The Beat With Joel Dunning Ep. 154: The Heart Sapling Program and Minimally Invasive Surgery in China

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Zhi Lin, Chief Director of Cardiovascular Surgery Division 1 at Xiamen Cardiovascular Hospital of Xiamen University in Xiamen, China, and Dr. Oscar A. Flores Flores, a cardiothoracic surgeon at Hospital Civil de Guadalajara Fray Antonio Alcalde in Guadalajara, Mexico, about The Heart Sapling Visiting Scholar Program. Chapters 00:00 Intro 02:22 AATS, UAE Conference, King Faisal 05:28 JANS 1, LAA Closure vs Therapy AF 09:53 JANS 2, Thrombus-Free LAA Occlusion 11:49 JANS 3, Immunosuppression & Retransplantation 13:06 JANS 4, Biomarkers & Outcomes Isolated CABG 15:18 Video 1, Rheumatic MV Reconstruction 17:02 Video 2, Morgagni Hernia 18:07 Video 3, Robotic Excision Anterior Mediastinal 19:35 Lin Zhi & Oscar Flores, Chinese Fellowship & Surgery 34:25 Upcoming Events 35:13 Closing Dr. Flores discusses what the program entails, sharing his experience as a fellow and the opportunities he gained from it. Dr. Lin then outlines the program’s goals and the various procedures that can be learned at Xiamen Cardiovascular Hospital of Xiamen University, which hosts the program. They also cover how to join the program and the application process. Furthermore, they discuss minimally invasive procedures in China and how this approach is growing in popularity. Joel also highlights recent JANS articles on left atrial appendage closure or medical therapy in atrial fibrillation, long-term thrombus-free left atrial appendage occlusion via magnetofluids, implications of immunosuppression and retransplantation for donor-derived cell-free DNA associated with increased risk of chronic lung allograft dysfunction and mortality, and immunosenescence biomarkers and outcomes in isolated coronary artery bypass grafting.  In addition, Joel explores rheumatic mitral valve reconstruction, tips for the surgical management of a Morgagni hernia, and right robotic excision of anterior mediastinal mass. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation  2. Long-Term Thrombus-Free Left Atrial Appendage Occlusion Via Magnetofluids  3. Donor-Derived Cell-Free DNA Associated With Increased Risk of Chronic Lung Allograft Dysfunction and Mortality: Implications of Immunosuppression and Retransplantation  4. Immunosenescence Biomarkers and Outcomes in Isolated Coronary Artery Bypass Grafting  CTSNet Content Mentioned  1. Rheumatic Mitral Valve Reconstruction  2. Tips for the Surgical Management of a Morgagni Hernia  3. Right Robotic Excision of Anterior Mediastinal Mass  Other Items Mentioned  1. Endoscopic Cone Repair in an Adult Patient With Ebstein Anomaly    2. CTSNet Website Redesign: Important Updates and Transition Details   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 Frank Tamru, author of Power: A Memoir and owner of Frank Tamru Consultants LLC, about aortic valve technology throughout the years. Chapters 00:00 Intro 01:51 New Website Preparation 02:53 AATS 2026 Overview 11:59 Video 1, Robotic Right-Sided MIDCAB 13:08 Video 2, Extra-Anatomic IAA Repair 14:29 Video 3, Double-Decker Procedure 16:38 Video 4, Aortic Disease Awareness 19:53 Video 5, Robotic Culmen in Situs Inversus 21:30 Frank Tamru, Aortic Valve Technology 35:32 Upcoming Events 36:03 Closing They explored Tamru’s professional background and involvement with heart surgeons and cardiovascular leaders. The conversation covered various topics, including heart valves and the evolution of open-heart centers. They also discussed the advancements in aortic valve replacement technologies and the critical role of surgeons as decision-makers in the field. Additionally, Frank shared his experience as the founding publisher of the Asian Cardiovascular and Thoracic Annals.  In addition, Joel explores a robotic-assisted right-sided minimally invasive coronary artery bypass for anomalous origin of the right coronary artery, a transdiaphragmatic aorto-supraceliac extra-anatomic bypass for interrupted aortic arch with collateralizations, double-decker procedure for partial anomalous pulmonary venous connection, robotic-assisted right upper segmentectomy (culmen) in situs inversus totalis, and an interview with Gareth Owens and Dr. Ben Youdelman on Think Aorta and aortic disease awareness.  Before closing, Joel highlights upcoming events in CT surgery.    