibitors in patients with locally advanced or early-stage esophageal/GEJ cancer, Implement a collaborative care model among surgical, medical, and radiation oncology specialists and the greater multidisciplinary team to integrate immunotherapy into multimodal treatment plans for eligible patients with locally advanced or early-stage esophageal/GEJ cancer based on recent evidence, patient- and disease-related factors, and guideline recommendations.

Go online to PeerView.com/PSN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. As key members of the interdisciplinary care team, thoracic surgeons play an essential role in collaborating and coordinating with their colleagues from other specialties to assess and manage patients with esophageal/GEJ cancer and determine the most appropriate treatment plans based on new evidence inclusive of local and systemic treatment modalities. Thoracic surgeons must also engage patients in shared decision-making to select appropriate treatment according to stage, tumor characteristics, and patient values and preferences, among other key factors. This activity will provide a comprehensive, practically oriented, multidisciplinary overview on the expanding role of immunotherapy in esophageal and GEJ cancer. The experts discuss essential evidence supporting clinical decisions and offer practical guidance on key clinical issues concerning the continued integration of immunotherapy into individualized management plans for patients with esophageal/GEJ cancer. Upon completion of this accredited CE activity, participants should be better able to: Summarize the biologic rationale for the use of immune checkpoint inhibitors in the multimodal treatment of locally advanced and early-stage esophageal/GEJ cancer, Appraise the latest safety and efficacy evidence and guideline recommendations on the use of immune checkpoint inhibitors in patients with locally advanced or early-stage esophageal/GEJ cancer, Implement a collaborative care model among surgical, medical, and radiation oncology specialists and the greater multidisciplinary team to integrate immunotherapy into multimodal treatment plans for eligible patients with locally advanced or early-stage esophageal/GEJ cancer based on recent evidence, patient- and disease-related factors, and guideline recommendations.

Go online to PeerView.com/PSN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. As key members of the interdisciplinary care team, thoracic surgeons play an essential role in collaborating and coordinating with their colleagues from other specialties to assess and manage patients with esophageal/GEJ cancer and determine the most appropriate treatment plans based on new evidence inclusive of local and systemic treatment modalities. Thoracic surgeons must also engage patients in shared decision-making to select appropriate treatment according to stage, tumor characteristics, and patient values and preferences, among other key factors. This activity will provide a comprehensive, practically oriented, multidisciplinary overview on the expanding role of immunotherapy in esophageal and GEJ cancer. The experts discuss essential evidence supporting clinical decisions and offer practical guidance on key clinical issues concerning the continued integration of immunotherapy into individualized management plans for patients with esophageal/GEJ cancer. Upon completion of this accredited CE activity, participants should be better able to: Summarize the biologic rationale for the use of immune checkpoint inhibitors in the multimodal treatment of locally advanced and early-stage esophageal/GEJ cancer, Appraise the latest safety and efficacy evidence and guideline recommendations on the use of immune checkpoint inhibitors in patients with locally advanced or early-stage esophageal/GEJ cancer, Implement a collaborative care model among surgical, medical, and radiation oncology specialists and the greater multidisciplinary team to integrate immunotherapy into multimodal treatment plans for eligible patients with locally advanced or early-stage esophageal/GEJ cancer based on recent evidence, patient- and disease-related factors, and guideline recommendations.

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, Alan M. Speir, MD, joins Dr. Varghese to discuss “easily one of the biggest issues that impacts the care of cardiothoracic surgical patients today”—the Medicare reimbursement cuts. In December 2020, Congress approved legislation that prevented the Centers for Medicare & Medicaid Services from implementing the cuts. But what was happening—much behind the scenes—to help earn this major victory for cardiothoracic surgeons and their patients? Dr. Varghese and Dr. Speir take a deep dive into this topic, covering the potential rationale for the “Draconian” cuts in reimbursement and the details of the close coordination and collaboration with other surgical societies that helped make a difference. Dr. Speir also shares his thoughts on future advocacy efforts. Read the related Annals article online: STS Advocacy Concerning CMS Reduction in the 2021 Medicare Physician Fee Schedule to Cardiac and Thoracic Surgeons.

  This Beat episode, hosted by Brian Mitzman MD, general thoracic surgeon with the University of Utah in Salt Lake City, focuses two recent publications and also a featured video on CTSNet. First, Dr Mitzman discusses a recent JTCVS expert opinion from Dr Craig Baker of USC discussing traditional and integrated models for cardiothoracic surgery training. He then dives into a recent Annals publication from the team at University Hospitals Cleveland Medical Center which analyzes the STS General Thoracic Database and evaluates postoperative day 1 discharge after lobectomy. Lastly, Dr Mitzman reviews a CTSNet featured video from Drs Watkins and Servais in Boston, where they run through tips and tricks for all five robotic lobectomies. For more information on this episode's topics, links are provided: Baker CJ. What is the optimal cardiothoracic surgery residency model? JTCVS Open. 2021; In Press. doi:10.1016/j.xjon.2021.01.012 Towe CW, Thibault DP, Worrell SG, et al. Factors associated with successful postoperative day one discharge following anatomic lung resection. Ann Thorac Surg. 2021; In Press. doi:10.1016/j.athoracsur.2020.07.059 Zhao K, Zhang J, Li S. Discharge on POD1 after anatomic lung resection to be treated with caution. Ann Thorac Surg. 2021; In Press. doi:10.1016/j.athoracsur.2020.12.094 Towe CW, Worrell SG, Finley DJ, et al. One day is here to stay. Ann Thorac Surg. 2021;In Press. doi:10.1016/j.athoracsur.2021.03.020 Linden PA, Perry Y, Worrell SG et al. Postoperative day 1 discharge after anatomic lung resection: A Society of Thoracic Surgeons database analysis. J Thorac Cardiovasc Surg. 2020;159:667-678. doi:10.1016/jtcvs.2019.08.038 Watkins A, Servais E. Robotic Lobectomy: Review of Anatomy and Technique for RUL, RML, RLL, LUL, and LLL.  

This Beat episode, featuring Brian Mitzman, general thoracic surgeon with the University of Utah in Salt Lake City, discusses recent highlights submitted to CTSNet along with a look at this weekend's Society of Thoracic Surgeons 57th Annual Meeting. For more information on this episode's topics, links are provided:Society of Thoracic Surgeons 57th Annual MeetingFontaine J-P, Parvathaneni A. Moffitt Technique. January 2021. doi:10.25373/ctsnet.13549418. Ceylan KC, Batihan G, Yazgan S, et al. Pleural complications in patients with coronavirus disease 2019 (COVID-19): How to safely apply and follow-up with a chest tube during the pandemic. Eur J Cardiothoracic Surg. 2020;58:1216-1221.

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, Juan A. Crestanello, MD, and Brian Mitzman, MD, join Dr. Varghese to discuss “the Year of the Pandemic” and how it disrupted every aspect of lives around the world, including the ability to attend in-person gatherings and academic conferences. The authors share some of the exciting and innovative features planned for STS 2021—which are expected to be unlike anything the cardiothoracic surgery specialty has seen to date. Also discussed in this episode are best practices and other considerations for virtual meetings such as interactivity, virtual etiquette, resource inequality, spontaneity, technical needs, and social components. Read the related Annals articles online: STS 2021: The Annual Meeting of The Society of Thoracic Surgeons and The Society of Thoracic Surgeons (STS) Virtual Conference Taskforce: Recommendations for Hosting a Virtual Surgical Meeting.

