2013 STS Weekend.qxp - Society of Thoracic Surgeons

2013 STS Weekend.qxp

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49TH STS ANNUAL MEETING

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JANUARY 26-30, 2013

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LOS ANGELES, CALIFORNIA R EDONDO B EACH C HAMBER

WEEKEND EDITION Friday 3:00 PM – 6:00 PM Registration: STS/AATS TechCon 2013 and STS 49th Annual Meeting West Exhibit Lobby

Saturday 7:00 AM – 6:00 PM Registration: STS/AATS TechCon 2013 and STS 49th Annual Meeting West Exhibit Lobby

8:00 AM – 12:00 PM STS/SCA: Intraoperative Echo and Decision Making in Cardiovascular Surgery Room 502B

8:00 AM – 12:15 PM STS/ACCP: Primer on Advanced and Therapeutic Bronchoscopy: Theory and Hands-On Session Room 515A

12:00 PM – 6:30 PM Tech-Con 2013 Exhibits Open Concourse Foyer

1:00 PM – 2:30 PM STS Cardiopulmonary Bypass Simulation Course Room 502A

1:00 PM – 2:45 PM Tech-Con 2013: Joint Session: Cardiac and General Thoracic Rooms 152 & 153

3:15 PM – 5:00 PM Tech-Con 2013: Cardiac Track I: Coronary Rooms 152 & 153

3:15 PM – 5:00 PM Tech-Con 2013: General Thoracic Track I: Current Technology Update Room 152

5:00 PM – 6:30 PM Tech-Con 2013 Reception Concourse Foyer

Sunday 7:00 AM – 6:30 PM Registration: STS/AATS TechCon 2013 and STS 49th Annual Meeting West Exhibit Lobby

7:00 AM – 8:00 AM Tech-Con 2013 Continental Breakfast Concourse Foyer

7:00 AM – 3:00 PM Tech-Con 2013 Exhibits Open Concourse Foyer

7:50 AM – 12:00 PM STS Practice Management Summit Room 515A

8:00 AM – 4:30 PM STS/AATS Cardiothoracic Critical Care Symposium Room 515B

8:00 AM – 9:35 AM Tech-Con 2013: Cardiac Track II: The Changing Landscape of Aortic Valve Therapies Rooms 152 & 153

8:00 AM – 9:35 AM Tech-Con 2013: General Thoracic Track II: A Look into the Future of Thoracic Surgery Room 151

10:20 AM – 11:35 AM Tech-Con 2013: Cardiac Track III: Next Generation TAVR Devices Rooms 152 & 153

10:20 AM – 11:35 AM Tech-Con 2013: General Thoracic Track III: Endoluminal, Minimally Invasive, and Ex-Vivo Room 151

11:50 AM – 1:00 PM Tech-Con 2013 Networking Lunch Petree Hall

1:00 PM – 4:00 PM Residents Symposium: Transitioning from Training to Practice Room 515A

Schedule continued on page 6

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C OMMERCE /LA T OURISM

World-class speakers, sessions converge in LA elcome to Los Angeles and the STS 49th Annual Meeting! After months of preparation, I’m looking forward to kicking off an unparalleled educational program. The Workforce on Annual Meeting and its various Task Forces have put together a timely, stimulating program that combines leading-edge translational science with interactive education and abundant networking opportunities. This year’s meeting has been enhanced by our collaborations with several organizations. As in years past, STS and the American Association for Thoracic Surgery are joining forces for STS/AATS Tech-Con 2013, which will provide interactive presentations on the most novel therapies in adult cardiac and general thoracic surgery. One of our exciting offerings on Saturday morning is jointly sponsored by STS and the Society of Cardiovascular Anesthesiologists and is titled “Intraoperative Echo and Decision Making in Cardiovascular Surgery.” The course will provide instruction on standard intraoperative transesophageal echocardiogram imaging techniques and their interpretation.

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New this year is a course co-sponture will be delivered on Monday sored by STS and the American Colmorning by Mark B. McClellan, MD, lege of Chest Physicians. The “Primer PhD, Director of the Engelberg Center on Advanced and Therapeutic Bronfor Health Care Reform at The Brookchoscopy: Theory and ings Institution. He is the Hands-On Session” course former Commissioner of will start off with lectures the Food and Drug Adminand case presentations covistration and Administrator ering endobronchial ultraof the Centers for Medicare sound and airway obstruc& Medicaid Services. Dr. tion, and then move into McClellan is one of the hands-on workstations to most respected leaders on familiarize attendees with US health care policy and many types of equipment. has implemented major reOther collaborative sesforms throughout his casions during the meeting in- Jeffrey B. Rich, MD reer, including the clude the “STS/AATS CarMedicare prescription drug diothoracic Critical Care Symposium,” benefit, the FDA’s Critical Path Initia“ACC @ STS,” and “SCA @ STS.” tive, and methods of helping conMany informative sessions will be sumers and providers utilize quality held on Sunday, including the STS and cost of care information. Practice Management Summit, which Also on Monday, the Affordable Care will guide participants in how to interAct session will provide analysis of the pret trends in health care that may diregulations implemented from provirectly impact their surgical practice. On sions of the ACA and discuss the law’s Sunday evening, join respected surspecific impact on cardiothoracic surgeons from around the world at the In- geons and the overall health care delivternational Reception and Symposium, ery system. Louis B. Jacques, MD, Diwhich this year will focus on the treatWorld-class speakers ment of rheumatic mitral valve disease. Continued on page 4 This year’s Thomas B. Ferguson Lec-

