Experts from around the world convened in Chicago in May for the annual meeting of the American Association of Thoracic Surgeons (AATS), a four-day event that brought together cardiothoracic surgeons, researchers, and other healthcare professionals to discuss groundbreaking clinical research, advanced surgical techniques, and the future of heart and lung care.
Emile Bacha, M.D., surgeon-in-chief at NewYork-Presbyterian and Columbia, served as 106th AATS president, and other NewYork-Presbyterian physicians who served as AATS program co-chairs included:
- Arnar Geirsson, M.D., chief of cardiac surgery at NewYork-Presbyterian and Columbia and adult cardiac program co-chair;
- Isaac George, M.D., co-director of the Structural Heart and Valve Center at NewYork-Presbyterian and Columbia and structural heart co-chair;
- Tamim Nazif, M.D., interventional cardiologist at NewYork-Presbyterian and Columbia and director of clinical research for Columbia Interventional Cardiovascular Care and structural heart co-chair;
- Joshua Sonett, M.D., chief of general thoracic surgery at NewYork-Presbyterian and Columbia and thoracic co-chair.
A highlight of the meeting was the presidential address given by Dr. Bacha, who explored themes of leadership, education, research and innovation in cardiothoracic surgery through the lens of his personal and professional journey. “I believe our stories are inseparable from who we are as surgeons,” he said.
Dr. Bacha served as 106th AATS president.
AATS Presidential Address: Leadership as Destiny
Dr. Bacha credited many of his skills as a surgeon and leader to growing up during the Lebanese Civil War and his subsequent experiences immigrating to Germany and the U.S. for his medical training. “You learn composure under pressure. You stop sweating the small things. You develop a profound and early understanding of the fragility and preciousness of human life,” he said. “And perhaps most importantly, you develop the ability to adapt quickly to unpredictable circumstances, and you learn that leading, in a proper way, is also a way to make the world a better place.”
When it comes to surgical leadership, Dr. Bacha cited authenticity, humility, empathy, and courage as key characteristics to strive for. “You cannot sustain the trust of a team, of patients, or of families on performance alone,” he said. “You have to mean it. You have to be the same person in the OR, in the hallway, and at three in the morning when everything is going wrong. And in this specialty, three in the morning comes for all of us.”
He also pointed to innovation as the lifeblood of cardiothoracic surgery, and warned that focusing too much on short-term metrics could lead to a level of risk aversion that stifles advancement. “Leadership and innovation are organically inseparable in this specialty. Without leadership, we fail. Without innovation, we die — and more importantly, our patients suffer,” he said. “Innovation is a specialty’s obligation to the future. [Technical] mastery is its obligation to the patient in front of you today.”
Dr. Bacha discusses the importance of authenticity in cardiothoracic surgical leadership during his presidential address.
Dr. Bacha closed his address by looking toward the future, including the integration of artificial intelligence into cardiothoracic surgery. He acknowledged that the role of the surgeon will shift and that physicians will need fluency and comfort with AI-assisted decision support. However, he emphasized that there should be no “cognitive surrender” to these new systems.
“We are the ones that know best what is needed for our patients,” he said. “The instinct and judgment we have been discussing, the qualities that define surgical mastery, are exactly what will be required to use these tools well and to know when to override them.”
2026 AATS Presentation Highlights
NewYork-Presbyterian physician-scientists from Columbia and Weill Cornell Medicine shared research and clinical advancements throughout the conference. Among the presentations were:
Implantable Intelligence: This year’s Basic Science Lecture was presented by NewYork-Presbyterian and Columbia oncologist Azra Raza, M.D., who highlighted how the focus on preventive treatment in cardiothoracic and cardiovascular medicine has inspired her work advancing early detection and intervention for cancer, including the development of an implantable intravascular device for real-time physiological monitoring of cancer cells in blood.
Acute Type A Aortic Dissection Repair: Leonard Girardi, M.D., cardiothoracic surgeon-in-chief at NewYork-Presbyterian and Weill Cornell Medicine, presented on acute type A aortic dissection repairs, stating that the overarching goal should be to match the right type of surgery with the right patient — while keeping in mind the experience level of the center and surgeon — to optimize short-term outcomes for patients with very high operative risk. He emphasized that in some instances, a conservative technique with a lower operative mortality may be the right approach if the more immediate objective is to save a patient’s life. However, patients who are stable and also undergoing care at surgical centers with experience and expertise in advanced techniques may be candidates for more complex arch and root surgeries, which not only benefit short-term outcomes but also reduce late reinterventions.
Dr. Andrew Goldstone participated in several sessions relevant to heart transplantation and congenital heart conditions.
Fontan Failures: NewYork-Presbyterian and Columbia surgeons Andrew Goldstone, M.D., Ph.D., director of pediatric and adult congenital cardiac surgery, Peter Liou, M.D., transplant surgeon, and Koji Takeda, M.D., surgical director of heart transplant and mechanical circulatory support, discussed how they take a multidisciplinary heart-lung approach to managing patients with failing Fontan circulation. Dr. Goldstone and Dr. Liou outlined their collaborative framework, which includes combined candidacy screening, donor selection, pre-transplant preparation, surgical strategy protocol, and simultaneous rounding during post-operative care. In a separate session, Dr. Takeda further detailed their shared protocol, which includes dual attending surgeon coverage, routine use of ex-vivo perfusion for both heart and liver; and cardiac monitoring with both cardiac and liver anesthesiologists during liver implantation.
AATS 2026 AFMR Expert Consensus: Dr. Geirsson presented the 2026 AATS Expert Consensus Document for the Management of Atrial Functional Mitral Regurgitation (AFMR), providing an evidence-based approach for the evaluation and treatment of the condition. Examples of class 1 recommendations include: evaluation by a multidisciplinary heart team for patients with moderate-severe or severe AFMR; concomitant surgical atrial fibrillation ablation for patients undergoing surgical therapy for AFMR with atrial fibrillation; and left atrial appendage exclusion for patients with AFMR and atrial fibrillation undergoing cardiac surgery.
Virtual Prehabilitation and Preop Education: Charles Mack, M.D., director of cardiovascular services at NewYork-Presbyterian Queens, shared the details of an early prehabilitation protocol he and his team piloted for patients undergoing cardiac surgery. Through a combination of virtual sessions via app and wearable devices for remote monitoring, the model focuses on optimizing several modifiable risk factors before surgery, including frailty and physical activity; nutritional status; comorbidities and medications; smoking cessation and lung capacity; anemia; patient/family education; and psychosocial readiness for surgery and recovery. Pilot study results showed both a reduced median length of stay and no readmissions at 30 days.