In this CTSNet roundtable, Dawn Hui of UT Health San Antonio, Texas, moderates a discussion on advocacy within the cardiothoracic surgery specialty. She is joined by Keith Naunheim of Saint Louis University in Missouri, John H. Calhoon of the UT Health San Antonio, Texas, Ourania Preventza of Baylor College of Medicine in Houston, Texas, Seth Wolf of the University of Vermont, and Courtney Yohe, director of government relations for the Society of Thoracic Surgeons in Washington, D.C. They discuss what advocacy means to them, the impact of advocacy on the specialty, and ways cardiothoracic surgeons can have a direct impact on federal policy.DisclaimerContributions to STS-PAC are voluntary and not tax deductible for federal income tax purposes. You have the right to decline to contribute without any reprisal against your STS membership. Your contribution must be made using a credit card, check or money order, and must be drawn on a personal account to be used to support federal candidates. You must be a US citizen or lawfully admitted permanent US resident to contribute. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer of each individual whose contributions exceed $200 in a calendar year. Federal law prohibits STS and STS-PAC from soliciting contributions from persons outside STS’s restricted class. STS’s restricted class includes individuals who are dues paying members or non-dues paying members with voting rights, and who are US citizens or lawfully admitted permanent US residents.

On this mini-podcast, we mark the beginning of Lung Cancer Awareness Month by looking at the present landscape for the diagnosis and treatment of one of the most common cancers in the world.Guest: Deepti Behl, MD, Medical Director, Sutter Institute for Medical Research; Medical Director, Thoracic Oncology, Sutter Medical CenterRelated Content:ACCC Cancer Types: Lung CancerImproving Care Coordination: A Model for Lung CancerEating the ElephantASTRO Abstract: Learnings from Thoracic Surgeons and Radiation Oncologists from a National Quality SurveyIASCLC Abstract: Variable Definitions of “Unresectable” Stage III NSCLC Among Lung Cancer SpecialistsASCO Abstract: Defining High-Quality NSCLC Care at US Cancer CentersThe views and opinions expressed herein are those of the author(s)/faculty member(s) and do not reflect the official policy or position of their employer(s) or the Association of Community Cancer Centers.

Leading cardiologist, Dr. Ross Walker, discusses a new study published in "Heart, Lung and Circulation" (published by Elsevier for the Australian and New Zealand Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand) that evaluates ubiquinol, the active form of the powerful antioxidant CoEnzyme Q10, for heart health in patients who are taking cholesterol management medication.

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, Francis D. Pagani, MD, PhD, joins Dr. Varghese to discuss the findings of the Intermacs 2019 Annual Report. They mentioned the percent decrease in patients listed for a transplant when they received an LVAD, introduction of new technologies, and a comparison of technologies. Read the related Annals article online: The Society of Thoracic Surgeons Intermacs 2019 Annual Report: The Changing Landscape of Devices and Indications. 

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, John S. Ikonomidis, MD, PHD, joins Dr. Varghese to discuss the findings of the 2019 STS Practice Survey. Mandatory cognitive testing, increasing the number of women in the workforce, and job satisfaction are a few of the topics that are addressed. Read the related Annals article online: https://bit.ly/2Y0uiqe

Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr Greg Hundley: And I'm Dr Greg Hundley from the VCU Health Pauley Heart Center in Richmond, Virginia. Well, Carolyn, we've got a great feature article this week, evaluating do we wait or do we do now ablation of ventricular tachycardia in patients with ischemic cardiomyopathy and implantable defibrillators? But before we get to that, how about if we grab our coffee or whatever it may be and jump into the other articles? Dr Carolyn Lam:               Sure. Well, Greg, have you ever wondered what the outcomes are of transcatheter aortic valve replacement, or TAVR, in patients with bicuspid aortic valve stenosis? Now, remember, patients with bicuspid aortic valve stenosis were excluded from the pivotal evaluations of TAVR. Dr Greg Hundley: I wondered that yesterday, Carolyn. Dr Carolyn Lam: Well, guess what, Greg, it's your lucky day because we're going to get answers now from corresponding author Dr Brennan from DCRI and coauthors who use data from the Society of Thoracic Surgeons, American College of Cardiology, TAVR registry from 2011 to 2018 to determine the device success procedural outcomes, post-TAVR valve performance and in-hospital clinical outcomes in almost 171,000 eligible procedures, of which 5,412 TAVR procedures were performed in bicuspid aortic valve patients, including 3,705 with current generation devices. Dr Greg Hundley: Wow. Carolyn, this sounds to me like probably one of the largest collections of patients that have had TAVR and bicuspid valves. What did they find? Dr Carolyn Lam: Well, compared to patients with tricuspid aortic valves, bicuspid aortic valve patients were younger and had a lower STS predicted risk of operative mortality score, so you have to bear that in mind first. With the current generation TAVR devices, the incidence of device success was only slightly lower for bicuspid versus tricuspid aortic valve patients and residual two-plus aortic insufficiency remains slightly higher, though, for bicuspid versus tricuspid aortic valve patients. There was no difference in adjusted one-year hazard of stroke in patients with bicuspid versus tricuspid valves, but the adjusted one-year hazard of mortality was lower among bicuspid aortic valve patients. Thus, using current generation technology, TAVR appears both safe and effective for the treatment of bicuspid aortic valve stenosis, although there remains a low incidence of moderate or greater aortic insufficiency among both bicuspid and tricuspid aortic valve patients. Dr Greg Hundley: Very nice. Well, Carolyn, do you ever wonder how white cells are recruited into areas of the heart that have sustained a myocardial infarction? Dr Carolyn Lam: Every day, Greg. Every day I think about that. Dr Greg Hundley: You know, we've got so much wondering on your side of the world and on my side of the world, but if we connect that we will solve a lot of things. Well, this paper is from Dr Prabhakara Nagareddy from Ohio State University. This group of investigators used a mouse model involving ligation of the LAD and flow cytometry to characterize the temporal and spatial effects of myocardial infarction on different myeloid cell types, a process termed myelopoiesis, that results in heightened production of neutrophils. The investigators sought to understand the mechanisms that sustain white blood cell production in recruitment to the injured heart using global transcriptome analysis of different cardiac cell types within the infarct. In addition, just as these clever circulation papers do, also a human subject study was performed utilizing a combination of genetic and pharmacologic strategies. The authors identified the sequela of events that led to MI-induced myelopoiesis. Cardiac function was assessed by echocardiography and the association of early indices of neutrophilia with major cardiac events, or MACE, was studied in those patients sustaining an MI. Dr Carolyn Lam: Wow, that's a huge amount of work. What was the bottom line results? Dr Greg Hundley: So, first, in the patients with acute coronary syndromes, a higher neutrophil count on admission and post-revascularization correlated positively with major adverse cardiovascular disease outcomes. And then, second, from the basic science component, the study identified novel evidence for the primary role of neutrophil-derived alarmins and, in particular in this study, S100A8-A9 in dictating the nature of the ensuing inflammatory response following myocardial injury. Therapeutic strategies aimed at disruption of this S100A8-A9 signaling, or its downstream mediators in neutrophils, were shown to suppress granulopoiesis and therefore, perhaps in the future, could improve cardiac function in those patients sustaining an acute coronary syndrome. Really elegant work. That combination of the basic science in the animal model and then the translational work in the human subject model. Dr Carolyn Lam: Exactly what I was going to say. Translational work. Well, hold onto your seat because this next one is super cool, too. It is the first time a pre-clinical development and first in human proof-of-concept of peritoneal direct sodium removal using a zero-sodium solution as a candidate therapy for volume overload. So, as a background, remember that loop diuretics have been well described to have toxicities and that loss of response to these agents are common when we try to treat volume overload. So alternative strategies are clearly needed for the maintenance of euvolemia in heart failure. These authors, led by Dr Testani from Yale University hypothesized that non-renal removal of sodium directly across the peritoneal membrane, that is called direct sodium removal, using a sodium-free osmotic solution should result in extraction of large quantities of sodium with limited off-target solute removal. So what they did is they performed porcine experiments followed by a human study in which participants with end-stage renal failure on peritoneal dialysis underwent randomization and crossover to either a two-hour dwell with one liter of this direct sodium removal solution or a standard peritoneal dialysis solution. Sodium-free 10% dextrose, by the way, was utilized as the direct sodium removal solution. Dr Greg Hundley: Boy, Carolyn, this is really another one of these elegant translational studies. So we have the animal model, we have the human subjects and then we have different concentrations of these peritoneal fluid that are injected and then extracted for dialysis. I can't wait to hear. So what did they find? Dr Carolyn Lam: First, cycling a sodium-free osmotic solution that's a 10% dextrose across the peritoneal cavity of swine resulted in substantial sodium removal. So, proof of principle there. The sodium removal increased proportionately as the volume of 10% dextrose cycled across the peritoneum increased. Experimental elevation of right-sided cardiac filling pressures also resulted in substantial increased sodium removal with this technique. Now, in the humans, a single dose of sodium-free 10% dextrose was well tolerated in human subjects and resulted in over four-fold greater sodium removal than the strongest commercially available peritoneal dialysis solution. So, direct sodium removal with a sodium-free osmotic peritoneum solution represents a new potential therapy for non-renal sodium and fluid removal in edematous disorders such as heart failure. However, there is a long way to go in deploying such a procedure in the heart failure population. And this is really highlighted and discussed in an accompanying editorial by Dr Robert Toto from UT Southwestern. Dr Greg Hundley: Fantastic. Carolyn. Bob Toto always puts things really in perspective. That'll be a great read. Well, let me tell you about a couple other articles in this issue. Dr Bina Ahmed from Santa Barbara Cardiovascular Group has a very nice on-my-mind piece getting at this issue of how we should, as physicians, be reacting to the healthcare issues. Also, particularly in cardiovascular disease, as they occur in the face of climate crisis. A great read. Then there's a beautiful adult learning excerpt put together by Dr Daniel Kramer from the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center. It involves a patient that presents with some symptomatology associated with their thoracic spine. They have to undergo an MRI. They've got an implanted device. How do you work through that? What do we need to do with anticoagulation? It turns out the patient also may need a Watchman device. Who is a candidate for that? Boy, it's just a great educational read. Carolyn, there is a lot in the mailbag this week. Professor John Madias from the Icahn School of Medicine at Mount Sinai and Dr Adaya Weissler-Snir from the Hartford Hospital and University of Connecticut exchanged some letters regarding the article previously published on hypertrophic cardiomyopathy-related sudden cardiac death in young people in Ontario. Robin Woods from Monash University has a research letter involving no modulation of aspirins effect by body weight in healthy older men and women. And then Myra Lipes from the Joslin Diabetes Center Harvard Medical School has a research letter entitled the Cardiac Autoimmunity is Associated with Subclinical Myocardial Dysfunction in Patients with Type 1 Diabetes. Dr Carolyn Lam: And I'll add one more research letter by Dr Dempsey on prospective associations of accelerometer-measured physical activity and sedentary time with incident cardiovascular disease, cancer and all-cause mortality. So something that's really a hot topic now. Man, that has been a great issue. But let's move on to our feature discussion, shall we? Dr Greg Hundley: You bet. Well, listeners, welcome to this feature discussion where we're going to understand a little bit more about ICDs and ventricular tachycardia and we have Dr Karl-Heinz Kuck from the University Hospital of Lübeck. We have Francis Marchlinski from the University of Pennsylvania and we have Dr Sammy Viskin, our own associate editor from the Tel Aviv Medical Center. What a great study. So, Karl, I'd like to start with you. Can you give us a little bit of background about why you wanted to perform the study and what was your hypothesis? Dr Karl-Heinz Kuck: There is an ongoing debate in clinical electrophysiology, what would be the optimal timing of catheter ablation in patients with