2010 Annual Report

It has been my privilege to serve as the Foundation's President for the past three years and as my term comes to an end I am excited by the significant progress the Foundation has made. This time has afforded me the opportunity to learn and experience first hand the generosity of the members of our specialty in supporting TSFRE's research and educational initiatives. The Foundation has truly become a pivotal force for the growth and vitality of our specialty and its role is increasing, particularly in the areas of research, academic career development and post-graduate education.

Since TSFRE’s inception, funding cutting edge research has been the hallmark of our mission. The pages of this report highlight this year’s success stories. In 2010 alone, TSFRE awarded over $528,000 to fund 3 research grants, 4 fellowships and 1 Nina Starr Braunwald Award, contributing significantly to the progress being made in cardiothoracic research. As well, the Foundation continues its partnership with the National Heart, Lung and Blood Institute (NHLBI) and the National Cancer Institute (NCI) by co-funding 4 K08/K23 awards. These partnerships brought the total Foundation research funding commitment to over $1,000,000 in 2010!

There has also been tremendous expansion in TSFRE’s educational programs. Stemming from the success of the 2007 Visioning Simulation Conference, to date 14 Simulation grants have been awarded for a total of $200,000 to increase the development and use of simulation in thoracic surgery education and certification.

The Foundation has also shown its commitment to thoracic surgery education by becoming a founding member of the Joint Council on Thoracic Surgery Education (JCTSE); pledging $1,000,000 payable over the next four years.The major foci of the JCTSE are to improve cardiothoracic surgical resident education, the development of innovative techniques for both resident and post graduate education and the redesign of the resident training paradigm.

I close this chapter with optimism and hope for the future because we have vibrant new programs in research and education. Join me as your Foundation moves ahead and support its efforts with a contribution. Your support will make a tremendous difference in TSFRE’s ability to continue offering these valuable research and educational opportunities and will significantly improve the future of our specialty.

Thank you for your continued support.

Michael J. Mack, M.D. President Thoracic Surgery Foundation for Research and Education

THE HISTORY and PHILOSOPHY of TSFRE

The Thoracic Surgery Foundation for Research and Education (TSFRE) was established in 1992 by the four leading thoracic surgery societies: the American Association for Thoracic Surgery (AATS), the Society of Thoracic Surgeons (STS), the Southern Thoracic Surgical Association (STSA) and the Western Thoracic Surgical Association (WTSA). Representatives from each of these organizations serve on the TSFRE Board of Directors and each organization provides annual financial support to the Foundation. The TSFRE represents all of thoracic surgery in the United States and its research and education initiatives support the broad spectrum of thoracic surgery.

The Mission of the TSFRE is two-fold:

Increase knowledge and improve the care of patients with thoracic disease

To nurture the development of the surgeon-scientist

The specialty and TSFRE remain committed to research, recognizing that it is today’s research that is the practice of tomorrow. Without the thousands of research hours and millions of dollars, new surgical techniques and today’s miracle drugs would remain undiscovered. Hundreds of thousands of lives would be adversely affected.

Thoracic surgeons, indeed all surgeons, face a changing health care system. TSFRE recognizes that education plays a vital role in the future of our specialty. Thus, TSFRE has developed new initiatives that will support thoracic surgeons in acquiring the transdisciplinary skills necessary for success in the years and decades ahead, developing new training programs that will utilize simulation activities for thoracic surgery and creating an emphasis on patient safety within the specialty.

The Thoracic Surgery Foundation for Research and Education (TSFRE) is the focal point for research and education programs and projects within cardiothoracic surgery. TSFRE ensures that research and education, the foundations for progress within the medical specialty, remain at the forefront and that innovative, new endeavors receive the support and commitment necessary to advance thoracic surgery in future years.

2010 Research Committee David R. Jones, M.D., Chair University of Virginia Charlottesville, VA James S. Allan, M.D.Emile A. Bacha, M.D. Frederick Y. Chen, M.D. John S. Ikonomidis, M.D. Daniel Kreisel, M.D., Ph.D. Christine L. Lau, M.D. Michael J. Mann, M.D. Kenneth R. McCurry, M.D. Marc R. Moon, M.D. Richard G. Ohye, M.D. Dennis Wigle, M.D. Y. Joseph Woo, M.D.