Tech-Con looks to the future of CT surgery T he Society of Thoracic Surgeons and the American Association for Thoracic Surgery have been conducting the joint STS/AATS Tech-Con program prior to the STS Annual Meeting for more than 10 years in order to provide up-to-date information on the latest technologies. The 2013 program, taught by internationally recognized surgeons, will begin on Saturday afternoon with a joint cardiac and general thoracic surgery session moderated by Tech-Con Task Force chair Gregory P. Fontana, MD, New York, and Keith S. Naunheim, MD, St. Louis. This session will consider the future of the field and discuss possible innovations that might evolve within the next decade. “We are trying to return to the origi-

nal concept of Tech-Con, which is to be forward-looking and focused on technology and procedures that surgeons can embrace,” said Dr. Fontana. “The most important thing I told the Task Force was that our specialties are clearly evolving rapidly, both cardiac and thoracic, and that creates a lot of discomfort to some people, but I think it is a very exciting opportunity for those who are willing to embrace the change. “We have very few forums where cardiothoracic surgeons can see and hear what is in the near and distant future as presented by world leaders in the field. Compared to academic-oriented meetings where completed research is mainly presented, Tech-Con is the meeting for the masses, for the surgeons who are in the trenches working

all the time and a place to get inspired,” Dr. Fontana said. Be sure to attend two important overview presentations on the future of cardiothoracic surgery that will help to launch this opening session on Saturday. The Cardiac Surgeon: The Year 2020 will be discussed by STS Immediate Past President, Michael J. Mack, MD, Plano, Tex., and The General Thoracic Surgeon: The Year 2020 will be addressed by former AATS President, G. Alexander Patterson, MD, St. Louis. The excitement of innovation will then be addressed in two presentations focusing separately on the overall technological evolution occurring in the fields of cardiac surgery and general thoracic surgery. Future Continued on page 12

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WEEKEND ISSUE

JANUARY 26-30, 2013

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Practice Management Summit frames future in health care iven the impact that the Affordable Care Act will have on physician practices, the 2013 STS Practice Management Summit will provide attendees with information on how they can adapt. The Summit is offered as a ticketed session on Sunday from 7:50 AM to 12:00 PM in Room 515A. Measuring and attaining quality has been a long-term focus for STS and cardiothoracic surgery. Similarly, the shift in emphasis from volume to value has been a focus of payers and health systems alike. This trend will likely accelerate in the coming years. With the goal of highlighting these and other key health care reform issues, the 2013 STS Practice Management Summit will provide an interpretation of health care trends that will directly impact CT surgical practice. The Summit will also offer insights on how to define the surgeon’s value to health systems and review the impact of new technology on the delivery of cost-efficient health care. The Summit features two sessions. Session I: “Health Care Delivery in Cardiothoracic Surgery,” will be moderated by Vinay Badhwar, MD, Pittsburgh, and Frank L. Fazzalari, MD, Ann Arbor, Mich. Session II: “Defining Health System Value” will be moderated by V. Seenu Reddy, MD, Nashville, Tenn., and Todd A. Carl, St. Petersburg, Fla. Specifically, the Summit program will cover: Value-Based and Outcome-Directed Care; The Future of Public Reporting (including an update on the AVR composite); Lessons Learned from Acute Care Episode Demonstration in CT Surgery and Cardiology; Tabulating Health System Value in Cardiac and General Thoracic Surgery Program Development; Post-Market TAVI Approval and Fis-

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Update your STS member information STS members: Stop by the STS Booth (#205) in the Exhibit Hall to update your contact information and pay your membership dues. While you’re there, take a moment to speak with STS staff about how you can take advantage of your member benefits.

cal Realities in the Community; and Updated Reimbursement Projections in CT Surgery for 2013–2014. Given the excellent Summit attendance in recent years, the content has been expanded for 2013 to ensure

coverage of issues common to those in both academic and private practice. In addition, the Summit welcomes the participation of practice managers or administrators. Further details about this session can

be found in your Program or online at www.sts.org/annualmeeting. If you do not have a ticket and would like to attend, visit the registration desk in the West Exhibit Lobby to see if there is still space available.

