The Beat With Joel Dunning Ep. 137: From Patient to Surgeon

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses how to get involved with Pace4Life, a charity he supports that provides reconditioned pacemakers to Ghana. He also previews upcoming podcast episodes and guests, including discussions on the Ross procedure guidelines and more interviews related to the JCOG0802 trial.  Chapters 00:00 Intro  02:31 JANS 1, Ethiopian Surgeon  07:08 JANS 2, RCA to Cor Sinus Fistula  09:30 JANS 3, Y-Incision Hemodynamics  12:38 JANS 4, Endograft Infection  15:06 Instructional Video Competition  16:01 Career Center  16:40 Video 1, Complications Podcast  19:34 Video 2, Totally Endoscopic Case  21:23 Video 3, Post-Infarction VSD Repair  23:15 Closing, Upcoming Events  Joel also highlights recent JANS articles on a heart surgeon who saved another surgeon’s life as a teen and how they now perform surgeries together, right coronary artery to coronary sinus fistula, a surgical aortic valve replacement with Y-incision aortic annular enlargement provided better hemodynamics than transcatheter aortic valve replacement, and management of endograft infection after thoracic endovascular aortic repair.  In addition, Joel explores totally endoscopic mitral and tricuspid valve repair, ASD with APVR repair, and LAA occlusion, as well as the repair of a post-infarction VSD, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Samer Nashef about complications in cardiothoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.)  A Heart Surgeon Saved His Life as a Teen. Now They Perform Surgeries Together.  2.) Right Coronary Artery to Coronary Sinus Fistula: A Rare Problem With an Elegant Solution  3.) Surgical Aortic Valve Replacement With Y-incision Aortic Annular Enlargement Provided Better Hemodynamics Than Transcatheter Aortic Valve Replacement  4.) Management of Endograft Infection After Thoracic Endovascular Aortic Repair  CTSNet Content Mentioned  1.) The Atrium: Complications  2.) Totally Endoscopic Mitral and Tricuspid Valve Repair, ASD With APVR Repair, and LAA Occlusion  3.) Repair of a Post-Infarction VSD  Other Items Mentioned  1.) Pace4Life   2.) MICS and Robotic-Assisted Surgery: A Roundtable Discussion With the Endoscopic Cardiac Surgeons Club  3.) Instructional Video Competition  4.) 2025 CTSNet Recruitment Guide   5.) Career Center   6.) 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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Nasser Altorki, thoracic surgeon at Weill Cornell Medicine in New York, and thoracic surgeon and CTSNet Senior Editor Leanne Ashrafian about the 10-year results from the JCOG0802 trial. Chapters 00:00 Intro 02:56 JANS 1, Re-Repair vs Replacement 05:07 JANS 2, Mini Mitral Multicentre RCT 07:01 JANS 3, PERSEVERE Study 08:54 JANS 4, Parietal Pleurectomy vs Pleural Abrasion 11:38 Career Center 12:33 Video 1, Endoscopic Post-Infarction VSD Repair 14:11 Video 2, 3D Dor Procedure & MVR Huge LV Aneurysm 15:19 Video 3, Non-Cardioplegic Myo Protection Robotic 17:16 Nasser Altorki Interview, JCOG 45:16 Upcoming Events 47:20 Closing They discuss key aspects of the trial, including the noninferiority primary endpoint. Dr. Altorki shares his overall thoughts on the trial, and they also examine topics such as pulmonary function, lobar vs sublobar resection, and segmentectomy vs wedge resection. Additionally, they explore secondary primary lung cancer, the importance of thoracic surgeons presenting data to patients, and best practices for segmentectomy to ensure patient safety. They also examine good wedge resection vs bad wedge resection, planning for segmentectomy, and the future of lobectomy and segmentectomy.   