CTSNet Content Mentioned  1. Robotic-Assisted Right-Sided Minimally Invasive Coronary Artery Bypass for Anomalous Origin of the Right Coronary Artery   2. A Transdiaphragmatic Aorto-Supraceliac Extra-Anatomic Bypass for Interrupted Aortic Arch With Collateralizations   3. Double-Decker Procedure for Partial Anomalous Pulmonary Venous Connection   4. Think Aorta and Aortic Disease Awareness: An Interview With Gareth Owens and Dr. Ben Youdelman   5. Robotic-Assisted Right Upper Segmentectomy (Culmen) in Situs Inversus Totalis   Other Items Mentioned  1. Power: A Memoir  2. Website Maintenance Alert!  3. The Lifeline  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. Zain Khalpey, an assistant attending surgeon at NewYork-Presbyterian/Columbia University Irving Medical Center, NY, USA, adjunct assistant professor of surgery at Columbia University Irving Medical Center, NY, USA, and Chief Medical AI Officer, Chair of Applied Clinical AI, and Director of Applied Translational Artificial Research Institute (ATARI), AZ, USA, about utilizing artificial intelligence (AI) in cardiothoracic surgery. Chapters 00:00 Intro 01:42 Upcoming CTSNet Activities 03:01 Website Transition 03:54 JANS 1, Mech vs Bio AVR in 50–70 YO 08:16 JANS 2, Abnormal Bleeding in OR 10:26 JANS 3, Intraop Assessment RV Function 11:54 JANS 4, Laser Anastomosis System CABG 14:49 Video 1, RAMT AVR Hemiarch Replacement 16:23 Video 2, Big Cyst & Small Incisions 17:33 Video 3, Left VATS Pneumonectomy 19:55 Dr. Khalpey, AI in CT Surgery 30:28 Upcoming Events 31:48 Closing They discuss the importance of ethical AI being and address risk scores. The conversation also covers the application of AI in preoperative, intraoperative, and postoperative settings, as well as predictive algorithms and the benefits of integrating AI within cardiothoracic surgery. Additionally, they emphasize that there will always be a need for surgeons, as AI cannot replace human expertise.   Joel also highlights recent JANS articles on a systematic review and meta-analysis on mechanical vs biological aortic valve replacement in patients aged 50-70 years, an observational study of inter-rater reliability between anesthetists and surgeons on abnormal bleeding in the cardiac operating room, advancing intraoperative assessment of right ventricular function, and the excimer laser assisted non-occlusive anastomosis (ELANA) anastomotic system surgical technique to construct distal anastomoses using a novel device in coronary artery bypass grafting.  In addition, Joel explores a right anterior minithoractomy aortic valve replacement, ascending aorta, and hemiarch repair, thoracoscopic resection of a large mediastinal cyst, and left VATS pneumonectomy in pediatric pulmonary mucoepidermoid carcinoma. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Mechanical Versus Biological Aortic Valve Replacement in Patients Aged 50-70 Years: A Systematic Review and Meta-Analysis  2. Abnormal Bleeding in the Cardiac Operating Room: An Observational Study of Inter-Rater Reliability Between Anesthetists and Surgeons  3. Echocardiographic Correlates of Pressure-Volume-Derived Indices: Advancing Intraoperative Assessment of Right Ventricular Function  4. The Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) Anastomotic System Surgical Technique to Construct Distal Anastomoses Using a Novel Device in Coronary Artery Bypass Grafting  CTSNet Content Mentioned  1. Right Anterior Minithoractomy Aortic Valve Replacement, Ascending Aorta, and Hemiarch Repair   2. When Size Is Not a Limitation: Thoracoscopic Resection of a Large Mediastinal Cyst   3. Left VATS Pneumonectomy in Pediatric Pulmonary Mucoepidermoid Carcinoma   Other Items Mentioned  1. Website Blackout Notice!  2. Career Center   3. 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 Amanda Rea, a nurse practitioner and Lead of Advanced Practice and Clinical Program Manager in the Division of Cardiac Surgery at the University of Maryland St. Joseph Medical Center in Townson, MD, USA, spoke with Kali Dayton, a critical care nurse practitioner, host of the Walking Home From the ICU and Walking You Through the ICU podcasts, and CEO of Dayton ICU Consulting, about early mobility, verticalization, and delirium.   Chapters 00:00 Intro  01:04 Patient Philosophy  02:45 Early Sedation-Delirium Relationship  05:23 RASS Scale, Sedation  07:06 Cardiac ICU Patients  08:35 Lack of Delirium Tracking or Data  10:56 ROI from Good Care & Data  14:44 Preventative Approach  16:16 Convincing Hesitant Adopters  18:59 Patient Case Study  21:19 Cultural Paradigm  24:48 Mobilization  27:07 Verticalization Beds  30:03 Gravity on Patient Health  32:14 Mobility Screening  33:14 Defining Walking  34:47 Mobility Responsibility  36:55 Standardization & Predictability  38:23 Key Points  They discussed what an awake and walking intensive care unit (ICU) is, how early mobility and sedation tie in with delirium, and the history of critical care medicine. The conversation also covered the Richmond Agitation-Sedation Scale (RASS) and deep sedation, as well as risk factors for delirium, outdated sedation practices and mobility management, and the importance of having a high reliability environment. Additionally, they explored the ABCDEF bundle and a case study of a patient experiencing delirium. The episode further addressed verticalization beds, walking pads for verticalization, nurse screening tools, and ambulation.  