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WEEKEND ISSUE


JANUARY 26-30, 2013

STS staff welcomes you to Los Angeles! n behalf of the Society’s staff, I join STS 4:30 PM on Sunday, with a reception that runs President Jeff Rich in welcoming you to The through 6:30 PM. The exhibitors that will have snacks and refreshments have been highlighted in the OpenSociety of Thoracic Surgeons 49th Annual ing Reception flyer that was inserted in your meeting Meeting and Exhibition in Los Angeles, California. bag. As in the past, the Annual Meeting will provide you While you’re at the meeting, I hope you will also with a wide range of educational, networking, and stop by the STS booth in the Exhibit Hall social offerings. (Booth 205). Staff members will be there, One of the positive changes you’ll see eager to talk with you about – and prothis year stems from your feedback that vide updates on – all things STS. Be sure having too many parallel course options to ask about our new long-term CABG made it difficult for you to attend everysurvival probability calculator; public rething you wanted to attend. porting initiatives (both the STS/ConFor this meeting, we’ve come up with a sumer Reports collaboration and STS way to provide the sessions that are imPublic Reporting Online); exciting develportant to your practice while right-sizing opments from the STS Research Center the number of concurrent courses. But, (now in its second year), including the because there is still so much to experiRob Wynbrandt STS/ACC TVT Registry; STS National ence between Saturday and Wednesday, Database participation opportunities, dothis STS Meeting Bulletin is here to help you keep track of what’s happening and provide up-to-date mestically and internationally; and upcoming educational programs. information about new sessions, meeting room locaYou also will want to take a moment and talk with tions, exhibitor descriptions, and much more. the STS Government Relations staff, who can bring Watch for the Monday and then the you up to date on the Society’s many efforts on CapiTuesday/Wednesday editions of the Bulletin; the newspapers will be placed in bins throughout the Los tol Hill. From coding and reimbursement issues to Angeles Convention Center during the Annual Meet- the implications of health care reform to important legislation relevant to cardiothoracic surgeons, STS ing. Check the front page left-hand column in each continues to champion the specialty in Washington. issue for a quick summary and update of the day’s Stop by and learn more. There’s a lot going on – activities. and you’ll want to understand the implications for The Bulletin also provides a handy reference to the your practice. Exhibit Hall, which is an important aspect of the If you are not already an STS member, please stop meeting you won’t want to miss. The Exhibit Hall is by Booth 205 and learn about the many membership a great place to learn about new and improved techbenefits we have to offer, including a complimentary nology and products, and it offers the perfect opporsubscription to The Annals of Thoracic Surgery. In that tunity to see and meet with colleagues and friends. Surveys from past meetings show that the majority regard, those attendees who are not cardiothoracic surgeons – i.e., other physicians, CT surgery and genof attendees make a point of visiting with the exeral surgery residents, medical students, and all allied hibitors at least three times over the course of the health care professionals – should especially note that meeting. The STS Exhibit Hall opens its doors at

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STS Annual Meeting World-class speakers from page 1

rector of the Coverage and Analysis Group at the Centers for Medicare & Medicaid Services, will provide the CMS perspective, while David F. Torchiana, MD, CEO of the Massachusetts General Hospital Physician Organization, will share thoughts from the standpoint of the cardiothoracic surgeon. In our jointly sponsored session with the American College of Cardiology on Monday afternoon, John V. Conte, MD and Neil Kleiman, MD will moderate discussions such as the role of hybrid procedures in the future of cardiothoracic surgery and whether appropriate use criteria are meaningful. The combined STS/ACC session will also include a panel discussion on the National Coverage Determination for transcatheter aortic valve replacement and the lessons learned from the pilot program that tested parallel pro-

cessing for FDA approval and the Medicare coverage decision. One event you won’t want to miss is the C. Walton Lillehei Lecture, which will take place on Tuesday morning. Our speaker this year will be Carolyn M. Clancy, MD, who currently serves as Director of the Agency for Healthcare Research and Quality at the US Department of Health & Human Services. She will discuss current trends and issues in health care quality and research that are shaping the future direction of our care delivery models. Robust discussion is usually an engaging part of the learning process, so be sure to attend some of the debate sessions that we have planned. I am especially looking forward to the debate over whether all aortic valve repairs will be performed with transcatheter technology in 2020, held on Tuesday afternoon during the “Adult Cardiac

our rolling admissions process for Candidate, PreCandidate, and Associate Membership allows for the prompt disposition of their STS membership applications, typically within a week or two, so that they can start enjoying the benefits of STS membership almost immediately. And if you are an STS member, please pick up a membership packet to take home to a colleague; you will be helping both your colleague and your Society. All the scientific sessions at this 49th Annual Meeting, including the symposia, early riser sessions, breakout sessions, hands-on sessions, and invited talks, create a vast array of educational opportunities – more than any one person could ever attend onsite. Fortunately, STS is again offering its “Online” meeting products. STS 49th Annual Meeting Online and STS/AATS Tech-Con 2013 Online are available for purchase, as are the standalone symposia, STS/SCA 2013 Online and STS/ACCP 2013 Online. These online products will allow you to catch those sessions you weren’t able to attend and review all the sessions you did attend – all in the comfort of your home or office throughout the year ahead. You can take advantage of a special reduced onsite rate if you purchase the online products while you’re at the meeting. For more information and to place your order, visit the online sales counter in the registration area. Remember, once we leave Los Angeles, prices will be significantly higher. In closing, please know that all of us on the staff are here to serve you. Look for the distinctive green STAFF ribbon on our name badges, and please don’t hesitate to let us know if there’s anything we can do to help. Thank you for attending, and enjoy the meeting!