In January of 2010, the Research Committee met to review 49 applications. Each major subspecialty area— congenital heart disease, adult acquired surgery, thoracic oncology and thoracic transplantation—was well represented. The proposals varied widely in scientific focus, ranging from transplantation immunology and molecular oncology to biomechanics and tissue engineering. There was also a healthy mix of mechanical, translational and clinical science. Most importantly, all of these proposals addressed issues important to improving care for our thoracic surgical patients. The Committee’s work includes providing constructive criticism for each applicant. We strongly believe that this feedback will help young residents and faculty to submit ever more polished applications, and thus compete more effectively in traditional venues for increasingly scarce research funds. The committee is acutely aware that academic departments can no longer depend on diverting professional revenues to support research. Lack of this traditional bridge or seed funding enhances the need for fundraising to make it possible for TSFRE to increase the amount of individual awards, particularly to young faculty. The Foundation continues to enthusiastically support the intellectual and scientific health of our young colleagues by committing to continue funding research grants and fellowships in spite of dismal economic news. The Foundation’s ability to continue funding these critical grants and fellowships is dependent on the generosity of TSFRE’s contributors. This vital basis for the future evolution of our specialty will remain healthy and vibrant, thanks to your participation.

Since its inception, TSFRE has awarded and administered over $11 million in research grants, fellowships and career development awards for thoracic surgeons. Awards are made after a rigorous examination of applications by the TSFRE Research Committee, composed of outstanding research surgeon-scientists.

Research Fellowship Awards
Support of up to $30,000 per year for up to two years for surgical residents who have not yet completed cardiothoracic surgical training.

Research Grants
Operational support of original research efforts by cardiothoracic surgeons who have completed their formal training and who are seeking initial support and recognition for their research program. Awards of up to $40,000 a year for up to two years are made each year to support the work of an early-career cardiothoracic surgeon (within five years of first faculty appointment).

Nina Starr Braunwald Career Development Awards
Provides a biennial award of $115,000 for two years to support the research career development of a woman cardiac surgeon who holds a full-time faculty appointment and who is within ten years of completion of thoracic surgery residency.

NIH Partnerships
TSFRE has formed valuable partnerships with the National Heart, Lung and Blood Institute and the National Cancer Institute to offer K08 and K23 awards. Through this partnership, the Foundation is able to increase the dollars available to support cardiothoracic research.

National Heart, Lung and Blood Institute K08 and K23 Awards
Support to outstanding clinician research scientists who are committed to a career in cardiothoracic surgery research and have the potential to develop into independent investigators.

National Cancer Institute K08 and K23 Awards
Provides support to outstanding clinically trained professionals who are committed to a career in laboratory or field-based research and have the potential to develop into independent investigators.

2010 TSFRE RESEARCH AWARD RECIPIENTS

TSFRE Research Fellowships:

Nicholas D. Andersen, M.D. Duke University Medical Center “Calcium Signaling Regulates Cardiomyocyte Growth in Hypoplastic Left Heart Syndrome”

David N. Anderson, M.D. Memorial Sloan Kettering Cancer Center “SCCRO (DCUN1D1) is Essential for Cellular Transformation”

Alejandro Bribriesco, B.S., M.D. Washington University “Role of Non-Alloimmune Stimuli in Airway Epithelial Cell Differentiation after Lung Transplantation”

William Hiesinger, M.D. University of Pennsylvania “Myocardial Angiogenic Tissue Engineering Via Ex-Vivo Modified Stem Cell Matrix” TSFRE Research Grants:

TSFRE Research Grants:

Mark Onaitis, M.D. Duke University “The Mechanism of Sox2 in Lung Cancer Development”

Thomas B. Reece, M.D. University of Colorado “The Role of Specific Adenosine Receptor Activation In Ischemic Preconditioning of the Spinal Cord”

Brendon M. Stiles, M.D. Weill Medical College, Cornell University “Disseminated Tumor Cells in the Bone Marrow of Patients With Surgically Resectable Non-Small Cell Lung Cancer: Comparative Genomic Analysis to Matched Primary Tumors

Nina Starr Braunwald Career Development Award:

Jennifer C. Hirsch, M.D., M.S. University of Michigan “Development of a Congenital Heart Assessment of Sensory and Motor Status (CHASMS) Instrument for Infants Following Cardiac Surgery”

TSFRE/NHLBI Jointly Sponsored Mentored Clinical Scientist Development Awards (TSFRE/NHLBI MCSDA)

Gorav Ailawadi, M.D. University of Virginia “The Effects of KLF4 in Experimental Aortic Aneurysm Formation”

Matthew J. Schuchert, M.D. University of Pittsburgh “Enhancement of Hematopoietic Stem Cell Engraftment with CD8+ Marrow Progenitors”

Receiving the Nina Starr Braunwald Award has been both an immense honor as well as a great catalyst for my research interests. Nina Starr Braunwald is an inspiration. She was an innovator taking on new fields of research as a young female cardiac surgeon. As a young woman in the field of congenital heart surgery, I am fortunate to practice in a specialty that has seen ever improving survival for our patients even with the most complex heart defects. With the remarkable improvement in survival rates, an important shift has occurred towards better understanding and mitigating the morbidity associated with surgical and supportive care. My research focus is based on characterizing and quantifying the impact of ICU care on congenital heart disease patients following congenital heart surgery. This is a novel field of study with the potential to significantly impact long-term quality of life for our patients and families. The Nina Starr Braunwald Career Development Award has provided me with the essential resources required to develop the formative metrics for my project. Through the work supported by this career development award, I will have the tools and credibility to successfully compete for extramural research grants to support my ongoing research and career aspirations. In honor of Nina Starr Braunwald and in recognition of this prestigious award, I hope to make significant and lasting contributions to the field of congenital heart surgery.