Joel also highlights recent JANS articles on the outcomes of re-repair vs replacement after failed primary mitral regurgitation repair, minimally invasive thoracoscopically-guided right minithoracotomy vs conventional sternotomy for mitral valve repair, one-year results of novel aortic arch hybrid prosthesis for repair of acute DeBakey Type I dissection with malperfusion, and a meta-analysis of efficacy and safety of parietal pleurectomy vs pleural abrasion in treating spontaneous pneumothorax.  In addition, Joel explores endoscopic post-infarction VSD repair, 3D video-assisted endoscopic Dor procedure and MVR for post-infarction huge LV aneurysm, and non-cardioplegic myocardial protection for robotic mitral surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Outcomes of Re-Repair Versus Replacement After Failed Primary Mitral Regurgitation Repair: STS Adult Cardiac Surgery Database Analysis  2.) Minimally Invasive Thoracoscopically-Guided Right Minithoracotomy Versus Conventional Sternotomy for Mitral Valve Repair: The UK Mini Mitral Multicentre RCT  3.) One-Year Results of Novel Aortic Arch Hybrid Prosthesis for Repair of Acute DeBakey Type I Dissection With Malperfusion: PERSEVERE Study  4.) A Meta-Analysis of Efficacy and Safety of Parietal Pleurectomy Versus Pleural Abrasion in Treating Spontaneous Pneumothorax  CTSNet Content Mentioned  1.) Endoscopic Post-Infarction VSD Repair  2.) Pushing Surgical Boundaries: 3D Video-Assisted Endoscopic Dor Procedure and MVR for Post-Infarction Huge LV Aneurysm  3.) Non-Cardioplegic Myocardial Protection for Robotic Mitral Surgery  Other Items Mentioned  1.) Instructional Video Competition  2.) 2025 Endoscopic Cardiac Surgeons Club Video Competition  3.) 2025 CTSNet Recruitment Guide   4.) Career Center   5.) 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.

In this episode of The Cardiac Recovery Room, moderator Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in North Carolina, USA, spoke with Alexander Gregory, a cardiovascular anesthesiologist and assistant professor in the Department of Anesthesiology, Perioperative and Pain Medicine, and the Libin Cardiovascular Institute at the Cumming School of Medicine, University of Calgary, Canada, and Dr. V. Seenu Reddy, a cardiothoracic surgeon at HCA’s TriStar Cardiovascular Surgery in Nashville, Tennesee, USA, about the 10 things they hate about Enhanced Recovery After Surgery (ERAS).   Chapters 00:00 Introduction  01:38 Overcomplication  05:29 Simple Barriers  08:54 Change Obstructionists  10:52 Status Quo  12:49 Messing with Protocol  14:21 Giving Up on Protocol  16:48 Need for Patient-Reported Outcomes  19:18 Struggle Into Cardiac Subspecialty  21:30 Takeaways  The goal of this discussion was to identify specific challenges and propose potential solutions. They emphasize the importance of having two leaders—a champion and a co-champion—to effectively guide ERAS initiatives. Additionally, they discuss creating standing orders and issues related to microbarriers and resistance to change. They also highlight the need for customization of protocols, acknowledging the differences between surgeons who utilize ERAS and those who do not, as well as the tendency to maintain the status quo. Patient perspectives are another key focus, with a call to implement changes that enhance tracking and monitoring of patient outcomes. Furthermore, they explore the role of technology designed for patients, as well as applying ERAS principles to surgeries that fall “outside of the box.”   The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  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.