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 edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Rakesh Arora, Director of Cardiothoracic Critical Care and a professor in the Department of Surgery and Anesthesia at Northwestern Medicine, Chicago, IL, USA. They discuss managing arrest in patients with temporary mechanical circulatory support (tMCS), focusing on a paper Arora authored titled “EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery.”   Chapters  00:00 Intro  01:08 Guidelines Background  02:02 Resuscitation, Monitoring Parameters  07:37 Approach to Patients in Extremis  11:39 Quality Assurance, Internal Data  12:22 End-Tidal  13:17 Bleeding Management  15:33 Arrhythmia, Defibrillation  17:21 Optimizing Tissue Perfusion  18:09 Key Points  20:26 Devices & Flow Patterns  They began by exploring how this paper was developed and how Arora became involved in this project. They discussed the importance of expediting the resuscitation process and examined the recommendations for a tMCS implantation in patients experiencing post-procedural low cardiac output syndrome (LCOS). Key considerations included oxygen saturation levels (SpO2) and point-of-care ultrasound (POCUS), as well as the significance of pulsatility. Additionally, they discussed the interaction between devices and patients and the importance of team training and simulation. They also addressed crucial topics such as coagulation, anticoagulation, and defibrillation. Finally, they examined optimizing tissue perfusion for better patient outcomes.   Every month, The Lifeline features intensive care specialists sharing their expert insights into the rapid and effective management of critically ill cardiac surgical patients. Don’t miss next month’s episode!  Related Resources  EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery  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. Adam Greenbaum, an Associate Professor of Medicine at Emory School of Medicine and Co-director of the Emory Structural Heart and Valve Center, Atlanta, GA, USA, about the groundbreaking percutaneous coronary artery bypass graft procedure he developed called the ventriculo-coronary transcatheter outward navigation and reentry (VECTOR) procedure. Chapters 00:00 Intro 02:46 FDA Device Recall 03:52 JANS 1, CDC WONDER Aortic Stenosis 06:10 JANS 2, Free vs In-Situ RIMA-CABG 08:04 JANS 3, AF Worsens Outcome of MVR 09:52 JANS 4, EXCEL Trial 12:29 New Website 13:43 Video 1, Ross Procedure Technique 16:16 Video 2, Total Arch Replacement 18:38 Video 3, Pleural Sepsis Podcast 20:51 Dr. Greenbaum, VECTOR Procedure 40:34 Upcoming Events 41:18 Career Center 41:43 Closing They delved into the development and rationale behind this innovative technique, which aims to provide a solution for patients with no other options, particularly those with narrow sinuses or low-lying coronaries. Additionally, they discussed other leaflet modification methods and the criteria for patient selection for the VECTOR procedure. The conversation also covered the technical steps involved in the procedure, along with specific cases in which it has been utilized, as well as the challenges faced and troubleshooting done by the surgeons. Finally, they explored the future of this procedure.   Joel also highlights recent JANS articles on concerning trends seen in aortic stenosis-related mortality, a meta-analysis on free vs in-situ right internal mammary artery as a conduit in coronary artery bypass surgery, if atrial fibrillation worsens outcome of mitral valve repair for degenerative mitral regurgitation, and the EXCEL trial on spontaneous myocardial infarction after left main revascularization.  In addition, Joel explores the Ross procedure with annular stabilization, interposition graft, and loose-jacket technique, total arch replacement with a novel dual stent device, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Professor Eric Lim about pleural sepsis. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER  2. Free vs In-Situ Right Internal Mammary Artery as a Conduit in Coronary Artery Bypass Surgery: A Meta-Analysis  3. Atrial Fibrillation Worsens Outcome of Mitral Valve Repair for Degenerative Mitral Regurgitation: Long-Term Follow-Up of 959 Patients  4. Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial  CTSNet Content Mentioned  1. Ross Procedure With Annular Stabilization, Interposition Graft, and Loose-Jacket Technique   2. Total Arch Replacement With a Novel Dual Stent Device   3. The Atrium: Pleural Sepsis   Other Items Mentioned  1. Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure  2. Website Blackout Notice!  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. Sameer Hirji, an associate surgeon at Brigham and Women's Hospital in Boston, MA, USA, about a paper he presented on at the 62nd Society of Thoracic Surgeons Annual Meeting titled “Concerning Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER.” Chapters 00:00 Intro  02:38 JANS 1, Female CT Surgeons NYT Article  04:38 JANS 2, Biopros vs Mech SAVR >65 YO  07:32 JANS 3, Fissure Last Tech, Randomized Trial  09:58 JANS 4, Ozaki Procedure, Perf & Durability  12:46 Video 1, MI Left Atrial Myxoma Resection  14:43 Video 2, Conduction System-Sparing Modified AVR  16:42 Video 3, RCAA w Coronary SF  18:55 Dr. Hirji, CDC WONDER Aortic Stenosis  31:40 Upcoming Events  32:11 Closing They discussed the study itself, including its overall results, as well as the demographic factors analyzed—such as race, gender, and location—and the results related to these demographics. They also addressed the limitations of the data used and explored possible reasons for the observed results, such as intervention strategies, underdiagnosis, and the prevalence of asymptomatic patients. The conversation further emphasized the importance of patient selection and the heart team.  Joel also highlights recent JANS articles on female cardiothoracic surgeons, unlocking the male fortress, bioprosthetic versus mechanical surgical aortic valve replacement in patients ≥65 years of age, results from a prospective randomized controlled trial on if the fissure last technique really reduces postoperative air leak after lung resection, and mid-term valve performance and durability of the Ozaki procedure in patients on chronic dialysis.  In addition, Joel explores a minimally invasive left atrial myxoma resection, safety and efficacy of a cardiac conduction system-sparing modified aortic valve replacement, and a surgical approach to right coronary artery aneurysm with coronary sinus fistula. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Female Cardiothoracic Surgeons, Unlocking the Male Fortress  2. Bioprosthetic Versus Mechanical Surgical Aortic Valve Replacement in Patients ≥65 Years of Age  3. Does the Fissure Last Technique Really Reduce Postoperative Airleak After Lung Resection? Results From a Prospective Randomized Controlled Trial   4. Mid-Term Valve Performance and Durability of the Ozaki Procedure in Patients on Chronic Dialysis  CTSNet Content Mentioned  1. Minimally Invasive Left Atrial Myxoma Resection   2. Safety and Efficacy of a Cardiac Conduction System-Sparing Modified Aortic Valve Replacement   3. Surgical Approach to Right Coronary Artery Aneurysm With Coronary Sinus Fistula   Other Items Mentioned  1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER   2. Career Center   3. 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 Atrium, host Dr. Alice Copperwheat speaks with Professor Eric Lim, Professor of Thoracic Surgery at Imperial College London and Consultant Thoracic Surgeon at the Royal Brompton Hospital in London, UK, about pleural sepsis.   Chapters  00:00 Intro  00:30 Dr. Lim Background  01:26 Why CT Surgery & Clinical Research?  05:09 Definition & Overview  07:50 Causes  09:29 Clinical Presentations & Investigations  16:03 Management, RAPID Score  19:49 Medical Management  22:15 Chest Tube Management (ICD)  25:12 IF, Medical Decortication  25:48 Surgical Management  29:30 History  30:34 Debridement & Decortication, Approach  34:30 Patient Positioning  35:18 Thoracotomy  38:43 VATS  39:37 Technical Steps  43:18 Postoperative Management  49:37 Complications  50:58 Summarizing Points  51:50 Surgery Training Advice  They provide an overview of pleural sepsis, highlighting its three stages: the exudative stage, fibrinopurulent stage, and organizing stage. The discussion covers its history and causes, including complications from pneumonia. They also examine symptoms, failure to progress, and imaging techniques such as ultrasound. Additionally, they delve into pleural fluid analysis, the RAPID score, and management strategies, including medical interventions, chest tube drainage, and intrapleural fibrinolytics. Various surgical management strategies are discussed as well, including thoracotomy, video-assisted thoracoscopic surgery (VATS), and robotic approaches. Finally, they address chest tube management, respiratory physiotherapy, acute complications, and long-term complications.    