The Society of Thoracic Surgeons 2024 Member Practice Survey.

Background: The Society of Thoracic Surgeons (STS) has conducted a practice survey every five years since 1974 to guide decision-making and resource allocation.

Methods: The 2024 Practice Survey, conducted online between January 25 to March 14, 2024, included a 72-question survey distributed to 4,692 active STS members from the Senior, Surgeon, and Resident/Fellow member categories. A total of 1,027 responses (22%) were received and interpreted.

Robotic-Assisted Transcatheter Aortic Valve Explantation and Aortic Valve Replacement.

Purpose: Transcatheter aortic valve replacement (TAVR) in younger patients may be complicated by premature structural valve degeneration. This report describes robotic TAVR explantation and aortic valve replacement.

Description: A 67-year-old woman who underwent low-risk, 23-mm balloon-expandable TAVR 4 years previously presented with severe prosthetic aortic stenosis, a drop in ejection fraction to 35%, severe type III mitral regurgitation, and symptomatic heart failure.

Endobronchial Valve Therapy versus Lung Volume Reduction Surgery in the United States.

Background: Lung volume reduction surgery (LVRS) and endobronchial valve placement (EBV) are therapeutic options in advanced emphysema. We sought to compare the two using a national dataset.

Methods: Using the United States Centers for Medicare and Medicaid Services inpatient claims database, we evaluated beneficiaries with severe emphysema undergoing either LVRS or EBV in accordance with Medicare reimbursement criteria.

Recurrent substance use and reoperative valve surgery for acute infective endocarditis.

Objective: Reoperative valve surgery in the setting of infective endocarditis (REDO) conveys a high risk of morbidity and mortality. Recurrent substance use in patients with substance use disorder (SUD) may complicate decision making in valve reinfection. We sought to evaluate the relative impact of recurrent substance use in REDO.

Surgical ablation of atrial fibrillation with concomitant cardiac surgery: a state-of-the-art review.

Patients with preoperative atrial fibrillation (AF) undergoing cardiac surgery face a heightened risk of complications and reduced survival. Concomitant surgical ablation (SA) has shown promise in mitigating the arrhythmic burden, prompting guideline upgrades by major scientific societies. However, SA remains underutilized, with performance rates varying between 22% and 48%, depending on the type of procedure.

Advancing robotic aortic valve replacement beyond isolated therapy: a platform for multivalve therapy.

The application of robotic cardiac surgery has long been considered the pinnacle of surgical care for an isolated procedure. This has been for good reason, as the quality and reproducibility of isolated procedures like mitral valve (MV) repair and robotic-assisted, minimally invasive, direct coronary artery bypass have grown steadily across the globe with shrinking learning curves. Once a robotic team's learning curve has crested, however, additional opportunities may be explored that may include concomitant procedures.

Surgical versus transcatheter aortic valve replacement: the future role of robotic aortic valve replacement.

Patients desire a minimally invasive option for management of their valve disease. As transcatheter aortic valve replacement (TAVR) remains a straightforward short-term solution, it is incumbent upon surgeons to provide an alternative, and preferably non-sternotomy or anterior chest option with the longitudinal benefits of surgical aortic valve replacement (SAVR). The present review will focus on the novel use of robotic aortic valve replacement (RAVR) via right lateral transaxillary mini-thoracotomy to perform standard SAVR, which permits the additional ability to perform concomitant procedures using the standard lateral approach popularized in mitral and atrial fibrillation surgery.

Center Volume Not Associated with Survival Benefit of Inter-Hospital Transfer for Pediatric Cardiac Surgery.

To evaluate the relationship between center volume and inpatient mortality among patients transferred to another hospital for pediatric cardiac surgery using contemporary real-world data. The Kids' Inpatient Database (KID) was queried for cardiopulmonary bypass (CPB) cases for the years 2016 and 2019. Hospitals were divided into three groups based on terciles of volume: low: ≤ 103 cases/year, mid: 104-194 cases/year, and high: > 194 cases/year.