Session: TAVR.” The popular Ethics Debate on Tuesday will question the dead donor rule and will feature two outstanding ethicists who are leading scholars in this field. Finally, the STS Annual Meeting wouldn’t be complete without the excellent hands-on courses offered on Wednesday morning as part of STS University. There are courses for every subspecialty, taught by leading experts. One of the things I enjoy most about the Annual Meeting is the chance to connect with colleagues and experts in our specialty, and you’ll have plenty of opportunity for networking over the next few days. We’ve also welcomed more than 100 exhibitors to our Exhibit Hall, giving you the chance to stay up-to-date on what’s new in the field. Watch The STS Meeting Bulletin in the coming days for details on programs such as the Scientific Posters & Wine event, the presentation of the J. Maxwell Chamberlain Memorial and

Rob Wynbrandt STS Executive Director & General Counsel

Richard E. Clark papers, and much more. You’ll also find full abstracts for the entire meeting in your Program. On behalf of the Society’s leadership and the 49th Annual Meeting Program Planning Committee, thank you for joining us here in Los Angeles. Jeffrey B. Rich, MD STS President

Opening Reception Learn about the specialty’s newest products, services, and technologies at the STS Exhibit Hall Opening Reception on Sunday from 4:30 PM to 6:30 PM in West Hall A. Check your STS meeting bag for information on which exhibitors will be providing refreshments.


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The JOSEPH LAMELAS Knot Pusher™ is intended for use to advance throws of extracorporeal knots to an intracorporeal surface or object within a small cavity during limited access cardiothoracic procedures. The JOSEPH LAMELAS Atrial Lift System™ is intended for use to retract the atrial wall during limited access cardiac surgical procedures. The CUFF™ device is intended for use to retract aortic wall tissue during specific cardiac surgical procedures. The COLLAR™ device is intended for use to retract valve leaflet tissue during specific cardiac surgical procedures. The TIE™ device is intended for use to assist in accurate suture knot placement during specific cardiac surgical procedures. The JOSEPH LAMELAS Intercostal Retractor System™ product is intended to provide surgical access for minimally invasive cardiothoracic procedures by retraction of soft and bony tissue. The SUTURE BELT device is intended for use to secure and manage surgical sutures during specific cardiothoracic surgical procedures. Medtronic, Inc. is the exclusive distributor for Miami Instruments in the United States. For more information, contact Medtronic at 1 (800) 328-2518. Trademarks are the property of their respective owners. ©Medtronic, Inc. 2013 UC201304102EN


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WEEKEND ISSUE


JANUARY 26-30, 2013

STS National Database sees growth, new opportunities

Make your voice heard through text polling

ver the past year, the STS National Database has marked many achievements. In particular, the Database hit two major milestones – it now includes more than 1,400 participants and 5 million surgical records.

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International Participants Welcome Additionally, in late 2012, the STS Adult Cardiac Surgery Database (ACSD) welcomed its third international participant – the Division of Cardiovascular Surgery at the Anadolu Medical Center Hospital in Turkey. Anadolu joined the Department of Cardiothoracic Surgery at the Hebrew University Hadassah Medical Center, Israel, and the Department of Cardiac Surgery at TotalCor Hospital, São Paulo, Brazil, as the earliest international participants to join the ACSD. International participants receive feedback reports with aggregate benchmarks based on data from North American participants, allowing them to measure their outcomes data against that of US and Canadian participants. Participant data are analyzed and risk-adjusted based on North American risk models. International participation is currently available for both the ACSD and the STS Congenital Heart Surgery Database, and international participation for the STS General Thoracic Surgery Database is planned soon. If your institution is interested in participating, visit the STS Booth (#205) for more information. New Public Reporting Measure This past year also saw new opportunities for

publicly reporting STS National Database composite results. Participants in the ACSD are now able to publicly report a newly developed measure, the aortic valve replacement (AVR) composite metric. The AVR score includes two domains – risk-adjusted mortality and risk-adjusted morbidity. Participants received their AVR composite scores in May 2012, and those who submitted their data-sharing consent forms were included in the January 2013 data update. If you are an ACSD participant and wish to sign up to publicly report your institution’s AVR score in the next data update, stop by the STS Public Reporting Online Booth (#311) to get more information. Additionally, public reporting of CABG scores is still available and continues to grow in popularity. More information is available at the booth. AFib Module Available ACSD participants also have the opportunity to participate in the Atrial Fibrillation Module, which is designed to collect benchmark data for the surgical treatment of AFib. Surgery for AFib is often performed in conjunction with other cardiac operations but can be a standalone procedure. Evaluation and comparisons of surgical techniques and results will advance knowledge and further the development of guidelines for this condition. The Society encourages you to contribute to this important dataset. Participation in the AFib module is available for $250 in 2013. Stop by the STS Booth (#205) for more information.

everal scientific sessions at this year’s meeting will feature a new audience participation opportunity. STS has partnered with Poll Everywhere, a company that provides webbased audience response software, to create a process that will allow you to share your opinion via your cell phone’s texting feature. During those sessions that include this polling feature, moderators will display questions onscreen and provide multiplechoice answers from which to choose. You’ll simply select the answer you support and send a text message or vote via the web with the corresponding number. Responses are displayed in real-time, giving you an instant view into what your colleagues are thinking. The following sessions will showcase this new polling feature. Additionally, in your Program, these sessions are indicated with a checkmark icon.