ventricular tachycardia and ventricular fibrillation. Now, until today, most patients come to catheter ablation at a very late stage of the disease, mostly after multiple ICD shocks. So the patients are in a very bad condition and our strong feeling is the patients should undergo, much early, a successful catheter ablation. The study was initiated with the background that we, and others, have shown that a very catheter ablation, which is before any ICTD shock, a so-called preventative ablation, is superior with respect to clinical endpoints as compared to optimal medical treatment. That's number one. And number two is that we know from retrospective analysis of multiple ICD studies that ICD shocks increase mortality as compared to patients with ICDs that have no shocks. So, on one side we have the benefit of a preventive ablation which has been shown in three randomized trials, and on the other side we know that ICD shocks increase mortality. So somewhere in between multiple ICD shocks and no shock should be the benefit of catheter ablation and this, exactly, was the background of the BERLIN-VT Trial to investigate whether a very only catheter ablation study, which is after the first episode of VT/VF, before any ICD shock, would be superior as compared to having an ICD implanted and follow the patients and then ablate the patients after an arbitrary taken number that we set to three ICD shocks. We were looking then for a combined clinical endpoint to see whether there is any benefit of prophylactic, or preventative, ablation versus what we call deferred catheter ablation. Dr Greg Hundley: Can you tell us about the BERLIN-VT? What was your study population? A little bit about the design. Dr Karl-Heinz Kuck: Yeah. The patients that we investigated were patients only with ischemic cardiomyopathy who would had a previous myocardial infarct, to reduce the number of interventions that would require an epicardial access in that patient population. That's number one. And number two, the patients should have an ejection fraction above 35 because a previous study that we have done, the VTACH Study showed that there was no benefit of catheter ablation in patients with a very low ejection fraction, so this was the patient population that we were looking. And then patients had to have had at least one episode of VT/VF before they were randomized either into preventive ablation or into deferred ablation. Dr Greg Hundley: How many participants were in your study? And then tell us a little bit about the study results. Dr Karl-Heinz Kuck: We randomized the 76 patients to preventive ablation, and 83 patients do differed ablation. The number, we originally thought to be higher, but we had redesigned interim analysis and after the second interim analysis at the DSMV, we commanded to terminate the trial for futility. And at that point in time when the study was terminated, these numbers were included, which was almost two thirds of the patients which were originally included in to the front. Dr Greg Hundley: What were your results? Dr Karl-Heinz Kuck: Now, which respect to the endpoint of the trial, which was the primary endpoint, which was a composite endpoint of all-cause mortality and unplanned re-hospitalizations for worsening of heart failure or ventricular arrhythmias, we did not find any significant difference between the preventive and the deferred ablation group. Actually, after 12 months, there were 21% of patients in the differed, and 27% in the preventive ablation group, and these numbers almost doubled over two years but didn't show any difference. So with respect to the components of the combined endpoint, we also didn't see any significant difference with respect to overall mortality, hospitalization for worsening of heart failure and hospitalization for worsening of ventricular tachycardia or ventricular fibrillation, despite the fact that there was a strong trend to a reduction of hospitalization for VT/VF in the preventive group as compared to the deferred group. But this was fully compensated for the primary endpoint by an increase of hospitalizations, early hospitalizations after ablation for worsening of heart failure and a somewhat higher mortality rate in the preventive group as compared to the deferred group, which I believe was really bad luck because almost none of the six [inaudible 00:17:12] in the preventive group died due to cardiovascular reasons. Whereas most patients in the deferred group died because of ventricular tachycardia, ventricular fibrillation. Now, what is interesting to mention is that with respect to the secondary endpoint, which is sustained VT and VF and appropriate ICD therapy, there was a significant benefit of preventive catheter ablation as compared to deferred catheter ablation but, as I mentioned before, this could not be translated into a benefit with respect to clinical outcome in the trial. Dr Greg Hundley: Thank you, Dr Kuck. Dr Marchlinski, could you help us put this in perspective as we're thinking about patients with ischemic heart disease that we are considering implantation of an ICD? Dr Frank Marchlinski: Yes, definitely. First, I like to congratulate the investigators. This is a real tour de force, a lot of effort, multiple centers involved. Dr Willems, Dr Kuck, congratulations because this is an important effort. I think that one needs to realize, of course, that it is our goal to try to eliminate VT with the hope that we're going to improve mortality outcome in addition to improving quality of life. It's a worthwhile goal. I hope someday we will achieve it and that we'll be able to use ablative therapy very early in the course, even in advance of ICD implantation and potentially even to prevent ICDs. That's a worthwhile goal and something that we all need to target as investigators in this area. But Dr Kuck's study demonstrated that we're not there yet to use it as very early in the course of a disease before patients manifest a lot of arrhythmia recurrences. One thing is for certain, though. This study, although important in suggesting that we need to take our time in terms of planning to do the ablation procedure, we don't want to delay. There's enough evidence to say that repeated shocks can increase mortality, as Dr Kuck pointed out, and enhance a bad outcome. It certainly provides a very poor quality of life for the patient to experience these shocks, so we need to consider the timing of when it's appropriate, when patients begin to experience ICD shocks after receiving a defibrillator and not wait for repeated shocks, not wait for excessive dosing with Amiodarone, but rather to intervene in a timely fashion after a patient begins to get the shock therapy. It was clear that even the BERLIN-VT investigators didn't wait for multiple additional shocks. As soon as patients received one or two shocks, they got enrolled in this study, this is the deferred limb, and took advantage of the effectiveness of ablation to reduce the number of VT episodes. Dr Greg Hundley: Sammy, now back to you. What study do we need to perform next in this field? How do you think the results here guide us moving forward with research in this area? Sammy Viskin: As Frank said, in [inaudible 00:20:25], it is very important that patients are not referred too late for ablation when they arrive after many shocks and they're already, sometimes even encouraged to getting shocks. The present study shows that perhaps they should not be referred for ablation too early at this point, at least not until we get better with our ablation techniques. So we need studies on how to improve our ablation techniques. They keep getting better, but they still have a long way to go. And then we should be able to define the optimal time when it's not too early and when it's not too late to perform the ablation procedure. Dr Karl-Heinz Kuck: I agree with all of what had been said. I just would like to mention that the study, the BERLIN-VT Study compared, actually, very early catheter ablation versus early catheter ablation. We just wanted to know whether very early ablation is better than early because I think that all the three physicians here, the three electrophysiologists, would agree that we would be happy if most of the patients would even be sent after the second or third shock. Many patients having multiple more shocks before they are sent for catheter ablation. So, in this sense, the BERLIN-VT Study was an aggressive study because they did not allow patients to be sent after the 10th shock, after the 15th shock, after an electrical storm. So we are comparing very early versus early ablation and I'm not giving up, like Frank Marchlinski was saying. I'm not giving up on the idea. Sammy is saying we are not yet there, but we should continue to prove that an early ablation is superior to a late ablation. But BERLIN-VT did not look at the very late ablation component of the strategy here. I think what this study shows and what all the other studies also show how difficult it is, in the field of VT/VF and severely diseased patients, to do such a randomized trial. We have a lot of problems to enroll these patients and therefore, I was glad that we could at least get some information out of the trial. I'm still supporting the idea that the international community should work closer together in the field of catheter ablation of ventricular tachycardia and ventricular fibrillation so that we could increase the number of patients within a rather short period of time that should be included in these VT ablation trials. That's, I think, another learning that I've done from this trial but also from some of the other trials that we and others have done in the field. Dr Greg Hundley: Well, listeners, we want to thank Dr Karl Kuck from University of Lübeck in Germany, Dr Frank Marchlinski from University of Pennsylvania, and Dr Sammy Viskin from Tel Aviv Medical Center. We've really heard some insightful results related to ICD placement and those with ischemic heart disease from the BERLIN-VT Study. It really emphasizes the importance of, as we move forward, international collaborations when we're trying to study this patient population. Well, on behalf of Carolyn and myself, we wish you a great week and look forward to chatting with you and grabbing a cup of coffee next week. Take care. Of this program is copyright of the American Heart Association 2020.  

