Jo Chikwe
@JoChikweMD
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Professor & Chief of Cardiac Surgery @CedarsSinai | Editor-in-Chief @annalsthorsurg
Joined December 2021
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🧵1/ With patient permission. This is one of our I6 PGY2s (right) doing a mitral repair, a superb PA (left) is assist and an attending is 2nd assist. A resident anesthesiologist is at bedside.
Many patients wonder how residents participate in their care.
One asked this week:
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With patient permission. Yes, that beautiful lung is going in that 2” incision. The team is doing 2 bilateral 🫁, 2🫀transplants and a type A tonight…thank you 🙏 thank you to the donors, their families, this awesome team and all the other folk working miracles overnight.
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I’d wave at our neighbor after my run - he’d wave back, cigarette in hand. My age.
One day I saw police running
Small kids crying on steps
-where’s your dad?
-he’s on the floor. He’s blue.
30 mins CPR. 11 shocks. 1 hour to ED
God bless EMS!
And IC!
PCI Cx
Years later, this:
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All 4 of our PGY 3’s have done complete Bentalls - including the newest ones, with 4 different surgeons. And Type-A’s, ascendings + AVRs, with good patient outcomes.
My best case in cardiac as a PGY3 (the highlight of my year) was getting to do one proximal.
🤣
Video adapted
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My all-time favorite operation. Robotic P2 Mitral Repair. 🙏Thank you to the amazing
@CedarsSinai
6OR team, cardiac anesthesia, CSICU,
@DEmersonMD
, Alfredo Trento MD (and GOAT 👑) for making this magic happen every day!
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Good luck to all in
#Match2023
or
#SOAP2023
!
Most of us fail a lot, we just don’t admit it
My CV of failures (grades that weren’t great, ideas that sank, talks that bombed, rejected papers, grants I didn’t get, missed opportunities) is longer than my job CV.
It will work out.
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Team did a lot this week
10 heart transplants
3 bilateral lungs
10 robotic mitrals
25 TAVRs
Couple Ross’s
10 aortas
All the other elective cases
This gingerbread cardiac OR
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👏🙏Thank you🙏👏to our awesome cardiac surgery residents &fellows
@CedarsSinai
from all your faculty and…..
@DGlaucomflecken
We couldn’t do this amazing work without you! 🫁🫀178 heart & lung transplants 2021, 📚resident 1st author in NEJM TODAY! (Amy Roach et al, NEJM 1/27/22)
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Heart surgery in Rwanda this morning. Amazing
@FiedlerAmy
@DrBowdish
with Dr Maurice Musoni and a spectacular home team supported by
#teamheart
and
@EdwardsLifesci
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2/10 for my first attempt….trying to draw selective non-coronary sinus root replacement. Wonder if AI can already draw this better.
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🧵2/ Patient: I came here as you’re the best. You won’t let residents play with my heart?
Resident:
Me: We’re ‘the best’ because of residents. There’ll be resident surgeons, resident anesthesiologists & students involved in all your care. Not playing. Helping
Patient: Oh. Ok
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🧵8/ Training tomorrow’s surgeons is central to our care. Our awesome PGY2s are doing CABG and valves beautifully, with 4 years of cardiothoracic residency ahead of them - so I know they’ll be technically and clinically accomplished cardiac surgeons well before they graduate.
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🧵11/11 Our residents - the future is bright. And working with them is one of the best things about cardiac surgery.
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@georgetolisjr
Residents and fellows deserve salaries that more fairly reflect their high level of training, hours and contribution to patient care. They are employees and trainees, many of whom view their profession as a vocation. What’s wrong with being better organized?
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👏👏👏Standing room only for 6:30am inaugural Extraordinary Women in Cardiothoracic Surgery - launched by Elaine Weiss CEO
@STS_CTsurgery
heartwarming and inspiring.
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Gasps and applause at the opening AHA Late Breaking Science Session as this practice changing trial is presented, simultaneously published in NEJM and the New York Times reports “..standing room only” in a 5000 capacity hall. Robust analysis and discussion to follow - ask
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It’s a wrap!!! Tell your Meeting Co-Chairs
@OuzounianMD
and me, what you enjoyed at
#AATS2022
and what you want to do differently in 2023…reply or DM or fill in the survey 👇
#CardioTwitter
@tssmn
#AATSBackTogether
👏👏👏Kudos to the awesome AATS Admin Team. See you all in LA!