Saturday, January 26 STS/SCA: Intraoperative Echo and Decision Making in Cardiovascular Surgery STS/ACCP: Primer on Advanced and Therapeutic

Bronchoscopy: Theory and Hands-On Session Sunday, January 27 STS Practice Management Summit STS/AATS Cardiothoracic Critical Care Symposium

Monday, January 28 Adult Cardiac Session: Arrhythmia General Thoracic Session: New Techniques and Bioassays Affordable Care Act Adult Cardiac Session: Aortic General Thoracic Session: Lung Cancer I ACC @ STS

Tuesday, January 29 Early Riser Health Policy Forum Ethics Debate: Should the Dead Donor Rule Be Abandoned? Adult Cardiac Session: Mitral Valve Adult Cardiac Session: TAVR Congenital Session: Pediatric Congenital II

More detailed instructions will be provided on slides at the sessions.

Schedule from page 1 1:15 PM – 2:50 PM Tech-Con 2013: Cardiac Track IV: Leaking Valves and Failing Pumps Rooms 152 & 153

3:20 PM – 4:30 PM Tech-Con 2013: Cardiac Track V: Thoracic Vascular

0825-0827

Rooms 152 & 153

1:15 PM – 4:30 PM Parallel Surgical Symposium: General Thoracic Room 502B

1:15 PM – 4:30 PM Parallel Surgical Symposium: Congenital Room 502A

2:30 PM – 4:30 PM Associate Membership Symposium: Interprofessional Leadership in the Operating Room and Lung Cancer Treatment Room 151

4:30 PM – 6:30 PM International Reception and Symposium: Choosing Repair or Replacement in Rheumatic Mitral Valve Disease Room 501A/B

4:30 PM – 6:30 PM Scientific Posters Open West Hall A

0825

-0827

4:30 PM – 6:30 PM Opening Reception in STS Exhibit Hall West Hall A


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WEEKEND ISSUE

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JANUARY 26-30, 2013

Looking to 2020 in cardiac and general thoracic surgery s part of its focus on the future, Dr. Patterson, a former president of STS/AATS Tech-Con 2013 will the American Association for Thoracic feature two special presentaSurgery, will address this dramatically tions with renowned experts speculatchanging future in his presentation ing on what practice will be like for General Thoracic Surgeon: The Year 2020 cardiac and general thoracic surgeons during the Cardiac and General Thoin the year 2020. Michael J. racic Joint Session on SaturMack, MD will tackle carday afternoon. diac surgery, and G. Alec “There will be refinePatterson, MD will address ments of the gadgets and the rapid changes occurinstruments we use,” he ring in general thoracic said, “specifically in robotsurgery. ics and VATS, and minimal“Seven years is not that ly invasive techniques will long from now, but change become more and more can happen rapidly. For exprevalent and better for the ample, it’s striking the patients. G. Alec number of people today “We are going to see anPatterson, MD who are actively engaged in other transformation in VATS lobectomies, whereas imaging, not only in terms 7 years ago it was a very small number. of its anatomic precision, but what I There are definitely innovations comthink we are going to see is more ing down the road in general thoracic ‘functional’ imaging or ‘physiologic’ surgery that we can look forward to, imaging. This will involve different and what thoracic surgeons as a group kinds of scans, not just PET scans need to do is to embrace those changes …but imaging that allows true assessand welcome them,” said Dr. Patterment of function. And there is the posson, who is the Evarts A. Graham Pro- sibility of us studying different sorts of fessor of Surgery and Chief, Division tumors with imaging based on their of Cardiothoracic Surgery at the Wash- markers. So I think there is going to be ington University School of Medicine, almost a revolution in imaging.” St. Louis. This will bring imaging even further

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Are you and your health care team prepared for the future role of transcatheter heart valve surgery?

into the operating room and, at the same time, distinctions between radiologists and nuclear medicine specialists will begin to blur as imaging becomes more comprehensive based on this need to assess functionality. CT scans in the last 7 years have become more routinely used, cheaper, and quicker, and the next 7 years will see even more expansion of the various types of imaging and their uses. Dr. Patterson said there were a couple of important issues that thoracic surgeons were going to have to grapple with in the next 7 years in a very serious way, and “once again, embrace the change.” These lie in the application of and adherence to quality measures. “We are going to have to become guideline- and data-based doctors,” he said, “much more so than we are now.” The government will mandate it and along with that, there will be a greater application of “centers of excellence” and regionalization of care, he added. “The government is simply not going to pay for every Tom, Dick, and Harry

to be doing all these complicated operations just a few times a year,” Dr. Patterson stated. In addition to these changes, Dr. Patterson foresees that thoracic surgeons will more and more become tied to hospitals, to the extent of becoming hospital employees, for two reasons: The hospitals are getting reimbursed based on quality, and they will demand more control and accountability. Also, larger institutions will be able to absorb the costs of doing business, including electronic health records and database reporting, in ways that private surgeons may not be able to afford. This will allow things to be streamlined in costs and efficiencies, Dr. Patterson added.

STS/AATS Tech-Con 2013 Joint Session: Cardiac and General Thoracic SATURDAY, 1:00 PM – 2:45 PM Rooms 152 & 153

Join the conversation online! Like the STS Facebook page at www.facebook.com/societyof thoracicsurgeons and follow STS on Twitter at @STS_CTSurgery for more information about Los Angeles. Be sure to use the hashtag #STS2013 if you tweet

about the STS 49th Annual Meeting. And after the Annual Meeting is over, the STS Facebook and Twitter pages will continue to deliver news on future STS events and CME credit opportunities.