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Samer Nashef, a consultant cardiac surgeon at Papworth Hospital in Cambridge, about complications in cardiothoracic surgery. Chapters 00:00 Intro 00:34 Dr. Nashef Background 04:06 Results Monitoring 08:55 Common Complications 14:40 Mentality 19:18 Identifying Room for Improvement 21:25 Pattern of Response 22:47 Long-Term Complications 26:08 Mortality/Morbidity Meetings 28:28 Perfection, Balance 30:33 Coping w Major Complications 35:06 Learning Your Psyche 35:51 Trainee-Consultant Responsibility 37:51 Resilience 39:19 Key Takeaways 41:07 Training Advice They delve into early complications that trainees experience, approaches to managing acute complications, and nonacute and postoperative complications. They also highlight learning from complications, coping strategies, and the emotional impact involved in cardiothoracic surgery. Additionally, they discuss the concepts of growth, resilience, and strength in cardiothoracic surgery. Furthermore, Dr. Nashef provides advice to trainees currently navigating difficult cases, and general guidance for those in training.   The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Be sure to watch for next month’s episode!   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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Laurens Ceulemans, thoracic surgeon at the University Hospitals Leuven in Belgium, about lung volume reduction. Chapters 00:00 Intro 02:41 Right to Repair, Robotics Re-Use 04:53 REPEAT Trial 06:30 JANS 1, PCI After CABG Randomized Trial 08:01 JANS 2, No-Touch vs Conventional Saph Veins 11:04 JANS 3, Sir Terence English & Keyvyn Mohagissi 12:09 CTSNet Recruitment Guide 12:54 Video 1, JCOG0802 Bombshell & Webinar 16:33 Video 2, Endoscopic Cardiac Foreign Body Extraction 17:56 Video 3, First Europe Robotic AVR Perceval Valve 18:42 Video 4, Bilateral VATS Sympathectomy 20:10 Laurens Ceulemans Interview 34:15 Upcoming Events 34:48 Closing They highlighted key takeaways from the procedure and addressed the issue of air leaks. They also discussed bilateral lung volume reduction and emphasized the importance of a team approach. Additionally, they focused on why surgeons should be selecting the healthiest patients for this operation rather than the most critically ill, as well as the future of lung volume reduction.    Joel also highlights recent JANS articles on a multicenter, randomized trial on the PCI of native coronary artery vs saphenous vein graft after prior bypass surgery, a meta-analysis of randomized trials on the outcomes of no-touch vs conventionally harvested saphenous veins for coronary artery bypass surgery, and the death of transplant pioneer Sir Terence English at 93.  In addition, Joel explores bombshell 10-year JCOG0802 results showing lobectomy is superior to segmentectomy for lung cancer, endoscopic extraction of a cardiac foreign body, the first robotic aortic valve replacement in Europe using a Perceval valve, and bilateral VATS sympathectomy for ventricular tachycardia electrical storm. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) PCI of Native Coronary Artery vs Saphenous Vein Graft After Prior Bypass Surgery: A Multicenter, Randomized Trial  2.) Outcomes of No-Touch Vs Conventionally Harvested Saphenous Veins for Coronary Artery Bypass Surgery: A Meta-Analysis of Randomized Trials  3.) Transplant Pioneer Sir Terence English Dies at 93  CTSNet Content Mentioned  1.) Bombshell 10-Year JCOG0802 Results Show Lobectomy Is Superior to Segmentectomy for Lung Cancer  2.) Military Heart Trauma: Endoscopic Extraction of a Cardiac Foreign Body  3.) First Robotic Aortic Valve Replacement in Europe Using a Perceval Valve   4.) Bilateral VATS Sympathectomy for Ventricular Tachycardia Electrical Storm  Other Items Mentioned  1.) Restore Robotics   2.) 2025 Endoscopic Cardiac Surgeons Club Video Competition  3.) 2025 CTSNet Recruitment Guide   4.) Career Center   5.) 