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👏Superb heart surgery
#Nursing
in 🇷🇼Rwanda
@kfaisalhospital
Terra Lawson (front left, green gloves) helping Fred Kamahandu (opposite in blue hat) on double valve: they haven’t missed a beat in 5 hours. Every step anticipated. Every instrument ready. First in, last out. Kudos! 👏
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Several of you asked how to get on an editorial board…
📚If you could change one thing about your favorite specialty academic journal, what would it be?
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With patient permission.
The
@NEJM
still images are great, but you have to see the video!
Credit among others to Dr. D’Attellis and
@DannyRamzy
#MedTwitter
#CardioTwitter
A 47-year-old woman presented with shortness of breath. Chest CT showed a filling defect in the left atrium, and a mobile left atrial mass was seen on transthoracic echocardiography (shown in a video, follow link to view).
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@MutemaMD
@CedarsSinai
@AATSHQ
@GlobalCardiac
Sir Magdi is why I studied medicine and became a heart surgeon. It was an honor asking him to lend his name to a award supporting cardiac surgery education and research benefitting low income countries. Thank you
@AATSHQ
and all who supported this. Thrilled to mentor Dr Mutema!!!
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🫁🙏With patient permission🙏 🫁full IRB & consent: first robotic assisted lung transplant
@CedarsSinai
Goal is to ⬇️ morbidity associated with large thoracotomy / sternotomy / clamshell without compromising graft function.
@LAlungTx
@CedarsSinai
#lungtransplant
Hello Twitter! Excited to put our lung program on the twitter map!
#transplant
#lungtransplant
@JoChikweMD
@pacman8it
@DEmersonMD
@ISHLT
@CedarsSinai
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Can’t wait for Wednesday’s Grand Rounds with Dr. Tirone David our Visiting Professor in person!
@CedarsSinai
April 20th 7-8am PST - join us on Zoom too. DM for link. It will be lively!!
#CardioTwitter
@tssmn
@OuzounianMD
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Highlight of great STS robotic cardiac surgery course - hours on super-realistic model anyone could set up on a training robot, designed by UPMC I6 resident Faaz Ashraf MD. This is how we increase LIMA-LAD without sternotomy.
@STS_CTsurgery
@tssmn
#CardioTwitter
@igeorge1975
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Major step today. Faces of sustainable heart surgery in Rwanda led by
@mauricemusoni1
a remarkable Rwandan cardiothoracic surgeon, with Dr. Yayu +awesome Rwandan scrub team
@kfaisalhospital
It takes vision + support at all levels to ensure great work goes on when missions go home
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Top reads
🫀 HCM surgery review -Schaff
🫀992 Crawford I repairs -Coselli
🫀750 Redo mitrals -Glower
🫁Home discharge 18h >lobectomy -Kim
🚸Congenital work survey
👉STS Presidential address
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“Let’s do this.” PGY4 Kevin Chen MD greets our Discussant - past President of
#AATS2022
David Adams MD in a superb Presidential Plenary, and nails this top-ranked abstract comparing 3-year national outcomes after TEER vs. mitral repair.
@tssmn
#cardiotwitter
@CedarsSinai
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🧵3/ There’s debate about teaching surgery - do we need 5 years general surgery to be a cardiac surgeon? Can cardiac surgeons teach interns? Will 6-year residency (I6) graduates be proficient? Here’s what the 3 I6 residents on our service did this week, and their highlights.🏆
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👏👏CONGRATULATIONS from the entire
@CedarsSinai
family to the inimitable Danny Ramzy MD, who takes a major leadership role at the University of Texas, Houston as Chief of Cardiac Surgery, and an endowed professor. Cardiac surgeon extraordinaire! 👏👏 They’re lucky to have you!!!
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Transplant Fellowship🫀
#1
in US for Adult Heart Transplant 2017-2021, 🫁
#1
in CA for Thoracic Transplant 2021
Interested in thoracic transplant surgery? We are seeking applicants to our transplant/MCS fellowship! Fellows learn all aspects of transplant, from selection to donor procurement to implant and beyond
#transplant
#cardiacsurgery
@TSRA_official
@ISHLT
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Woohoo! FINALLY!!! Hopefully this makes life easier for authors!