Congratulations to our own Nicole Rich for being featured in this month’s JVS Editor’s Choice!  In this latest installment of our JVS collaboration, Jacob discusses the March Editor’s Choice articles with Editor in Chief of the Journal of Vascular surgery, Dr. Peter Gloviczki. Dr. Gloviczki YouTube Video   Articles Discussed:   The new Society for Vascular Surgery and Society of Thoracic Surgeons reporting standards for type B aortic dissections (Editor’s Choice) Incidence, natural course, and outcome of type II endoleaks in infrarenal endovascular aneurysm repair based on the ENGAGE registry data (CME) Critical analysis and limitations of resting ankle-brachial index in the diagnosis of symptomatic peripheral arterial disease patients and the role of diabetes mellitus and chronic kidney disease Long-term freedom from aneurysm-related mortality remains favorable after endovascular abdominal aortic aneurysm repair in a 15-year multicenter registry Original Publication: Ten-year results of endovascular abdominal aortic aneurysm repair from a large multicenter registry The incidence and risk factors of stent fracture in patients treated for proximal common carotid artery stenosis   If you enjoy our content, please contribute to Support Audible Bleeding!   Tell us about yourself through our Listener Survey!

Emily Garner, RN, Dr. Eric Sievers, Clay Cox, RNFA and Steve Diamond discuss the recent announcement of the West Tennessee Heart and Vascular Center receiving a 3 Star Ranking by the Society of Thoracic Surgeons, how big of a deal this is for West Tennessee, and just what that means for our heart patients. Hosts: Dr. Eric Sievers, Cardiothoracic SurgeonEmily Garner, RN, Clinical ManagerClay Cox, RNFASteve Diamond, Clinical Manager

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Go online to PeerView.com/CPZ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. New evidence from clinical trials assessing immunotherapies and combinations in lung cancer is emerging at a rapid pace. As a result, the treatment landscape is constantly evolving, and checkpoint inhibitor–based therapeutic approaches are establishing a foothold not only in advanced disease but in earlier stages of lung cancer as well. Immunotherapy has proven to be effective in the context of multimodal therapy in stage III locally advanced NSCLC. This has increased excitement about further expanding the role of this therapeutic approach in earlier stages of lung cancer, including resectable disease. A range of novel single-agent and combination immunotherapeutic approaches are being explored in studies in different settings and populations throughout the disease continuum, and the results are eagerly anticipated. However, many challenges and questions related to the optimal use of immunotherapy in stage III and earlier stages of lung cancer remain. In this activity, based on a recent satellite symposium, an expert panel of two surgeons and a medical oncologist offers practical guidance on how to navigate the rapidly changing and complex immuno-oncology landscape in earlier stages of lung cancer. Upon completion of this activity, participants will be able to: Describe the mechanisms of action of immune checkpoint inhibitors and other novel cancer immunotherapies and the rationale for using immunotherapy as a component of multimodal therapy in earlier stages of lung cancer, Review the present immunotherapy landscape and state of the science in lung cancer, including key approvals/indications in different settings from early-stage to more advanced disease, Discuss key clinical trials assessing immunotherapies and immune-based combinations in stage III and earlier stages of lung cancer, including resectable disease, and available data from such trials, Determine the best treatment approaches for patients with stage III or earlier lung cancer as part of clinical practice or clinical trials based on the latest evidence, recommendations, patient needs and preferences, and effective multidisciplinary collaboration and coordination of care.

Dr. Lauren Kane practices as a Congenital Cardiac Surgeon at The Heart Center at Arnold Palmer Hospital for Children, University of Central Florida. Dr. Kane attended medical school at the University of Texas Houston and completed General Surgery Residency at University of Texas Southwestern Dallas. Following this she went on to complete a fellowship in Cardiothoracic Surgery at Emory University, and fellowship in Congenital Heart Surgery at University of Southern California at Children’s Hospital of Los Angeles. She has served as faculty at the University of Texas Health Science Center San Antonio and Baylor College of Medicine before her current position at Arnold Palmer Hospital for Children. Dr. Kane serves as the President of the Women in Thoracic Surgery organization, is active in the Society of Thoracic Surgeons, Southern Thoracic Surgical Association, and was recently awarded the Carolyn Reed Traveling Scholarship, during which she gathered international surgical experience in her travels to India, Japan and England. Dr. Kane is chair of the patient education website for Society of Thoracic Surgeons and enjoys participating in the education of both patients and physicians.