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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Christopher McGregor, professor in the Department of Surgery at the University of Minnesota Twin Cities, about the current state of cardiac and kidney xenotransplantation. Chapters 00:00 Intro  03:10 Sir Terence English  08:00 JANS 1, Cardiac Xenotransplantation  09:13 JANS 2, Coffee Consumption on AF  11:06 JANS 3, Environmental Factors Acute AD  12:49 JANS 4, PROTHOR Trial  15:15 Video 1, Combined AV & Coronary via LAM  17:08 Video 2, ARCA w MV Prolapse  19:32 Video 3, Redo Elephant Trunk After EAR  22:06 Chris McGregor Interview  48:23 Upcoming Events  50:15 Closing  They discussed the three approved trials for xenotransplantation in 2025, the preclinical efficacy assessment, and the various challenges of xenotransplantation. Additionally, they explored the history of orthotopic transplants, heart failure, and antibody-mediated rejection. They also examined the future of xenotransplantation and the anatomy of pig hearts vs human hearts.   Joel also highlights recent JANS articles on the status of cardiac xenotransplantation including preclinical models, the DECAF randomized clinical trial on if caffeinated coffee consumption or abstinence reduces atrial fibrillation; the impact of environmental factors on acute aortic dissection; and a multicenter, international, randomized, controlled, phase 3 trial on the effects of intraoperative higher vs lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR).   In addition, Joel explores combined aortic valve and coronary surgery via left anterior minithoracotomy, management of anomalous right coronary artery in a patient with mitral valve prolapse, and redo frozen elephant trunk after endovascular arch repair. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) 2025: Status of Cardiac Xenotransplantation Including Preclinical Models  2.) Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial  3.) Weathering the Aorta: The Impact of Environmental Factors on Acute Aortic Dissection   4.) Effects of Intraoperative Higher Versus Lower Positive End-Expiratory Pressure During One-Lung Ventilation for Thoracic Surgery on Postoperative Pulmonary Complications (PROTHOR): A Multicentre, International, Randomised, Controlled, Phase 3 Trial  CTSNet Content Mentioned  1.) Combined Aortic Valve and Coronary Surgery via Left Anterior Minithoracotomy: Clinical Experience With Sutureless Bioprosthesis  2.) Management of Anomalous Right Coronary Artery in a Patient With Mitral Valve Prolapse  3.) Redo Frozen Elephant Trunk After Endovascular Arch Repair  Other Items Mentioned  1.) Resident Video Competition  2.) 2025 CTSNet Recruitment Guide   3.) Career Center   4.) 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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Evgenij Potapov, a consultant senior surgeon and co-chairman of the mechanical circulatory support program in the Department of Thoracic and Cardiovascular Surgery at the German Heart Center in Berlin, about the guidelines on temporary mechanical circulatory support (tCMS) in adult cardiac surgery. Chapters 00:00 Intro 01:56 Segmentectomy vs Lobectomy News 18:51 JANS 1, CT Residents Emergency Surgery 20:56 JANS 2, Interventional vs Surgical 22:49 JANS 3, Robotic Vascular Surgery 24:32 JANS 4, Surgery vs Surveillance 26:30 Video 1, Branch-First Arch Replacement 28:19 Video 2, Manougian Technique Double Patch 30:14 Video 3, Bentall Surgery via RAM 31:23 Evgenij Potapov Interview 53:55 Upcoming Events They discussed the key elements of the guidelines, active unloading, and current trends and outcomes in tMCS. Additionally, they addressed protected cardiac surgery for high-risk patients, cardiac arrest, and the impact of recent changes to the donor heart allocation system on tMCS. Dr. Potapov also shared valuable insights on hints and tips for tMCS, anticoagulation management, and the future of tMCS. Furthermore, Joel elaborated on recent discussions regarding lobectomy vs segmentectomy in a detailed analysis.  Joel also highlights recent JANS articles on a 10-year propensity-matched analysis on if we can safely train cardiothoracic surgical residents to perform emergency surgery, investigating the personality of interventional and surgical cardiovascular specialists, a clinical perspective on robotic-assisted vascular surgery, and a quality-of-life analysis of patients with moderately dilated aortic root or ascending aorta.  