Electronic CME/CEU evaluation

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April 25-26, 2013 • Dallas, TX www.sts.org/THV The Society of Thoracic Surgeons is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This activity has been approved for AMA PRA Category 1 Credit™.

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The STS 49th Annual Meeting utilizes an entirely electronic evaluation and CME/Perfusion CEU credit claim process. Both physicians and perfusionists can use this system to claim credit, complete evaluations, and print CME/Perfusion CEU certificates. Certificates of Attendance are also available for attendees and international physicians not wishing to claim CME credit. Attendees will not be able to evaluate and claim CME/Perfusion CEU credit for ticketed sessions unless they have registered for those sessions. Attendees can complete overall meeting evaluations and all individual session evaluations at computer terminals in the following locations: Cyber Café: West Lobby

CME Stations (certificate printing available): Concourse Hall West Exhibit Lobby by registration Attendees can also access evaluations and CME/Perfusion CEU credit by visiting the online evaluation site through personal computers or handheld devices at www.sts.org/2013evaluation. In order to make this process more convenient for attendees, the meeting evaluations will be available online through Friday, February 8. Attendees can log in to the website with the following information: Username: 6-digit member ID number located at the lower lefthand side of the meeting badge Password: First initial and last name


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This moment your team meets our hands-on training

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This is the moment your skill and technique are complemented with the latest advances in heart valve therapies. It’s the moment world-class training, expert clinical support, and meaningful innovations continue to compliment your patient care. This is the moment you partner with Edwards Lifesciences along your path to success.

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JANUARY 26-30, 2013

Ex-vivo perfusion expands pool of lung transplants

A

been building upon their initial experience with EVLP reported in The New England Journal of Medicine (2011;364:1431-40). Dr. Keshavjee will discuss this experience in now over 80

of lungs outside the body without injuring them. It is possible to keep lungs over 12 hours outside the body and normothermic.” “We are developing ways to figure out which lungs need a fix and to target treatment to lungs that need [it],” said Dr. Keshavjee. Examples include resolution of pulmonary edema and infections through EVLP. Treating infected lungs with lavage and high-dose antibiotics may one day make these organs acceptable for transplantation, even in cases of pneumonia. EVLP, as performed at Toronto General Hospital, may Critical to these efenhance the utility of marginal donor lungs. forts is the proper assessment of these lungs. cases and other aspects of ex-vivo organ Among the innovations Dr. Keshavjee treatment during his Tech-Con presenwill discuss is the use of Steen Solutation on Sunday afternoon. tion, which has an FDA status of inves“The important aspect is that extigational, and is proving itself useful vivo lung perfusion is taking some of worldwide in the ex-vivo assessment of the adventure out of lung transplantamarginal lung function. The ventilated tion,” Dr. Keshavjee said. “EVLP has lung is perfused with deoxygenated shown itself to be clinically feasible. Steen Solution and the critical parameWe can perform a long-term perfusion ters of gaseous exchange, pulmonary compliance, vascular resistance, and other key variables under normothermic conditions are monitored, enabling lung assessment. In a study of EVLP lungs at Toronto General Hospital, lungs were used from 32 brain death donors and 26 cardiac death donors. Dr. Keshavjee and his colleagues compared the outcomes of these EVLP procedures to another 253 conventional lung transplantations performed at their institution from September 2008 to December 2011. C OURTESY D R . M ARCELO C YPEL

mong the major problems in lung transplantation are perpetual organ shortages and low utilization rates. Around 17% of lungs from brain death donors and 2% of lungs from cardiac death donors are used currently. Additional research, however, continues to show good outcomes with a new process that allows successful transplant of lungs that might otherwise be deemed unusable. Shaf Keshavjee, MD, Director of the Toronto Lung Transplant program and Professor of Thoracic Surgery at the University of Toronto, will summarize aspects of this research and its successful translation into clinical practice in his talk on Ex-Vivo Lung Salvage for Transplant at Sunday afternoon’s STS Tech-Con “General Thoracic Track III: Endoluminal, Minimally Invasive, and Ex-Vivo.” Dr. Keshavjee and his colleagues at the Organ Regeneration Laboratory at Toronto General Hospital evaluated and repaired 58 donor lungs over 4 to 6 hours in a process called normothermic ex-vivo lung perfusion (EVLP). In all, 50 of these lungs were successfully transplanted into patients, for a final utilization rate of 86%. Dr. Keshavjee and his colleagues have

Annual Meeting & Exhibition A Orlando, Florida January 25-29, 2014

www.sts.org/annualmeeting

STS 49th Annual Meeting Mobile App Access the STS 49th Annual Meeting Mobile App for iPhone/iPad by searching for “ScholarOne” in the Apple App Store. After downloading the app, select STS from the list of meetings. If you have a nonApple device, a mobileoptimized website version of the app is available by visiting www.sts.org/ mobileapp or scanning the QR code at right.