  Welcome to another episode of Biotechnology focus radio! I am your host – Michelle Currie – here to give you the rundown on what is happening in the life sciences sector from coast to coast. This week brought new collaborations, new cohorts, and new research. Keep listening to find out more!  +++++  As regenerative medicine grows around the world, topping a whopping $36-billion annually and only expected to rise, it comes as no surprise that more and more international collaborations are happening – especially within Canada.  CCRM and the Japanese Society for Regenerative Medicine (JSRM) liaise to advance the field of regenerative medicine (RM) and cell and gene therapies in Canada and Japan, signing a Memorandum of Understanding (MOU) this week at the Annual Meeting of the Tissue Engineering and Regenerative Medicine International Society (TERMIS) in Kyoto, Japan.  Michael May, president and CEO, CCRM says that CCRM’s mission is to generate sustainable health and economic benefits through global collaboration in cell and gene therapy, and regenerative medicine. CCRM is catalyzing a global network of highly integrated commercialization centres working together to enable viable and cost-effective patient access to revolutionary new treatments. The Memorandum of Understanding with Japanese Society for Regenerative Medicine, through its vast research network and industry-enabling activities, is a positive step in that direction.”  The Memorandum of Understanding has been put in place to promote academic and industry partnership in Japan, Canada and internationally to advance the field of regenerative medicine and cell and gene therapies. This will include supporting knowledge translation about technologies, policies (e.g., regulatory and health economics), legal and ethical issues.  Prof. Sawa, president of Japanese Society for Regenerative Medicine.  Says that “There are many obstacles to establish a sustainable business model for regenerative medicine in Japan, as it requires a whole new value chain. Canada’s CCRM has been fostering and promoting a successful commercialization model since its launch. JSRM is proud to announce that we have entered into a partnership with CCRM to develop sound industrialization pathways, learning from CCRM’s excellent model to make regenerative medicine an available treatment worldwide.”  Regenerative medicine – that can be a bit of an umbrella term – includes cell and gene therapy, stem cells, biomaterials, molecules and genetic modification to repair, regenerate or replace diseased cells, tissues and organs. This approach is disrupting the traditional biotechnology and pharmaceutical industries with the promise of revolutionary new cures for devastating and costly conditions such as heart disease, diabetes and cancer.  This sector represents so many potential untapped possibilities. Forecasted to grow to US$49.41-billion by 2021, there were 977 clinical trials in cell, gene and tissue therapy underway worldwide at the close of the second quarter of 2018. The sector achieved the first global approvals and reimbursements for major cellular immunotherapies and gene therapies in 2017, that resulted in record-breaking investment and acquisitions in the sector. This field encapsulates the phrase “the world is truly their oyster”.  +++++  The Centre for Drug Research and Development, Canada’s national life sciences venture, announces the first cohort of the CDRD Academy’s Executive Institute.  Earlier this year, CDRD and Pfizer Canada announced the launch of the Executive Institute under the umbrella of The CDRD Academy. The Institute is a 10-month, focused executive development program open to a limited number of senior-level life sciences professionals annually. It was made possible by a $1M contribution by Pfizer Canada.  After reviewing dozens of applications from across Canada, the Adjudication Committee has selected a cohort of diverse, talented, and forward-thinking individuals that is gender balanced, and represents a variety of personal and professional backgrounds. The following individuals have been accepted into the inaugural 2018-2019 class:  Naveed Aziz, Chief Administrative and Scientific Officer, CGEN – Canada’s Genomic Enterprise, Toronto, ON  Deanna Dryhurst, Chief Scientific Officer, ImmunoPrecise Antibodies Ltd., Victoria, BC  Alexander Graves, Chief Executive Officer, Symvivo Corporation, Vancouver, BC  Allison Gaw, Senior Director, Corporate Development and Intellectual Property, Sierra Oncology, Vancouver, BC  Nataša Jovic, Senior Director, Personal Health, Microbiome Insights, Vancouver, BC  Andrew Knowles, Senior Vice President, Operations, STEMCELL Technologies, Vancouver, BC  Frédéric Leduc, Chief Executive Officer and Co-Founder, Immune Biosolutions, Sherbrooke, QC  Stephanie Michaud, President and Chief Executive Officer, BioCanRx, Ottawa, ON  Carolyn Nalder, Director of Business Operations, Tevosol, Edmonton, AB  Frederic Ors, Chief Executive Officer, IMV, Quebec City, QC  Chris Sinclair, Vice President, Global Commercial Operations, Emergent BioSolutions, Winnipeg, MB  Kimberly Stephens, Chief Financial Officer, Appili Therapeutics Inc., Halifax, NS  Carol Stiff, Senior Director, Sales and Marketing, Santen Canada, Toronto, ON  Jefferson Tea, Vice President, Medical and Scientific Affairs, Takeda Canada Inc., Oakville, ON.  Gordon C. McCauley, president and CEO of CDRD  says that “The core of any business is people and supporting and growing our pool of highly-qualified personnel is critical to drive Canada’s health sciences sector. Through the CDRD Academy’s Post-Graduate and Undergraduate Institutes, we have seen tremendous success over the past 10 years in helping high-potential scientists be more commercially minded. But, with the addition of the Executive Institute to the CDRD Academy, we are now extending our work to also help high-potential business people lead Canada’s science-based businesses of tomorrow; and ensure Canada has the management talent it needs to lead the life sciences world.”  The CDRD Executive Institute program is delivered in collaboration with the not-for-profit Center for Creative Leadership (CCL). The program has been custom-designed and aims to combine researched and proven best practices/principles with targeted industry topics to take participants on a leadership journey. It will blend in-depth assessments, workshops, simulations, challenging assignments and executive coaching.  John Helou, president, Pfizer Canada says that ‘’The CDRD Executive Institute is off to a very strong start. The first cohort of life science executives exemplifies the type of leaders needed for the industry to reach its full potential. We are pleased to help meet the development needs expressed by life sciences industry stakeholders across the country, and to be able to count on the leadership of CDRD to implement concrete measures that will increase the innovative skill level of this vital industry. We are confident that the tailored training and coaching will contribute to the success of many life science organizations in Canada, which is critical for the development of new treatments for unmet medical needs’’.  This course offers a unique opportunity that will further the life sciences community within Canada and potentially bring the sector and consequently, the economy to new heights. The first face-to-face session will happen in Vancouver September 12-13, 2018, with additional workshops to be held in Montreal and Toronto throughout the Winter and Spring 2019.  +++++  Concordia synthetic biology researchers develop a method to fight disease at a genetic level that may revolutionize patient care.  Steve Shih, an assistant professor of electrical and computer engineering in Concordia University’s Faculty of Engineering and Computer Science and with a cross-appointment in biology, is also the founder of the Shih Microfluidics Laboratory.  His team created a system that integrates the automation of complex biology experiments in order to find genes that are related to cancer and kill them before they develop into a potentially fatal disease.  The system is described in a paper published last July by the journal Lab on a Chip.  Shih says that “Finding genes related to cancer is already very difficult. It’s like finding a needle in a haystack, especially with current methods. But hopefully, with this new method, we can expedite the whole process and rapidly find the culprit genes.”  However, finding the genes is one thing. Preventing them from causing cancer is another.  To do that, Shih’s team uses CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) a genetic engineering technique that uses a Cas9 protein (essentially a pair of ‘programmed genetic scissors’) to find a cancer-causing gene and essentially snip it out of the DNA and replace it with a healthier one.  Shih says that “Once both ends of the gene are snipped, it degrades to the point where we won’t have it anymore. Now that gene won’t be able to go through pathways that cause cancer. To be able to do that on a typical platform is very difficult, because we’re dealing with very static, very manual techniques.  “By doing this in an automated way, and by also miniaturizing the scale which we’re working on, we’re able to expedite the whole process. Instead of looking at this process as a matter of weeks, we can look at it in a matter of days.”  The paper’s authors — Hugo Sinha, Angela Quach, Philippe Vo and Shih, all affiliated with Concordia’s Centre for Applied Synthetic Biology — created the first digital microfluidic method that automated arrayed gene editing in mammalian cells.  This involves using tiny amounts of fluid to culture lung cancer cells for up to six days, while at the same time automating gene transfection and knockout procedures.  The whole automation and miniaturization process that they have developed has not only saved them heaps of time, but it has also slightly augmented the efficiency of the knockout procedure itself.  The mission to eradicate cancer has been a personal aspect for Shih, and he believes his work will have direct material benefits for people diagnosed with cancer.  He hopes his project will contribute to the development of personalized platforms for treatment based on their genetic makeup. That platform would be easily transferable and can be set up in any kind of lab or hospital.  In fact, Sinha started a company called DropGenie that will create gene-editing platforms that can bring this idea to realisation.  Despite CRISPR being controversial, Shih believes that only now researchers are reaping its benefits.  He adds that “There still isn’t a killer application for microfluidics, but I think we’ve found it. I think we found that we can use these miniaturized platforms for something that can really save people’s lives down the line. That’s why I say it can be a killer app because hopefully, we’ll be able to eventually kill all cancer cells.”  +++++   Researchers from the Peter Munk Cardiac Centre (PMCC) at UHN suggest that the model used by the Canadian Institute for Health Information (CIHI) significantly underestimates mortality in specialized heart surgery centres. The study’s findings show that CIHI’s model does not encapsulate all the medical problems that patients have when at elevated risk for surgery.  The study, looked at the outcomes of 1,635 cardiac operations performed at the Peter Munk Cardiac Centre between 2013 and 2016. It compared the observed mortality within 30 days of surgery to the predicted mortality rates estimated with either the CIHI administrative data model or the clinical data model used by the Society of Thoracic Surgeons (STS).  Of the 1,635 patients that had heart surgery at the Peter Munk Cardiac Centre, 32 died within 30 days of surgery. These results were in line with the 1.96 per cent mortality predicted by Society of Thoracic Surgeons model – which uses comprehensive data to describe how sick patients are before surgery – for this group of patients. In contrast, the CIHI Cardiac Care Quality Indicator estimated that the mortality rate for these 1,635 patients would be 1.03 per cent.  Peter Munk Cardiac Centre researchers noted that the Society of Thoracic Surgeons model captures seven medical conditions that predict worse outcomes after heart surgery that are not captured in the CIHI model.  These risk factors include whether the patient had heart failure, an abnormal heart rhythm, a recent heart attack, very low blood pressure (shock), needed recent CPR or a mechanical heart pump to live, or had kidney failure. These serious conditions forecast a worse outcome after heart surgery, and are not included in the CIHI database.  Dr. Barry Rubin, medical director of the Peter Munk Cardiac Centre and one of the authors of the study  says that “The predicted mortality of patients undergoing heart surgery based on the Society of Thoracic Surgeons model is similar to what we actually observed,” says. “The failure to include these seven medical conditions causes the CIHI database to underestimate predicted mortality after heart surgery in high risk patients.”  According to Dr. Douglas Lee, senior scientist at the Peter Munk Cardiac Centre and lead author of the study, mortality prediction models – either based on clinical or administrative data – use risk adjustment to account for how sick patients are before surgery at different hospitals. This is necessary as outcomes may vary if leading academic institutions such as the Peter Munk Cardiac Centre operate on sicker patients.  Dr. Lee says that “The CIHI and Society of Thoracic Surgeons models aim to predict outcomes based on the medical complexity and acuity of the patient. In general, academic hospitals take on higher risk cases compared to community hospitals, and good risk adjustment models should factor that in when predicting mortality rates,” explains Dr. Lee.  Incorrect data may lend the impression that there is a higher level of mortality then there should be at the PMCC or other academic centres. This could have the inadvertent effect of causing the highest risk surgery patients to defer potentially-life saving heart surgeries.  CIHI has a legislative mandate to publicly release Cardiac Care Quality Indicator data and has done so since October 2017. Clinicians and researchers have been concerned that the CIHI model may underestimate how sick cardiovascular surgery patients are at Peter Munk Cardiac Centre.  Incorrect data may lend the impression that there is a higher level of mortality then there should be at the Peter Munk Cardiac Centre or other academic centres. This could have the inadvertent effect of causing the highest risk surgery patients to defer potentially-life saving heart surgeries.  The Society of Thoracic Surgeons model considers vital medical conditions to accurately predict how high-risk patients will do after surgery. The CIHI model does not accurately account for complexity of patients, which is recorded in databases specifically designed for the measurement of surgical quality, such as Society of Thoracic Surgeons.  Dr Rubin says that “Clinical data-based models like the Society of Thoracic Surgeons collect much more detailed patient information, but are also more costly to maintain. “Administrative models like CIHI’s continue to play a very important role in assessing quality of care across Canada. We will continue to work in collaboration with CIHI to improve the accuracy of quality report cards that can be used as valid evaluation tools for Canadian hospitals.”  The authors caution that there are limitations to the study, as it was completed in a single centre during a three-year period, observing 1,341 isolated coronary bypass grafts, 143 isolated aortic valve replacements and 151 combined procedures. PMCC researchers declared there were no conflict of interests but would suggest validation of these findings in other academic centres over a longer time interval that would include a larger subset of cardiac operations. This study was supported by the Canadian Institutes of Health Research.  +++++  Well that wraps up another episode of Biotechnology Focus radio. Thanks for listening! If you have any questions or comments, please email us at press@promotivemedia.ca . From my desk to yours – this is Michelle Currie.