In addition, Joel explores branch-first arch replacement, revisiting the Manougian technique with double-patch, and Bentall surgery via right anterior minithoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Can We Safely Train Cardiothoracic Surgical Residents to Perform Emergency Surgery? A 10-Year Propensity-Matched Analysis   2.) Cut From the Same Cloth? Investigating the Personality of Interventional and Surgical Cardiovascular Specialists  3.) Robotic-Assisted Vascular Surgery: A Clinical Perspective  4.) Surgery Versus Surveillance: A Quality-of-Life Analysis of Patients With Moderately Dilated Aortic Root or Ascending Aorta  CTSNet Content Mentioned  1.) Branch-First Arch Replacement: How to Do It   2.) Revisiting the Manougian Technique With Double-Patch   3.) Bentall Surgery via Right Anterior Minithoracotomy   Other Items Mentioned  1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery   2.) The Cardiac Recovery Room  3.) Resident Video Competition  4.) 2025 CTSNet Recruitment Guide     5.) Career Center   6.) 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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Randas Batista, cardiac surgeon and founder of Vilela Batista Heart Foundation, about the surgical treatment of Eisenmenger syndrome. Chapters 00:00 Intro 02:51 JANS 1, DAMSUN-HF Study 05:41 JANS 2, TAVR vs SAVR Guidelines 07:45 JANS 3, Myocardial Infarction After CABG 10:31 JANS 4, VAD Bridge-to-Transplant 12:27 New Recruitment Guide 13:54 Video 1, Anomalous Right Coronary Artery 15:27 Video 2, Beating Heart Transplant OCS 17:51 Video 3, Aortic Dissection Podcast w Marc Moon 19:26 Randas Batista Interview 37:38 Upcoming Events They explored what Eisenmenger syndrome is and outlined the most common causes of the condition. They also delved into the history of this syndrome, highlighting the significant contributions of Viktor Eisenmenger and Paul H. Wood. Furthermore, they discussed the impact of this syndrome on lung function and extracting oxygen within the pulmonary artery. Dr. Batista shared valuable technical tips for performing the surgical procedure as well as solutions for managing this syndrome.   Joel also highlights recent JANS articles on the DAMSUN-HF study on AI-enabled digital auscultation for detecting heart failure with reduced ejection fraction in Sub-Saharan Africa, transcatheter or surgical aortic-valve replacement in low-risk patients at seven years, current clinical practices and future perspectives on periprocedural myocardial infarction after coronary artery bypass grafting, and an analysis of UNOS.  In addition, Joel explores anomalous right coronary artery, beating heart transplantation using the Organ Care "Heart-in-a-Box" System (OCS), and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Marc Moon about aortic dissection. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) AI-Enabled Digital Auscultation for Detecting Heart Failure With Reduced Ejection Fraction in Sub-Saharan Africa: The DAMSUN-HF Study  2.) Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years  3.) Periprocedural Myocardial Infarction After Coronary Artery Bypass Grafting: Current Clinical Practices and Future Perspectives  4.) Analysis of UNOS: Ventricular Assist Device as Bridge-to-Transplant in Paediatric Patients With Congenital Heart Disease  CTSNet Content Mentioned  1.) Anomalous Right Coronary Artery  2.) Beating Heart Transplantation Using the Organ Care "Heart-in-a-Box" System (OCS)  3.) The Atrium: Aortic Dissection  Other Items Mentioned  1.) The Cardiac Recovery Room  2.) Resident Video Competition  3.) 2025 CTSNet Recruitment Guide   4.) Career Center   5.) 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.