Salvage surgery is safe and effective for clinical stage III non-small-cell lung cancer.

Objectives: The utility of surgery for stage III non-small-cell lung cancer (NSCLC) has yet no consensus. Surgery is mainly deployed in a planned multimodality regimen or as a salvage option after definite chemoradiation. We sought to explore outcomes after salvage surgery, planned surgery or oncological treatment alone for clinical stage III NSCLC.

Lessons from 19 Years of a Pediatric Heart Surgery Volunteer Program in Jamaica: Partnership, Teamwork, and Sustainability.

Background: The purpose of this analysis was to review our 19-year experience (2006-2024) of a pediatric cardiac surgery volunteer program in Jamaica and to examine the transition of surgical responsibility to the local team, case complexity, and Operative Mortality.

Methods: This was a retrospective study with a prospectively maintained database. Data points included diagnosis, procedure, surgeon, assistant, patient age, weight, sex, postoperative complications, and Operative Mortality.

Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients 40 to 75 Years of Age.

Background: The choice of bioprosthetic or mechanical surgical aortic valve replacement (AVR) should balance individual valve durability with the potential liabilities of oral anticoagulation.

Objectives: To inform clinical practice, this study sought to evaluate contemporary, real-world, long-term AVR outcomes from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD).

Methods: All patients undergoing primary isolated bioprosthetic or mechanical AVR were identified.

Longitudinal outcomes following international multicentre experience with robotic aortic valve replacement†.

Objectives: In an effort to maintain the technical aspects of traditional prosthetic surgical aortic valve replacement (AVR) while reducing invasiveness and facilitate options for concomitant operations, transaxillary lateral mini-thoracotomy endoscopic robotic-assisted aortic valve replacement (RAVR) has been introduced. The present data highlight the contemporary international collaborative experience.

Methods: All consecutive patients undergoing standardized RAVR across 10 international sites (1/2020-7/2024) were evaluated using a central database with 1 year follow-up.

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2024 Update on National Trends and Outcomes.

The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) is the most robust and advanced clinical database in cardiac surgery. With more than 8.3 million procedures and more than 1000 participating institutions encompassing more than 97% of cardiac surgery in the United States, the ACSD is the specialty's vital instrument for quality improvement, patient safety, and outcome reporting in cardiac surgery.

Surgical vs Transcatheter Aortic Valve Replacement in Patients 65 Years of Age and Older.

Background: Approval of transcatheter aortic valve replacement (TAVR) for all risk profiles has extended TAVR use in patients not otherwise examined in clinical trials. We sought to evaluate contemporary real-world outcomes of surgical aortic valve replacement (SAVR) vs TAVR in Medicare beneficiaries by risk strata.

Methods: Using the US Centers for Medicare Services database, all patients aged 65-85 years undergoing isolated first-time SAVR (n = 34,215) or TAVR (n = 124,897) were evaluated (2018-2022).

Minimally Invasive Valve Surgery for Patients With Infective Endocarditis: A Comparative Study.

Background: Patients with endocarditis frequently require valve surgical procedure, and despite the recent growth of minimally invasive cardiac surgery (MICS) for complex valve operations, consensus recommendations still suggest conventional sternotomy.

Methods: The institutional Adult Cardiac Surgery Database of The Society of Thoracic Surgeons (STS) evaluated all patients undergoing valve surgical procedure for endocarditis from July 2016 to March 2024. Patients were stratified by conventional sternotomy vs an MICS approach, including hemisternotomy, right thoracotomy, and robotic-assisted mitral, tricuspid, or aortic valve surgical procedure.

Mitral Valve Repair: Optimal Annual Case Volume for Surgery.

Background: Despite strong recommendations from multiple societies to pursue durable mitral valve repair (MVr), repair rates and outcomes remain inconsistent across the world. This is partly due to limited surgeon and center experience and lack of centralization of care for this technically challenging operation.

Objectives: The authors evaluate the association between annual case volume and contemporary long-term outcomes of patients undergoing isolated MVr.