Jennifer C. Hirsch, M.D., M.S.
University of Michigan
2010 Nina Starr Braunwald Award Recipient

Education Committee Thoralf M. Sundt, M.D., Chair Mayo Clinic Rochester, MN Shanda H. Blackmon, M.D., MPH John R. Doty, M.D. Kristine Guleserian, M.D. Cynthia S. Herrington, M.D. Leslie J. Kohman, M.D. Raj B. Lal, M.D. M. Blair Marshall, M.D. Ross M. Ungerledier, M.D. Ara A. Vaporciyan, M.D.

The mission of the Thoracic Surgery Foundation for Research and Education is grounded in two distinct areas of concentration: Research and Education. Education was central to the formation of TSFRE and we remain indebted to the visionary leaders who saw educational programming to acquire skills outside of the traditional practice, research and residency training critical to our specialty.

For much of the history of TSFRE, the Education Committee has been primarily focused on the Health Policy Leadership Program offered originally through Harvard’s Kennedy School and most recently with Brandeis University. Since 1992, the Alley-Sheridan fund has awarded over $875,000 to members of our specialty. TSFRE’s national health policy programs have had a profound impact upon the hundreds of surgeons who have attended and provided invaluable insights into the public policy programs of the US health care system. Attendees gain a real sense of how they can impact the system to the benefit of surgeons and patients. Over the past few years, the Foundation has expanded its educational opportunities by offering Simulation in Thoracic Surgery Education grants. Based on the success and feedback of the Visioning Simulation Conference held in April 2007, these grants are offered to support the demonstration study for the application of simulation in thoracic surgery education.

2010 was a year of many educational accomplishments for the Thoracic Surgery Foundation for Research and Education:

• 6 Alley-Sheridan Scholars attended the Health Policy and Leadership program offered at Brandeis University. This program has had a profound impact upon the hundreds of surgeons who have attended and gained invaluable insight into the public policy process of the US health care system.
• 4 Scholarships to attend the American College of Surgeons—17th Annual Surgeons as Educators Course. This six-day intensive course is designed to provide surgeons with the knowledge and skills to enhance their abilities as teachers and administrators of surgical education programs.
• Simulation in Thoracic Surgery Education A Visioning Simulation Conference was held in April 2007 to provide a forum for leaders in thoracic surgery and invited simulation experts to discuss our shared vision for development and use of simulation in education and certification. The Foundation believes that cardiothoracic surgery is an ideal specialty to demonstrate and evaluate the use of advanced simulation and other innovative approaches to quality and safety as a model for other highly technical medical specialties. The outcome of this forum has resulted in a new educational simulation grant offered by the Foundation. In January 2010, the Foundation’s Education Committee reviewed 19 proposals for grants to support the demonstration of the application of simulation in thoracic surgery education. The Board of Directors approved $100,000 total for funding 7 of these Simulation Grants.

ALLEY-SHERIDAN SCHOLARS:
2010 AMERICAN COLLEGE OF SURGEONS SURGEONS AS EDUCATORS SCHOLARSHIP RECIPIENTS
ACS—Surgeons as Educators Course
This six-day intensive course is designed to provide surgeons with the knowledge and skills to enhance their abilities as teachers and administrators of surgical education programs.

Andrew Chang, M.D., FACS
University of Michigan Health Systems
Ann Arbor, MI

Richard Feins, M.D., FACS
University of North Carolina, School of Medicine
Chapel Hill, NC

M. Blair Marshall, M.D., FACS
Georgetown University Medical Center
Washington, DC

Matthew Steliga, M.D.
University of Arkansas
Little Rock, AR

2010 TSFRE BRANDEIS COURSE SCHOLARSHIP RECIPIENTS
R. Duane Cook, M.D.
Leesburg-Ocala Heart Institute
Leesburg, FL

Robert A. Frank, M.D.
Ochsner Medical Center
Gretna, LA

Eric S. Lambright, M.D.
Vanderbilt University Medical Center
Nashville, TN

Frank W. Sellke, M.D.
Rhode Island Hospital
Providence, RI

Timothy L. Van Natta, M.D.
Harbor-UCLA Medical Center
Torrance, CA

Benny Weksler, M.D.
Thomas Jefferson University Hospital
Philadelphia, PA

2010 EDUCATION AWARD RECIPIENTS:
Simulation in Thoracic Surgery Education Grants
Provides grants to support the demonstration study for the application of simulation in thoracic surgery education.