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.

Hypoplastic left heart syndrome (HLHS) is a critical congenital heart defect -- meaning that surgery within the first year of life is necessary to survive. Several decades ago, HLHS was uniformly fatal (except in some very rare cases) and most infants died within the first month of life. Since the 1980s there have been efforts made to save babies with HLHS. The results have been amazing. Now the success rate for babies born with HLHS is at an all-time high. What advancements have been made? What current treatments are most promising? What new treatments are on the horizon? Dr. Edward L. Bove is known throughout the world as "the man with the golden hands" because of his surgical skill working on babies with critical congenital heart defects. He joined the faculty at the University of Michigan as director of Pediatric Cardiovascular Surgery and became Head of the Section of Cardiac Surgery in 1999. He has given hundreds of presentations on heart surgery around the world. He has served on numerous committees including the American Heart Association, the Society of Thoracic Surgeons, the American Association for Thoracic Surgery, and the American Board of Thoracic Surgery. Dr. Bove serves on a number of editorial boards, has published over 300 manuscripts, dozens of book chapters, and edited two books. Dr. Bove is Anna's featured Guest today and he'll answer the questions posed above and much, much more! If you, or someone you love, has HLHS, you won't want to miss this program!Support the show (https://www.patreon.com/HearttoHeart)

Dr. Lundell’s experience in Cardiovascular & Thoracic Surgery over the last 25 years includes certification by the American Board of Surgery, the American Board of Thoracic Surgery, and the Society of Thoracic Surgeons. Dr. Lundell was a pioneer in “Off-Pump” heart surgery reducing surgical complications and recovery times. He’s in the Beating Heart Hall of Fame and has been listed in Phoenix Magazine’s Top Doctors for 10 years.He has been recognized by his peers as a leader and has served as Chief resident at the University of Arizona and Yale University Hospitals and later served as Chief of Staff and Chief of Surgery.He was one of the founding partners of the Lutheran Heart Hospital which became the second largest Heart hospital in U.S. and is now owned by Banner HealthAs a recognized leader in his field, Dr. Lundell has consulted and advised for a variety of leading medical device manufacturers such as Cardio Thoracic Systems, Inc. before and after it’s acquisition by Guidant Corporation. He advised St. Jude Medical on tissue valve implantation and marketing. For A-Med, Inc., he consulted on, conducted, and published the first clinical study on miniature pumps for heart support. He co-authored a clinical study validating key technology for Coalescent Surgical, which was subsequently acquired by Medtronic, Inc.

Go online to PeerView.com/ZUJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In the era of precision medicine, genomic profiling to individualize management of patients with advanced non–small cell lung cancer (NSCLC) is paramount. Advances in targeted therapy in advanced/metastatic NSCLC have heightened interest in expanding its use into earlier stages of the disease to improve outcomes in curative intent settings. Subsequently, a growing body of evidence now supports the use of EGFR-targeted therapy in early-stage disease, with remarkable efficacy results in the adjuvant setting. Results from ongoing studies of neoadjuvant and adjuvant targeted therapy are eagerly awaited as well. Given that targeted therapy is becoming an increasingly useful tool in early-stage NSCLC, it is essential that thoracic surgeons and other members of the multidisciplinary lung cancer team remain current with the latest clinical trial data and practical implications of incorporating systemic therapy into multimodal management strategies. This web broadcast provides the most important information required to effectively navigate the increasingly complex evidence base of EGFR-targeted therapy, focusing on the nuances of molecular testing and targeted treatment in the context of patient-centered, multidisciplinary management of EGFR-mutant NSCLC. Upon completion of this activity, participants should be better able to: Characterize the molecular heterogeneity of NSCLC and the oncogenic drivers such as EGFR mutations that serve as therapeutic targets and help to inform treatment decisions regarding targeted therapies, Describe the latest safety and efficacy data on neoadjuvant/adjuvant EGFR-targeted therapies in patients with early-stage EGFR-mutated NSCLC, Discuss evolving evidence and best practices for EGFR testing in lung cancer, including in early-stage NSCLC, and the thoracic surgeon's role in optimizing sample collection and evaluation, Collaborate with the multidisciplinary team to safely integrate neoadjuvant/adjuvant EGFR-targeted therapies into multimodal treatment plans for eligible patients with early-stage NSCLC in the context of clinical practice or clinical trials, according to recent evidence, precision oncology principles, and patient values and preferences.