In this inaugural episode of CTSNet’s new podcast, The Cardiac Recovery Room, moderator Dr. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society, spoke with Drs. Rakesh Arora, Director of Perioperative and Cardiac Critical Care and Research Director in the Division of Cardiac Surgery at University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio, USA, and Michael C. Grant, Associate Professor at Johns Hopkins University School of Medicine in the Department of Anesthesiology and Critical Care Medicine, about cardiac surgery myths.   Chapters 00:54 Are There Myths? 02:49 Applying Non-Cardiac Surgery Data 04:52 Reducing NPO, Diabetes Carb-Load 08:17 Postop, Crystalloid Volume 10:31 Bicarb Usage 12:10 Hematocrit & Hemoglobin 14:53 Bronchoscopy for Early Extubation 18:54 Routine X-Rays 22:19 Lactates 24:48 Sleeplessness & Delirium 31:14 Final Thoughts They discuss important topics such as the rationale for reducing nothing by mouth (NPO) guidelines, NPO after midnight, and the implications of carbohydrate loading for patients with type 1 diabetes. They examine critical issues of volume resuscitation, comparing the use of albumin vs crystalloids, as well as bicarb usage. Additionally, they evaluate hematocrit and hemoglobin levels, questioning whether specific thresholds should be established. The conversation also covers bronchoscopy for early extubation, inline suctioning for a bronchoalveolar lavage (BAL), and the necessity of daily chest x-rays following cardiac surgery. Furthermore, they address topics such as lactates, sleep aids, and delirium.  The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Zara Shirazi, a congenital cardiac surgery post-fellow at the National Institute of Cardiovascular Diseases, about advancing pediatric cardiac surgery in Pakistan using what she learned from her fellowship in Austria. Chapters 00:00 Intro 02:28 Vince TAVR Roundtables 03:05 Foreign Body, Case of the Month 03:49 JANS 1, Temporary MCS Guidelines 13:50 JANS 2, Parenting as a CT Surgeon 16:20 JANS 3, Utilization of Long Distance Donors 18:20 JANS 5, Multi-A Grafting in Redo CABG 20:58 Career Center 21:20 Video 1, Pulm & Tricuspid Endocarditis 22:35 Video 2, Valvular Heart Disease Guidelines 27:05 Video 3, Thoraflex Hybrid Graft Insertion 28:16 Zara Shirazi Interview 39:30 Upcoming Events 42:42 Closing They explored the advantages of working in a hospital in Pakistan compared to Austria, as well as the different techniques and operations, such as extracorporeal membrane oxygenation (ECMO). Dr. Shirazi also shared her experiences as a fellow in Austria and the valuable insights she gained from that experience. Additionally, she discussed her vision for the growth of her unit over the next five years and provided an overview of what a typical surgical week looks like in Pakistan.   Joel also highlights recent JANS articles on the EACTS/STS/AATS guidelines on temporary mechanical circulatory support in adult cardiac surgery, the unique challenges and positive impacts on children raised by cardiothoracic surgeon mothers, evolving changes in center-level utilization of longer distance donors in heart transplantation, and multiarterial grafting in redo coronary artery bypass grafting.  In addition, Joel explores pulmonary and tricuspid valve endocarditis, an interview with Drs. Borger and Marin-Cuartas on the guidelines for the management of valvular heart disease, and Thoraflex Hybrid graft insertion in a patient with Marfan syndrome. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery   2.) Parenting From the OR: The Unique Challenges and Positive Impacts on Children Raised by Cardiothoracic Surgeon Mothers  3.) Evolving Changes in Centre-Level Utilization of Longer Distance Donors in Heart Transplantation  4.) Multiarterial Grafting in Redo Coronary Artery Bypass Grafting: Type of Arterial Conduit and Patient Sex Determine Benefit  CTSNet Content Mentioned  1.) Pulmonary and Tricuspid Valve Endocarditis: A Late Sequelae of Unrepaired Double Chambered Right Ventricle in an Adult  2.) Guidelines for the Management of Valvular Heart Disease: An Interview With Drs. Borger and Marin-Cuartas  3.) Thoraflex Hybrid Graft Insertion in a Patient With Marfan Syndrome  Other Items Mentioned  1.) Adapting Global Innovations to Local Realities: Advancing Pediatric Cardiac Surgery in Pakistan—Lessons From Austria  2.) Roundtable: Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani   3.) Case of the Month: The Case of a Foreign Body  4.) Resident Video Competition  5.) The Cardiac Recovery Room  6.) Career Center   7.) 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.