A Cut Above: Cardiothoracic insights from EACTS

This episode examines the foundations of cardiopulmonary bypass, focusing on the 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery & the EBCP Expert consensus statement on basic qualifications and competencies for clinical perfusionists in Europe developed in collaboration with EACTS and EACTAIC. Joined by Alexander Wahba and Adrian Bauer, our hosts discuss what has evolved since the 2019 recommendations, where evidence has strengthened, and why practice still varies across Europe. The conversation covers pump technology, minimally invasive circuit strategies, key perfusion techniques, and the push to standardise perfusion education—highlighting how these documents aim to improve safety, consistency, and outcomes in everyday cardiac surgery.

Recorded live at the EACTS Annual Meeting, this special episode explores the theme "Nightmares in CABG." Our hosts are joined by Faisal Bakaeen, Thomas Gudbjartsson, and Miguel Sousa Uva for an open and practical discussion on the challenges of coronary surgery. The panel shares their approaches to complex scenarios—from fragile conduits and calcified aortas to dissected mammaries and "full metal jacket" targets—offering insight into preparation, technique, and team communication. Emphasis is placed on patient assessment, intraoperative decision-making, and the humility required to learn from complications. The conversation closes with reflections on mentorship, transparency, and the value of honest debriefing in shaping safer surgical practice.

Our hosts are joined by Joseph Bavaria for a practical discussion on surgical innovation and industry collaboration. The conversation covers pathways from idea to device - patents, partnering with companies, and when a startup makes sense - along with funding from angel backing to venture rounds and the realities of regulatory approval. Bavaria reflects on advisory board work, managing conflicts of interest in clinical trials, and why surgeons should help shape product design while advocating for the broader platform rather than a single brand. He also offers guidance for early-career clinicians on finding mentors, protecting IP, and building the multidisciplinary ecosystem needed to bring ideas to patients.

In this episode, we are joined by Dr. Emile Bacha to discuss the emerging field of partial heart transplantation. The conversation explores the history of the concept, its reintroduction in recent years, and how techniques such as domino procedures are being developed to expand donor availability. Dr. Bacha explains the practical challenges of regulation, organ procurement, and immunosuppression, as well as early outcomes seen in paediatric patients. With reflections on valve durability, patient growth, and the future potential of this approach, this episode offers a detailed look into a promising area of congenital cardiac surgery and beyond.