Go online to PeerView.com/ZUJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In the era of precision medicine, genomic profiling to individualize management of patients with advanced non–small cell lung cancer (NSCLC) is paramount. Advances in targeted therapy in advanced/metastatic NSCLC have heightened interest in expanding its use into earlier stages of the disease to improve outcomes in curative intent settings. Subsequently, a growing body of evidence now supports the use of EGFR-targeted therapy in early-stage disease, with remarkable efficacy results in the adjuvant setting. Results from ongoing studies of neoadjuvant and adjuvant targeted therapy are eagerly awaited as well. Given that targeted therapy is becoming an increasingly useful tool in early-stage NSCLC, it is essential that thoracic surgeons and other members of the multidisciplinary lung cancer team remain current with the latest clinical trial data and practical implications of incorporating systemic therapy into multimodal management strategies. This web broadcast provides the most important information required to effectively navigate the increasingly complex evidence base of EGFR-targeted therapy, focusing on the nuances of molecular testing and targeted treatment in the context of patient-centered, multidisciplinary management of EGFR-mutant NSCLC. Upon completion of this activity, participants should be better able to: Characterize the molecular heterogeneity of NSCLC and the oncogenic drivers such as EGFR mutations that serve as therapeutic targets and help to inform treatment decisions regarding targeted therapies, Describe the latest safety and efficacy data on neoadjuvant/adjuvant EGFR-targeted therapies in patients with early-stage EGFR-mutated NSCLC, Discuss evolving evidence and best practices for EGFR testing in lung cancer, including in early-stage NSCLC, and the thoracic surgeon's role in optimizing sample collection and evaluation, Collaborate with the multidisciplinary team to safely integrate neoadjuvant/adjuvant EGFR-targeted therapies into multimodal treatment plans for eligible patients with early-stage NSCLC in the context of clinical practice or clinical trials, according to recent evidence, precision oncology principles, and patient values and preferences.

Go online to PeerView.com/ZUJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In the era of precision medicine, genomic profiling to individualize management of patients with advanced non–small cell lung cancer (NSCLC) is paramount. Advances in targeted therapy in advanced/metastatic NSCLC have heightened interest in expanding its use into earlier stages of the disease to improve outcomes in curative intent settings. Subsequently, a growing body of evidence now supports the use of EGFR-targeted therapy in early-stage disease, with remarkable efficacy results in the adjuvant setting. Results from ongoing studies of neoadjuvant and adjuvant targeted therapy are eagerly awaited as well. Given that targeted therapy is becoming an increasingly useful tool in early-stage NSCLC, it is essential that thoracic surgeons and other members of the multidisciplinary lung cancer team remain current with the latest clinical trial data and practical implications of incorporating systemic therapy into multimodal management strategies. This web broadcast provides the most important information required to effectively navigate the increasingly complex evidence base of EGFR-targeted therapy, focusing on the nuances of molecular testing and targeted treatment in the context of patient-centered, multidisciplinary management of EGFR-mutant NSCLC. Upon completion of this activity, participants should be better able to: Characterize the molecular heterogeneity of NSCLC and the oncogenic drivers such as EGFR mutations that serve as therapeutic targets and help to inform treatment decisions regarding targeted therapies, Describe the latest safety and efficacy data on neoadjuvant/adjuvant EGFR-targeted therapies in patients with early-stage EGFR-mutated NSCLC, Discuss evolving evidence and best practices for EGFR testing in lung cancer, including in early-stage NSCLC, and the thoracic surgeon's role in optimizing sample collection and evaluation, Collaborate with the multidisciplinary team to safely integrate neoadjuvant/adjuvant EGFR-targeted therapies into multimodal treatment plans for eligible patients with early-stage NSCLC in the context of clinical practice or clinical trials, according to recent evidence, precision oncology principles, and patient values and preferences.

Go online to PeerView.com/ZUJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In the era of precision medicine, genomic profiling to individualize management of patients with advanced non–small cell lung cancer (NSCLC) is paramount. Advances in targeted therapy in advanced/metastatic NSCLC have heightened interest in expanding its use into earlier stages of the disease to improve outcomes in curative intent settings. Subsequently, a growing body of evidence now supports the use of EGFR-targeted therapy in early-stage disease, with remarkable efficacy results in the adjuvant setting. Results from ongoing studies of neoadjuvant and adjuvant targeted therapy are eagerly awaited as well. Given that targeted therapy is becoming an increasingly useful tool in early-stage NSCLC, it is essential that thoracic surgeons and other members of the multidisciplinary lung cancer team remain current with the latest clinical trial data and practical implications of incorporating systemic therapy into multimodal management strategies. This web broadcast provides the most important information required to effectively navigate the increasingly complex evidence base of EGFR-targeted therapy, focusing on the nuances of molecular testing and targeted treatment in the context of patient-centered, multidisciplinary management of EGFR-mutant NSCLC. Upon completion of this activity, participants should be better able to: Characterize the molecular heterogeneity of NSCLC and the oncogenic drivers such as EGFR mutations that serve as therapeutic targets and help to inform treatment decisions regarding targeted therapies, Describe the latest safety and efficacy data on neoadjuvant/adjuvant EGFR-targeted therapies in patients with early-stage EGFR-mutated NSCLC, Discuss evolving evidence and best practices for EGFR testing in lung cancer, including in early-stage NSCLC, and the thoracic surgeon's role in optimizing sample collection and evaluation, Collaborate with the multidisciplinary team to safely integrate neoadjuvant/adjuvant EGFR-targeted therapies into multimodal treatment plans for eligible patients with early-stage NSCLC in the context of clinical practice or clinical trials, according to recent evidence, precision oncology principles, and patient values and preferences.

Go online to PeerView.com/ZUJ860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In the era of precision medicine, genomic profiling to individualize management of patients with advanced non–small cell lung cancer (NSCLC) is paramount. Advances in targeted therapy in advanced/metastatic NSCLC have heightened interest in expanding its use into earlier stages of the disease to improve outcomes in curative intent settings. Subsequently, a growing body of evidence now supports the use of EGFR-targeted therapy in early-stage disease, with remarkable efficacy results in the adjuvant setting. Results from ongoing studies of neoadjuvant and adjuvant targeted therapy are eagerly awaited as well. Given that targeted therapy is becoming an increasingly useful tool in early-stage NSCLC, it is essential that thoracic surgeons and other members of the multidisciplinary lung cancer team remain current with the latest clinical trial data and practical implications of incorporating systemic therapy into multimodal management strategies. This web broadcast provides the most important information required to effectively navigate the increasingly complex evidence base of EGFR-targeted therapy, focusing on the nuances of molecular testing and targeted treatment in the context of patient-centered, multidisciplinary management of EGFR-mutant NSCLC. Upon completion of this activity, participants should be better able to: Characterize the molecular heterogeneity of NSCLC and the oncogenic drivers such as EGFR mutations that serve as therapeutic targets and help to inform treatment decisions regarding targeted therapies, Describe the latest safety and efficacy data on neoadjuvant/adjuvant EGFR-targeted therapies in patients with early-stage EGFR-mutated NSCLC, Discuss evolving evidence and best practices for EGFR testing in lung cancer, including in early-stage NSCLC, and the thoracic surgeon's role in optimizing sample collection and evaluation, Collaborate with the multidisciplinary team to safely integrate neoadjuvant/adjuvant EGFR-targeted therapies into multimodal treatment plans for eligible patients with early-stage NSCLC in the context of clinical practice or clinical trials, according to recent evidence, precision oncology principles, and patient values and preferences.