THANK YOU to the other editors and managers of Annals, JTCVS and EJCTS!!!!
Joint statement from
@STS_CTsurgery
,
@EACTS
&
@AATSHQ
📣
Editors of
@annalsthorsurg
,
#EJCTS
&
#JTCVS
acknowledge the importance of a unified submission process. To enhance author experience, we’ve aligned submission requirements for full-length research articles. Read more below👇
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🧵10/ Today at 🎓graduation we recognize our residents and teaching faculty of the year - again won by
@DEmersonMD
- here last year recognizing our amazing cardiac 6OR nurse and scrub techs (without all of whom none of this would be possible) with MVP awards.
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🧵5/ PGY2:
Did a mitral repair, a CABG3 both skin to skin, opened and cannulated then assisted 2 Bentalls.
🏆Highlight: “Being left to close for the first time. I must have asked how much was in the chest tubes 50 times.” Driest patient that day.
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Meet Lina Elfaki
@lina_elfaki
AATS Member for a Day - 3rd year medical student at Toronto working with
@OuzounianMD
on aortic remodeling after dissection, applying to I6 this year…getting the inside view on
@annalsthorsurg
board meeting & Cardiothoracic Careers College
#aats2022
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Last night this team performed our 100th and the 101st 🫀🫁transplants of 2022….both lung transplants. Thank you to everyone in 6OR, CSICU, cardiac anesthesia, perfusion and the entire heart and lung transplant teams
@CedarsSinai
“We are leveraging one of the greatest teams in cardiothoracic medicine,” says
@JoChikweMD
. An amazing team indeed, including Dr. Megna,
@ReyRampollaMD
&
@pacman8it
👏Congrats to the entire
@LALungTx
team at
@CedarsSinai
!
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🧵4/ PGY1:
Opened, cannulated (1 bicaval, 2 robotic femoral), first assisted triple valve, second assisted Ross.
🏆Highlight: “Cannulating”
Our 2 interns do 2 months on cardiac, including 1 month on our cardiac surgery ICU, and transplant procurement.
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In awe of this amazing
@CedarsSinai
team, including 8 residents and medical students, together responsible for 27 podiums at
#AATS2022
including the highest ranked abstract (PGY3 Kevin Chen presenting in Plenary tomorrow).
@tssmn
#CardioTwitter
#AATSBackTogether
🤩
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Trying to be blasé about this free transfer to JFK and failing….literally grinning the entire 5 mins from Hudson Yards to JFK at peak rush hour. Thanks
@flybladenow
and
@JetBlue
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Celebrating!
252 “Thank You for Being the Best Team in Cardiac Surgery!” notes signed, 114 to go…
@CedarsSinai
#MedTwitter
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Fab Friday - getting ready for
@DrBowdish
, a national leader, outstanding role model and star educator to join our awesome cardiac surgery team
@CedarsSinai
, as Vice Chairman on Monday!
#CardioTwitter
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@ElliotServaisMD
@AATSED
@STS_CTsurgery
@SAGES_Updates
@SurgJournal
@AmBdSurg
@TomVargheseJr
@juliomayol
@pturnermd
When OR team members refer themselves or their loved ones to you for surgery.
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👏📈Great job by our general surgery chief resident
@CedarsSinai
Dr Shah Akhmerov presenting today
@STS_CTsurgery
📈👏worse survival in heart transplant after prior CABG compared to prior LVAD
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🧵7/ We’re here first and foremost for patients.
@CedarsSinai
and
@SmidtHeart
are ranked
#2
and
#3
nationally, hopefully reflecting consistently great care, often in the most challenging patients. Every other program in the top 20 teaches residents too.
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🧵9/ How? Our great team including 10 superb teaching surgeons who love teaching a complex case mix.
Like 200🫀🫁transplants a year with the attending on the left of the table.
My goal is to teach the Ross’s, robotic mitrals and triple valves I did this week as well as they do.
