The Beat With Joel Dunning Ep. 150: Concerning Trends Seen in Aortic Stenosis Related-Mortality

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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. John Forrest, a cardiologist and Director of both Interventional Cardiology and the Structural Heart Disease Program at Yale Medicine, New Haven, CT, USA, about a paper he authored titled “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis,” published by the Journal of the American College of Cardiology. Chapters 00:00 Intro  02:38 TAVR vs SAVR Context  03:54 CDC WONDER Data, TAVR SAVR  05:37 JANS 1, TAVR vs SAVR 5-Year Outcomes  07:31 JANS 2, Temporary MCS Devices Landscape  09:17 JANS 3, Pulm Resection Post-CABG  10:23 JANS 4, PRE-HIIT Randomized Trial  12:36 Career Center  13:10 Video 1, Redo MVR After VIV TAVR  15:37 Video 2, Repair After Acute Intramural Hematoma  18:01 Video 3, Acute Severe MR Repair  19:36 Dr. Forrest, 6-Year TAVR vs SAVR  44:49 Upcoming Events  45:33 The Lifeline Podcast  They explored other randomized trials involving high-risk and intermediate-risk patients with aortic stenosis and examined the specific goals of this low-risk trial. The discussion then delved into the trial’s results, highlighting that there was no significant difference in the composite endpoint of all-cause mortality or disabling stroke. However, a noteworthy finding was that the transcatheter aortic valve replacement (TAVR) arm experienced a higher reintervention rate compared to surgery, primarily due to an increased incidence of aortic regurgitation. They also addressed factors such as valve dilation, stents, and various reasons for surgical valve failure. Additionally, they examined the similarities between this trial and other partner trials and the future for low-risk patients with aortic stenosis.   Joel also highlights recent JANS articles on the updated five-year outcomes of transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis at low- to intermediate-surgical risk, a United States nationwide analysis on the changing landscape of temporary mechanical circulatory support devices in the new heart allocation system, pulmonary resection post-coronary artery bypass grafting, and a randomized controlled trial on the preoperative exercise to improve fitness in patients undergoing complex surgery for cancer of the lung or esophagus (PRE-HIIT).  In addition, Joel explores redo mitral valve replacement after previous valve-in-valve mitral TAVR, aortic repair after acute intramural hematoma, and repair of acute severe mitral regurgitation due to iatrogenic papillary muscle rupture. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk  2.) The Changing Landscape of Temporary Mechanical Circulatory Support Devices in the New Heart Allocation System—A United States Nationwide Analysis  3.) Pulmonary Resection Post-Coronary Artery Bypass Grafting: Feasible, but Right-Sided Procedures Demand Caution  4.) Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Esophagus (PRE-HIIT): A Randomized Controlled Trial  CTSNet Content Mentioned  1.) Redo Mitral Valve Replacement After Previous Valve-in-Valve Mitral TAVR  2.) Aortic Repair After Acute Intramural Hematoma   3.) Repair of Acute Severe Mitral Regurgitation Due to Iatrogenic Papillary Muscle Rupture  Other Items Mentioned  1.) Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis  2.) The Lifeline: End-Tidal Carbon Dioxide Monitoring in Cardiac Surgical Emergencies  3.) Instructional Video Competition     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 Drs. Mateo Marin-Cuartas, CTSNet JANS Editor and cardiac surgeon at the University Department of Cardiac Surgery at Leipzig Heart Centre University Hospital in Leipzig, SN, Germany; and Samuel Heuts, a cardiothoracic surgeon in the Department of Cardiothoracic Surgery at Maastricht University Medical Center in Maastricht, LI, about a paper they authored titled “Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk,” published in Heart, a journal produced by the British Medical Journal. Chapters 00:00 Intro 01:51 JANS 1, 6-Year Outcomes TAVR vs SAVR 06:45 JANS 2, Evolut THV Postdilation 09:22 Video 2, TAVI in SAVR Explantation 11:10 JANS 3, High Risk Increasing Adoption of DCD 13:17 JANS 4, Lobar Quantitation for Assessment 15:16 Video 1, Narayana Robotic AVR 17:23 Video 3, Extended Resections Podcast 18:30 Dr. Marin-Cuartas & Heuts, TAVR vs SAVR 36:42 Upcoming Events 37:32 Instructional Video Competition 38:55 Career Center They discussed the motivations behind the creation of this paper and provided insights into its Bayesian hierarchical design. Key findings included the five-year all-cause mortality rates and the risk of stroke associated with the procedures. They also referenced other studies with similar findings, such as a recently published paper from the Journal of the American College of Cardiology on the “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis.” Finally, they explored the future of transcatheter aortic valve implantation and surgical aortic valve replacement.   