The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Keep an eye out 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. Shanda Blackmon, a thoracic surgeon and Professor of Surgery, as well as the Director of the Lung Institute at Baylor College of Medicine, Houston, TX, USA, about an article from The New York Times in which she was featured, titled “Female CT Surgeons, Unlocking the Male Fortress.” Chapters 00:00 Intro  01:35 JANS 1, Fractured Sternal Wires Post-Surgery  05:21 JANS 2, ERAS Protocols in Spain, Consensus Study  07:00 JANS 3, Preserving Native MVs in VSD & MR Patients  09:53 JANS 4, Sternal Closure After Norwood  12:15 Video 1, LIMA Harvest, Robotic Harmonic Scalpel  13:55 Video 2, Butterfly Resection for MV Leaflets  15:26 Video 3, Bidirectional Glenn via Axill Thorac  17:18 Dr. Blackmon, Women in CT Surgery  33:17 Upcoming Events  35:13 Closing  They discussed her experience working with The New York Times and the goal of the article. Key highlights included the pay disparity, with women cardiothoracic surgeons receiving lower pay than their male counterparts, as evidenced by the Society of Thoracic Surgeons (STS) compensation survey. Additionally, they addressed the rewarding aspects of cardiothoracic surgery, the challenges surgeons face, and the initiatives that women cardiothoracic surgeons are starting to tackle, such as the pay equity and leadership opportunities.   Joel also highlights recent JANS articles on a cross-sectional study examining wire configurations, sternal locations, and breakage sites for fractured sternal wires post-coronary surgery, a Delphi consensus study on the standardized recommendations for the implementation of enhanced recovery protocols in thoracic surgery in Spain, surgical strategy for preserving native mitral valves in infants with ventricular septal defects and mitral regurgitation, and routine primary sternal closure after the Norwood procedure.  In addition, Joel explores robotic-assisted left internal mammary harvest with the robotic harmonic scalpel, butterfly resection for prolapsed posterior mitral valve leaflets, and minimally invasive bidirectional Glenn via vertical right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Fractured Sternal Wires Post-Coronary Surgery: A Cross-Sectional Study Examining Wire Configurations, Sternal Locations, and Breakage Sites  2.) Standardized Recommendations for the Implementation of Enhanced Recovery Protocols in Thoracic Surgery in Spain: A Delphi Consensus Study  3.) Surgical Strategy for Preserving Native Mitral Valves in Infants With Ventricular Septal Defects and Mitral Regurgitation  4.) Routine Primary Sternal Closure After the Norwood Procedure  CTSNet Content Mentioned  1.) Robotic-Assisted Left Internal Mammary Harvest With the Robotic Harmonic Scalpel​   2.) Butterfly Resection for Prolapsed Posterior Mitral Valve Leaflets   3.) Pushing Boundaries in Pediatric Cardiac Surgery: Minimally Invasive Bidirectional Glenn Via Vertical Right Axillary Thoracotomy   Other Items Mentioned  1.) Female Cardiothoracic Surgeons, Unlocking the Male Fortress  2.) Instructional Video Competition     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.

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 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 Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, about preoperative optimization of cardiac patients.   Chapters 00:00 Intro 01:27 Vulnerable Patients, Identifying Risk 04:24 Assessing Patients, Biological Prep 09:57 Psychological & Cognitive Prep 12:09 Time Between Discharge & Follow-Up 15:40 Anemic Patients, Iron Studies 20:12 Nutrition Screening & Malnutrition 25:30 Future Optimization Topics They discussed the importance of identifying risks, conducting thorough assessments before the operation, and preoperative education. They also emphasized psychological and cognitive preparation, as well as the time frame between discharge and follow-up. Additionally, they addressed issues related to iron deficiency without anemia, anemic patients, and iron studies. Furthermore, they highlighted the importance of nutrition screening and addressing malnutrition as essential aspects of preoperative care.    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.