A Cut Above: Cardiothoracic insights from EACTS

Are you looking to deepen your understanding of perioperative medication? Join us for the first episode of 2025, where we offer listeners an author insight into the recently published '2024 EACTS Guidelines on perioperative medication in adult cardiac surgery'. With working group members Anders Jeppsson and Emma Hansson, our host Miia L Lehtinen explores the fundamental intricacies considered to ensure these diverse guidelines are current and clinically applicable. Discussions include how the varied specialities of clinical intervention contribute to individual patient needs, including indication specific medication schedules, and the nuanced effects these bring to patients.

We also encourage our listeners to view the recently published perioperative guidelines here: https://academic.oup.com/ejcts/advance-article/doi/10.1093/ejcts/ezae355/7815986?searchresult=1&login=false

In our final episode of the year, our hosts discuss the notorious complexities of the tricuspid valve, joined by specialists Nikos Bonaros and Victoria Delgado. Join Miia L Lehtinen and Can Gollmann-Tepeköylü in their exploration of the increasing relevance of tricuspid valve interventions, analysing the dynamic considerations of diagnostics, imaging, anatomy, cardiology and surgical interventions. Listeners can expect to learn of the fundamental principles of tricuspid disease, as well as how experts navigate nuanced challenges faced in challenging cases.

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen for their late-breaking trials highlights presented at the 38th EACTS Annual Meeting in Lisbon, including:

• (0:39 - 4:31) Long-term mortality after PCI or CABG in patients with diabetes and multivessel coronary artery disease: A SWEDEHEART study by Dr Emma C Hansson
• (4:32 - 8:33) Long-term (>10 years) results of transcatheter Mitral valve-in-valve implantation for degenerated surgical mitral bioprosthesis: Italian MItral VIV registry (MIVIV registry) by Dr Edoardo Zancanaro
• (8:34 - 11:55) Personalized multimodal teleprehabilitation in elective cardiac surgery: results from the Digital Cardiac Counselling multicentered randomized Controlled Trial (ClinicalTrials.gov number, NCT04393636.) by Dr Bart Scheenstra
• (11:55 - 16:15) 5-Year Results on Aortic Remodeling in the Dissected Aorta Repair Through Stent (DARTS) Implantation Trial by Dr Ryaan EL-Andari
• (16:16 - 19:49) Clinical impact of continuous postoperative pericardial flushing on bleeding-related complications after cardiac surgery by Dr Robert Klautz

Following the European Society of Cardiology's (ESC) guidelines publication in collaboration with EACTS, Miia L Lehtinen and Can Gollmann-Tepeköylü host the esteemed Atrial Fibrillation experts, Manuel Castella and Niv Ad. In this month's episode, our guests explore the nuances of how a surgical approach might be used to treat Atrial Fibrillation and why cardiac surgeons are increasingly interested in this complex electrophysiological condition. In light of the developing accepted practices, listeners can expect comparisons between the Maze procedure and non-surgical approaches, as well as an exploration of the endpoints used to determine patient outcomes.

This month's episode is hosted by Miia L Lehtinen and Can Gollmann-Tepeköylü, who are joined by Wouter Oosterlinck, exploring his experience and expertise in the field of robotic cardiac surgery. Although already popular amongst thoracic surgeons, Wouter discusses the creation of his fast growing minimally invasive programme, which has been influential in this emerging field. Listen in for insight into the ever-developing applications of robotic cardiac surgery as well as the challenges being faced, such as nuanced medical device regulations.

In this Episode, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen speak with Karl-Henrik Grinnemo on the provocative subject of scientific misconduct. Listeners can expect to hear a firsthand experience of his notorious high-profile case discrediting the use of dangerous artificial tracheae. Karl describes his team's journey from reporting poor patient outcomes in 2013, to being wrongfully accused of misconduct, and to finally being exonerated in 2016. Tune in to hear this unique story of courage, controversy, and vindication.

Joining our hosts this month are the esteemed 'Ex Vivo Organ Perfusion' experts, Edris Mahtab Leiden University Medical Center, The Netherlands) and Andreas Zuckermann (Medical University of Vienna, Austria). In this episode, Can Gollmann-Tepeköylü and Miia L Lehtinen discuss how these guests have influenced the developing field of heart and lung transplantation. Listeners can gain an understanding of the evolving difficulties associated with transplantation, and how innovative techniques are improving organ preservation.

Listeners are also encouraged to take a look at a related MMCTS article demonstrating relevant techniques.

This month, our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen explore the future of coronary surgery with renowned experts: Sigrid Sandner, Anders Jeppsson and Torsten Doenst. This discussion addresses the evolving utility of CABG following the introduction of PCI, involving evidence-based comparisons between these approaches. Listen for a detailed analysis of how patient risk versus benefit is understood, and the diverse nuances available between clinical outcomes and patient groups.

This month's episode features Sam Heuts, the first author of a recent Editor's Choice article published in ICVTS entitled 'TAVR vs. SAVR – A Bayesian interpretation'. Our hosts, Can Gollmann-Tepeköylü and Miia L Lehtinen, find out more about the analysis of trials comparing transcatheter valve replacement and surgical aortic valve replacement. Including discussions of the fundamental statistics used and the effect upon 5-year all-cause mortality.