Joel also highlights recent JANS articles on the six-year outcomes after transcatheter vs surgical aortic valve replacement in low-risk patients with aortic stenosis, postdilation of Evolut transcatheter heart valves, insights into current practices in the United States regarding increasing adoption of donation after circulatory death in high-risk heart transplant recipients, and the value of V/Q SPECT/CT lobar quantitation for pre-treatment assessment of lung malignancy.  In addition, Joel explores robotic-assisted aortic valve replacement, TAVI in SAVR explantation, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Maninder Kalkat about extended resections. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis  2.) Postdilation of Evolut Transcatheter Heart Valves: Insights From Bench Testing  3.) Increasing Adoption of Donation After Circulatory Death in High Risk Heart Transplant Recipients: Insights Into Current Practices in the United States  4.) The Value of V/Q SPECT/CT Lobar Quantitation for Pre-Treatment Assessment of Lung Malignancy  CTSNet Content Mentioned  1.) Robotic-Assisted Aortic Valve Replacement   2.) TAVI in SAVR Explantation: A Two-Step Technique for Successful Removal   3.) The Atrium: Extended Resections   Other Items Mentioned  1.) Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk  2.) The Lifeline  3.) Instructional Video Competition     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 first 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 Barbara McLean, a Critical Care Clinical Nurse Specialist at Grady Memorial Hospital in Atlanta, GA, USA. They discuss end-tidal carbon dioxide (EtCO2) monitoring in cardiac surgical emergencies.  Chapters 00:00 Intro 01:30 End-Tidal CO2 Monitoring Overview 09:16 Case 1 13:52 Case 2 19:57 Outlier Cases 21:01 Global Application Mclean began by providing an overview of EtCO2, including bedside interpretation, values for rapid non-invasive cardiopulmonary evaluation during acute decompensation, critical values that warrant intervention, and how to differentiate ventilation and perfusion abnormalities, metabolic acidosis, hypoventilation, hyperventilation, and arterial CO2. They then discuss various case studies outlining postoperative outcomes and the symptoms patients were experiencing emphasizing this important monitoring modality to aid in accurate and timely clinical assessment during complex emergencies.  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!  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. Niv Ad, Editor-in-Chief of the journal Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery and professor of surgery at Johns Hopkins University School of Medicine in Baltimore, Maryland, USA, about the journal. Chapters 00:00 Intro 02:04 JANS 1, Adverse Effects Statin Therapy 06:21 JANS 2, Mortality & Reintervention, Robotic MR 09:15 JANS 3, Balloon vs Self Expanding Transcath Valves 11:41 JANS 4, Transcath Aortic Valve in MV Replacement 13:54 Career Center 14:33 Video 1, Endo Cone Repair w Ebstein Anomaly 16:26 Video 2, Retrograde Cardioplegia Cath Placement 17:19 Video 3, Standardized Strategy, Rheumatic MV Disease 20:31 Dr. Ad, Innovations Journal 31:05 Upcoming Events 31:38 New Podcast, The Lifeline 32:15 Closing They discussed the main topics and procedures covered by Innovations, highlighting its double-blind peer-review process and the special feature section. Additionally, they provided tips for those interested in submitting to the journal.   Joel also highlights recent JANS articles on a meta-analysis of double-blind randomized controlled trials for the assessment of adverse effects attributed to statin therapy in product labels, mortality and reintervention after robotic mitral repair in the United States, the three-year results of the LYTEN trial on balloon- vs self-expanding transcatheter valves for failed small surgical aortic, and the first-in-human study on transcatheter aortic valve-in-mechanical valve replacement.  In addition, Joel explores an endoscopic cone repair in an adult patient with Ebstein anomaly, an alternative cannulation site for the placement of a retrograde cardioplegia catheter, and a standardized surgical management strategy for rheumatic mitral valve disease. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Assessment of Adverse Effects Attributed to Statin Therapy in Product Labels: A Meta-Analysis of Double-Blind Randomised Controlled Trials  2.) Mortality and Reintervention After Robotic Mitral Repair in the United States  3.) Balloon- Versus Self-Expanding Transcatheter Valves for Failed Small Surgical Aortic Bioprostheses: 3-Year Results of the LYTEN Trial  4.) Transcatheter Aortic Valve-in-Mechanical Valve Replacement: A First-in-Human Study   CTSNet Content Mentioned  1.) Endoscopic Cone Repair in an Adult Patient With Ebstein Anomaly   2.) Placement of a Retrograde Cardioplegia Catheter: An Alternative Cannulation Site  3.) Standardized Surgical Management Strategy for Rheumatic Mitral Valve Disease  Other Items Mentioned  1.) Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery  2.) The Lifeline  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 Atrium, host Dr. Alice Copperwheat speaks with Dr. Maninder Kalkat, a consultant cardiothoracic surgeon in the Regional Department of Thoracic Surgery at University Hospital Birmingham, about extended resections.   Chapters 00:00 Intro  01:07 Inspiration & Areas of Interest  03:23 Definition & Classification  09:28 History  10:16 Preop Considerations  19:07 Operating Team Plan  22:23 Fitness for Surgery  23:55 Airway Resections  31:33 Chest Wall Resections  36:17 Reconstructive Material  38:43 Vascular Resections  43:53 Postoperative Care  47:59 Future of Extended Resections  50:15 Summary  50:48 Surgery Training Tips They provided an overview of extended resections, including the definition, indications, and examples, as well as the history of extended resections. They also discussed preoperative considerations and examined airway resections, detailing what it is, indications, and the technical principles of the operation. Additionally, they explored chest wall resections, including the definition, indications, and technical principles. Drs. Copperwheat and Kalkat also examined vascular resections, highlighting what they are, indications, and the technical aspects involved. They also reviewed postoperative considerations, complications, and outcomes. Finally, they shared training tips, future directions, and key principles in extended resections.   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. Puja Khaitan, thoracic consultant at Sheikh Shakhbout Medical City, Abu Dhabi, UAE, and Founder and Congress Chair of the Emirates International Thoracic Surgery Congress, about thoracic surgery in the United Arab Emirates (UAE). Chapters 00:00 Intro 02:35 JANS 1, Therapy & Risk in Idiopathic Pulm Fibrosis 04:18 JANS 2, Sex-Related Treatment Effects 06:03 JANS 3, Endoscopic vs Open RAH in CABG 08:14 JANS 4, Textbook Outcome in MV Surgery 11:16 Career Center 12:08 Video 1, AMDS to FET Conversion 13:13 Video 2, Constrictive Pericarditis & Pericardiectomy 14:42 Video 3, Right Axillary Thoracotomy 16:17 Dr. Khaitan, Thoracic Surgery in the UAE 23:46 Upcoming Events 24:46 Instructional Video Competition They discussed her professional background and training, as well as the differences in cases between the UAE and United States. They also delved into research in the UAE, the state of thoracic hospitals, general surgical residency programs, and the future of fellowships in the country.   Joel also highlights recent JANS articles on a large retrospective propensity-weighted cohort study on antifibrotic therapy and lung cancer risk in patients with idiopathic pulmonary fibrosis, sample size considerations to assess sex-related treatment effects, endoscopic or open radial artery harvest in coronary artery bypass surgery, and results from the Netherlands Heart Registration on mitral valve surgery.  In addition, Joel explores a safe and reproducible redo aortic surgery approach on AMDS to frozen elephant trunk conversion, an approach to constrictive pericarditis and pericardiectomy from diagnosis to definitive surgical, and right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Antifibrotic Therapy and Lung Cancer Risk in Patients With Idiopathic Pulmonary Fibrosis: A Large Retrospective Propensity-Weighted Cohort Study  2.) Sample Size Considerations to Assess Sex-Related Treatment Effects  3.) Endoscopic or Open Radial Artery Harvest in Coronary Artery Bypass Surgery  4.) Textbook Outcome in Mitral Valve Surgery—Results from the Netherlands Heart Registration  CTSNet Content Mentioned  1.) AMDS to Frozen Elephant Trunk Conversion: A Safe and Reproducible Redo Aortic Surgery Approach    2.) From Diagnosis to Definitive Surgical Therapy: An Approach to Constrictive Pericarditis and Pericardiectomy  3.) Right Axillary Thoracotomy: A Minimally Invasive Gateway to Multiple Defects  Other Items Mentioned  1.) Emirates International Thoracic Surgery Congress  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.