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🎒Usual travel stuff in this carry-on+
🍫20 bars chocolate (2/day)
🩺Stuff for Rwanda (5 days worth of 6 1/2 Biogels, masks, OR hats & shoe covers, scrubs, loupes)
👟Running kit (
@FiedlerAmy
)
AHA & STS suits
Laptop + chargers
Traffic bad, pray I make this flight!
#teamheart
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Cardiac Surgery Graduation
@CedarsSinai
- our 🔥🔥graduating Chief Mo
@MT_HAS
awards
@DEmersonMD
Top Surgeon Educator 2022….AND congratulations to our 3 superb graduating transplant fellows: 🔥Joshua Chan🔥Phil Tremblay & 🔥Tyler Gunn -rising stars & transplant surgeons to watch
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@georgetolisjr
Learned 30% from operating with giants, 30% from operating with great surgeons you’ve never heard of, and 30% from operating on everything that came through the doors of small, underserved programs with zero back-up and no resources. +/- 10% from errors you never forget.
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📚
@HenriFordMD
says: “Do not equate advocacy with lowering standards….it is all about excellence.”📚
“Deans and CEOs must advance opportunities for underrepresented minorities and women,” says
@HenriFordMD
in the Vivien T. Thomas Lecture, “The Imperative for Diversity in Academic Surgery.” A more diverse workforce provides more equitable care.
#STS2022
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🧵6/ PGY3:
Pericardial window, CABG3, AVR, Bentall all skin to skin. Assisted VATSMaze.
🏆Highlight: The Bentall. “Being able to perform a root operation was awesome….autonomy is very valuable”.
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@GreggWStone
Ahem…..read the superb accompanying editorial by William Boden, Raffaele De Caterina and David Taggart for a fresh dose of reality.
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How to train residents in robotic🫀 and 🫁 surgery?
High-fidelity simulation helps! Our I6 PGY1-3 residents today in our amazing sim center (2 fully equipped ORs, robots, ICU, VR) with the awesome
@DEmersonMD
&
@IntuitiveSurg
Link to virtual tour 👇
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Condolences to the family & friends of Dr Griepp, a real giant. A superb transplant, congenital & aortic surgeon; clinician, teacher, leader & scientist, he remains a role model for excellence and kindness in the OR and beyond. His brilliant technique and wit made surgery a joy.
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Tirone David MD - Legend, role model and still biking >100k a week between cases and giving all-time greatest Grand Rounds on mitral prolapse
@CedarsSinaiMed
#CardioTwitter
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Join Grand Rounds with Dr. Pedro del Nido tomorrow Wednesday 15th November 7am PT/ 10am ET 👇
DM me for link
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Kudos to our authors & superb editorial board for making us the most cited journal in cardiac & thoracic surgery (5th highest in all surgery) with >45k citations in 2021
2021 saw some Covid-crazy ⬆️impact factors (Lancet ⬆️203 >>NEJM⬆️176
What’s a better way to assess impact?
Notably, The Annals is not only the most-cited journal in
#CTsurgery
(45K+ total citations in 2021), but it is the 5th most-cited journal in the entire Surgery category (211 total journals).
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⚔️Why we need RCTs
📈EHJ analysis of mitral TEER vs surgery in administrative data shows better 1 yr outcomes with TEER (but doesn’t separate out functional from degenerative, or repair from replacement)
📉👇JTCVS analysis of US Medicare data shows better 1y and 3y survival with
Mitral transcatheter edge to edge repair versus isolated mitral surgery for severe mitral regurgitation: A French nationwide study just published in
#EHJ
@escardio
@ESC_Journals
#CardioTwitter
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2/2: Catarino lab
@CedarsSinaiMed
Focus on 🫀🫁transplant organ preservation using translational science and big data.
Post-docs, residents & medical students welcome: in 2022 this group published in NEJM, Circulation, JHLT, and shared >50 podiums.
#CardioTwitter
@TSRA_official
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Rereading this superb review - so many pearls
🫀State of the Art Review: Contemporary Surgical Management of HCM by Hartzell Schaff & Xiang Wei
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📚The first author of this NEJM article is Amy Roach MD, a PGY3 General Surgery resident
@CedarsSinai
doing a 2-year cardiac surgery research fellowship with us: this was her idea & her analysis👊.