EVLP patients received a significantly higher percentage of lungs from cardiac death donors, which are considered higher-risk donors than brain death donors. They also received a higher percentage of high-risk lungs from brain death donors and more lungs with chest x-ray abnormalities, such as signs of pulmonary edema, than did the conventional group. Donor lungs in the EVLP group were significantly more injured at baseline; however, the outcomes were comparable, Dr. Keshavjee and his colleagues found. For example, posttransplant survival at 1 year was 86% for the EVLP group and 87% for the traditional transplant group in this retrospective study; at 3 years, these rates dropped to 70% and 72%. There were no significant differences between recipients from cardiac death donors and brain death donors. Other findings included no significant difference in the rate of primary graft grade 3 dysfunction at 72 hours between groups, according to International Society for Heart and Lung Transplantation criteria. EVLP now composes 20% of transplants in Toronto as the overall transplant volume continues to increase and early posttransplant outcomes continue to improve with shorter ICU times and hospital stays. The major contribution of EVLP will be for the majority of transplant centers, which use 10% or less of the available lungs. EVLP can safely increase the number of organs available, according to Dr. Keshavjee.

Annual Meeting Sponsors The Society gratefully acknowledges the following sponsors for their support of the STS 49th Annual Meeting.

Patron Sponsors Provided $25,000 or more

Covidien Ethicon Endo-Surgery, Inc. Medtronic, Inc. St. Jude Medical

Supporter Sponsor Provided $10,000 or more

Abbott Vascular

This list is accurate as of January 9, 2013.


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Replace the native sinus of Valsalva with something more... natural.

Features the only FDA-approved aortic tissue valve for use in a Valsalva conduit The Mitroflow Valsalva Conduit* uses the Mitroflow® Aortic Pericardial Heart Valve, a valve known for exceptional hemodynamics, long-term durability and ease of implant.

The graft is infused with minimally cross-linked, biodegradable gelatin sealant instead of collagen. This encourages a secure neointimal attachment with reduced inflammatory response and faster healing.

The 1:1 ratio between the annulus and the sinotubular junction supports the use of a graft that is 5mm larger than the measured valve size.1

We invite you to learn more about the Mitroflow Valsalva Conduit and its many possibilities in the treatment of patients with ascending aortic aneurysms, infective aortitis and Marfan’s Syndrome.

The performance of the Mitroflow valve is backed by more than two decades of clinical data, demonstrating excellent reliability and durability in a wide range of patient anatomies.2, 3

For more information, contact your Sorin Group Sales Representative.

References

Join us Monday, January 28, 2013 in booth #433 for a discussion…

1. Maselli D., et al. Sinotubular Junction Size Affects Aortic Root Geometry and Aortic Valve Function in the Aortic Valve Reimplantation Procedure: An In Vitro Study Using the Valsalva Graft. Ann Thorac Surg. 2007;84:1214–1218. 2. Yankah, et al. Aortic valve replacement with the Mitroflow pericardial bioprosthesis: Durability results up to 21 years. JTCVS. 2008;136:688–96. 3. The ISTHMUS Investigators. The Italian study on the Mitroflow postoperative results (ISTHMUS): A 20-year, multicentre evaluation of Mitroflow pericardial bioprosthesis. Eur J Cardiothorac Surg. 2011;39:18–26.

The management of the aortic root: use of a ELRORJLFDOYDOYHLQD0LWURÁRZ9DOVDOYD&RQGXLW Presented by Wilson Y. Szeto, M.D., Associate Professor of Cardiac Surgery, University of Pennsylvania Medical Center

* Not available outside the United States

The 20-minute discussions will be held at 11:00 a.m. and 12:45 p.m.

ETHICAL COLLABORATION IN HEALTHCARE

CERTIFIED

Licensed by Eucomed

14401 W. 65th Way, Arvada, CO 80004 ID[WWW.SORIN.COM

Federal law (USA) restricts this device to sale by or on the order of a physician. Trademarks used herein are owned by or licensed to Sorin Group. ©2012 Sorin Group


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Tech-Con 2013 Future from page 1

The Tech-Con Task Force designed the program to address the most important and innovative topics, focusing on concepts that are currently in development and providing the most up-todate information and opinion. There are dramatic changes in cardiac surgery, in part inspired by the rise of TAVR and collaborative heart teams. “TAVR is probably the first in a long line of technology in structural heart disease, and also there are breakthroughs in heart failure, with the new mini-assist devices that are just now commercializing,” according to Dr. Fontana. “We are also going to be focusing on some new and innovative techniques that are going to be available soon in bypass surgery, hybrid surgery, where you can have the best of both worlds, minimally invasive surgery and transcatheter therapies. One important area to be addressed is that of sutureless valves, which are in use overseas, and which are likely get to the United States within the next 18 months.” Following the general opening session on Saturday, which addresses the future in a global sense, a series of lectures will provide robust technical re-

views of particularly important, leading-edge technologies and methods, which will be delivered by an assembly of internationally recognized surgeons and physicians. “All the talks are short and succinct presentations, and one important aspect to this year’s Tech-Con is the fact that there will be a lot of ‘Crossfires’ and lively debates. The Crossfires will follow a group of speakers on a particular topic area and feature a discussion, almost like a talk show, with the experts sitting in a conversational environment rather than up on the dias,” Dr. Fontana added. Separate cardiac and general thoracic surgery sessions will follow with discussions on coronary revascularization strategies, moderated by Robert W. Emery, MD, Minneapolis, and Robert A. Guyton, MD, Atlanta; how to improve coronary artery bypass grafting (CABG) results, moderated by Robert S. Poston, MD, Tucson, Ariz., and William E. Cohn, MD, Houston. Innovations in general thoracic surgery, including ECMO, localization of lung nodules, developing an Internet presence, and video-assisted tho-

racic surgery tools and management, will be moderated by Marc de Perrot, MD, Toronto. On Sunday, there will be a thoracic vascular session focusing on problems in the thoracic aorta, moderated by Ali Khoynezhad, MD, Los Angeles, and Joseph S. Coselli, MD, Houston. The Sunday cardiac sessions will feature “The Changing Landscape of Aortic Valve Therapies,” moderated by Dr. Fontana and Joseph E. Bavaria, MD, Philadelphia. Perhaps one of the most exciting innovations in modern cardiothoracic surgery is the development of transcatheter valve implantation. Currently focused on the aortic valve, driven by the success of the PARTNER trial, transcatheter valve technology is also poised to impact mitral valve disease. These developments will be highlighted in two main sessions, the first