@ThoracicStudent
#MedTwitter
“Our experience treating
#COVID19
has shown us that
#ECMO
can be used in carefully selected patients, either as a bridge to
#LungTransplantation
, or to allow a patient’s own lungs to heal,” says Cedars-Sinai's
@JoChikweMD
.
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Two next-Presidents of
@STS_CTsurgery
and
@AATSHQ
and Joe Woo at Cardiothoracic Careers College now in room 311 at
#AATSBackTogether
. Come engage with leaders sharing great tips and experience.
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You want to be in the room tomorrow 11am for this pivotal NEJM clinical trials session at TCT, starting with 4 and 5-year data from 2 low-risk SAVR/TAVR trials, and ending with TAVR for AI.
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👍With patient’s permission, here’s a very unusual mitral lesion. 🙏Thanks to the awesome 6OR robotic team and
@DEmersonMD
🙏🙏🙏
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🧵Super surprised by what AI (GPT4) can and can’t do right now.
1/ Generates a management plan for a 79 year old patient with severe MR - skipping a detailed history, physical exam, labs, CT and medication, but recommending a heart team evaluation of the patient’s preferences.
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Why change?
@annalsthorsurg
has the largest print + online readership in cardiac & thoracic surgery (see 2021 top cited and viewed articles👇), but big challenges face all academic journals. Here’s what we’re doing:
@tssmn
@ThoracicStudent
@STS_CTsurgery
June’s
#EditorsChoice
from Editor-in-Chief
@JoChikweMD
is on Strengths, Challenges and Opportunities: . Also highlighted are 4 award-winning research articles in this issue 🧵
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Well I didn’t expect that….
#AHA2023
Presidential Address by Dr Joe Wu - his journey from a California fruit farm to the international space station
And a new American Board of Cardiovascular Medicine
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📚If you could change one thing about your favorite specialty academic journal, what would it be?
Nothing - it’s perfect!
13
More expert reviews.
114
Better digital content.
116
Topics tailored to me.
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The 3 amazing inaugural awardees..
@leahbackhusmdMPH
FACS
@StanfordMed
Jennifer Ellis MD
@nyulangone
@BTongMD
@DukeUniversity1
So many firsts.
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Friday night in LA
Thank you to the 2am Dream Team Mich Pedro Kaveh Josh James Kevin Manxu Victoria Aaron Chris Warren Justine Chris Christina Deborah Ben Jenifer Hari Steve Mujeeb Sruthi Victoria Dom Ali & CSICU for your help with 2🫁🫀transplants + 🫀emergency
3 big saves
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📚📈Today we randomized our first patient in the pivotal NHLBI trial of TEER vs Surgery for primary MR 👏👏👏to the truly amazing team at the NHLBI, CTSN, and 200+ investigators that got us this far!
#MedTwitter
#CardioTwitter
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Wow. Some teams just have it.
Superb leadership, teamwork & culture.
These MGH residents are inspiring - wise, kind & accomplished surgeon-scientists.
Thor shaped my career, Yolonda my research, & Duke is my role model.
Humbled. Inspired
#MedTwitter
Amazing evening honoring
@JoChikweMD
as the Mortimer J. Buckley Visiting Professor in Cardiac Surgery.
#Legendary
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The Annals 1 year in:
📚More relevant, expert, quality content you can trust. Less of everything else.
📚Still the most cited CT surgery journal
📚Easier to access, navigate and respond thanks to faster turnaround, new website features, and journal redesign. Try it and feedback!
Our January issue is now online! The first issue of 2023 features a cover and interior re-design, the inaugural video from our new digital “Annals Animated” series, and curated research highlights from our EIC,
@JochikweMD
:
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Talking Ross on a 3-Ross week with a master congenital surgeon - 10am ET 7am PT today! DM for link
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To all cardiothoracic surgeons & trainees wanting support for training, research or professional development. Visit the AATS, STS and EACTS websites now for details of >50 award opportunities
@tssmn
@TSRA_official
@ThoracicStudent
Take your career to the next level through the Sir Magdi Yacoub International Mentored Career Development Award, which supports research and academic exchange for cardiac surgeons from around the world. Apply to train with AATS leaders in
#CTSurgery
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