JANUARY 26-30, 2013

on next-generation TAVR devices, moderated by Arvind K. Agnihotri, MD, Boston, and Robert C. Hagberg, MD, Hartford, Conn; and the second, “Leaking Valves and Failing Pumps,” which will focus on mitral valve disease on the one hand and the problem of congestive heart failure on the other, and be moderated by Michael Argenziano, MD, and Nirav C. Patel, MD, both of New York, and John V. Conte, MD, Baltimore, and Nicholas G. Smedira, MD, Cleveland. The General Thoracic Tracks will feature a session on the future of thoracic surgery, moderated by M. Blair Marshall, MD, Washington, D.C., and one on endoluminal, minimally invasive, and ex-vivo techniques, moderated by Joseph B. Shrager, MD, Stanford, Calif. A general reception for all TechCon attendees will be held after the Saturday sessions.

Course on intraoperative echo Members of STS and the Society of Cardiovascular Anesthesiologists will lecture on the use of intraoperative TEE imaging techniques. The utility of TEE in decision making will be demonstrated by interactive case presentations of patients undergoing surgery of the mitral valve, aortic valve, and thoracic aorta. “STS/SCA: Intraoperative Echo and Decision Making in Cardiovascular Surgery” will be held Saturday, 8:00 AM – 12:00 PM, in Room 502B.

Extend Your Meeting Experience with STS 49th Annual Meeting Online Products Save 50% when you purchase STS 49th Annual Meeting Online, STS/AATS Tech-Con 2013 Online, STS/ACCP 2013 Online, and/or STS/SCA 2013 Online before the end of the meeting! With these web-based video presentations, you can earn up to 102.5 AMA PRA Category 1 Credits™. Watch sessions you were unable to attend or review sessions of special interest from your own home or office. Compatible with desktop, iPad, iPhone, and Android mobile devices.

Visit the registration desk in the West Exhibit Lobby or the Annual Meeting Online Sales Booth in the West Lobby to make your purchase today. Savings expire after January 30, 2013. Accreditation Statement The Society of Thoracic Surgeons is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

STS 49th Annual Meeting Online The Society of Thoracic Surgeons designates this enduring material for a maximum of 84.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

STS/AATS Tech-Con 2013 Online The Society of Thoracic Surgeons designates this enduring material for a maximum of 13.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

STS/AACP 2013 Online The Society of Thoracic Surgeons designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

STS/SCA 2013 Online The Society of Thoracic Surgeons designates this enduring material for a maximum of 3.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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JANUARY 26-30, 2013

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New exhibitor helps educate and support Afib patients topAfib.org is among the new exhibitors this year at the STS Annual Meeting. StopAfib.org is a “patient-to-patient” website that offers educational information on atrial fibrillation, the most common sustained cardiac rhythm disturbance. “We are delighted to be an exhibitor at the STS Annual Meeting,” said Mellanie True Hills, who founded StopAfib.org after being diagnosed with Afib in October 2003. The organization’s mission is to educate patients, improve communication between patients and health care providers, raise awareness about Afib, and decrease Afib-related strokes. Thanks to the Mini-Maze procedure, True Hills has been free from Afib for more than 7 years. “I couldn’t stand on the sidelines and watch others suffer, so I founded StopAfib.org to help others living with Afib.” StopAfib.org addresses medication management and electrical cardioversion as well as surgical procedures, catheter ablation, and hybrid ablation; presents statistics on success rates for various procedures; provides access to patient forums; puts patients in touch with medical specialists who have registered with the site; and covers upcoming patient events and recent research. At the StopAfib.org Booth (#351) in the STS Exhibit Hall, attendees can add their practice to the site’s atrial fibrillation services locator and pick up free educational materials for their patients. The reliability and credibility of StopAfib.org’s information is certified by the Health on the Net Foundation Code of Conduct. StopAfib.org is funded through corporate and private donations, as well as hospitals and doctors who purchase featured listings. The Society welcomes more than two dozen first-time exhibitors to the STS Exhibit Hall:

S

Name

Hawaiian Moon 550 Lancaster General Health 952 Life Technologies 652 MedXPert North America 143-145 Merrill Lynch 1124 Minimally Invasive Devices, Inc.851

New Wave Surgical Corp. Pace Medical, Inc. Preclinical Surgical Services QED Medical Sanofi BioSurgery Skeletal Kinetics

942 616 452 136 109 450

StopAfib.org Stryker Endoscopy Syneo USB Medical

351 1126 653 647

*This list is accurate as of January 9, 2013.

2$./(