Leora B. Balsam, M.D.
New York University
“Simulator for Conventional and Limited Access Mitral Valve Surgery”

Raphael Bueno, M.D.
Brigham and Women’s Hospital
“Simulation-Based Curriculum Development for Intraoperative Decision Making and Technical Performance: Cognitive Task Analysis for Video-Assisted Thoracoscopic Surgery (VATS) Lobectomy”

Joanna Chikwe, M.D.
Mount Sinai Medical Center
“High Fidelity Simulation in Preparing Medical Students for Integrated Cardiothoracic Residency Training”

Yolonda L. Colson, M.D., PhD
Brigham and Women’s Hospital
“Exportable Crisis Management Assessment Curriculum (ECMAC)”

Richard Feins, M.D.
University of North Carolina
“Multicenter Cardiac Simulator Beta Testing”

M. Blair Marshall, M.D.
Georgetown University Hospital
“Development of Task Specific Cardiothoracic Simulation Models for Independent Study and Skill Acquisition”

Shari L. Meyerson, M.D.
University of Arizona
“Validation of a Thoracoscopic Lobectomy Simulator”

I want to express my deepest gratitude to the TSFRE for awarding me an Alley-Sheridan scholarship to attend the week-long Leadership Program in Health Policy and Management at Brandeis University. The course was extraordinary in organization, faculty caliber, breadth and depth of topics, and degree of interaction between participants. Professors were comfortable straying from prepared remarks to engage the audience in provocative, meaningful discussions. Much of the recent health care legislation and national challenges were clarified and put in perspective. We explored decision making, conflict negotiation, financial literacy, and several other aspects of leadership. Every detail was meticulously attended to by faculty and staff; never have I participated in such a well developed course.

My interactions with other cardiothoracic surgeons were invaluable, as we discussed challenges unique to our specialty and our respective settings. My own aspiration is to improve health care performance relative to thoracic surgical services for Los Angeles County residents. I left Brandeis feeling informed and wiser, possessing a remarkable new tool set to improve my leadership abilities. On multiple levels, the Brandeis course advanced the capabilities of selected thoracic surgeons to advance our specialty’s leadership performance regionally and nationally. I greatly appreciate having been given the opportunity by the TSFRE to participate in such a worthwhile program.

Timothy L. Van Natta, M.D.
Harbor-UCLA Medical Center
2010 Alley-Sheridan Scholar  

The 2010 TSFRE Simulation in Thoracic Surgery Education Award has allowed us to access a national panel of experts in VATS Lobectomy in order to develop a comprehensive simulation curriculum for trainees. We hope to supplement task driven simulation education to include the decision making aspects of this complex procedure using cognitive task analysis. Without the support from TSFRE we would not be able to utilize an educational psychologist who is able to deconstruct knowledge that is often automated for experts and is omitted in the operating room and the simulation lab. By including multiple viewpoints we will be able to include both the procedural tasks and intraoperative decision making associated with the procedure in our simulation instruction. We are hopeful that the results of our expert panel interviews and resulting curriculum can be implemented nationwide to aid trainees in seeing multiple pathways in performing a VATS lobectomy

Raphael Bueno, M.D.
Brigham and Women’s Hospital
2010 Simulation in Thoracic Surgery Award Winner

STATEMENT OF FINANCIAL POSITION As of June 30, 2010

Assets:
Cash and Investments	$3,694,791
Pledges Receivable	$266,484
Total Assets	$3,961,275
Liabilities:
Awards Payable	$2,130,549
Total Non-Current Liabilities	$1,306,630
Total Liabilities	$3,437,179
Fund Balances:
Fund Balance	$879,683
Year to Date Income (Loss)	($355,587)
Total Fund Balances	$524,096
Total Liabilities and Net Assets	$3,961,275

The combination of research and new technology, which go hand-inhand, have advanced the capabilities of thoracic surgeons dramatically over the past two decades. Today, thoracic surgeons can very successfully treat diseases and medical conditions that were a short time ago deemed untreatable. The financial resources that made these advances possible were most often large private organizations or federal agencies. Within our specialty clinical work supported the bulk of research.

Our changing health care environment and radical transformation within industry have, quite frankly, diminished those traditional sources of funds. Research and training opportunities for young, talented surgeonscientists have been sharply curtailed.

The specialty and the TSFRE remain committed to research, recognizing that it is today’s research that is the practice of tomorrow. Without the thousands of research hours and millions of dollars, new surgical techniques and today’s miracle drugs would remain undiscovered. Hundreds of thousands of lives would be adversely affected.

The results of thoracic research ultimately reduce the toll of thoracic diseases and defects. Given the pervasiveness of cardiovascular diseases and lung cancer, today’s research has the potential to improve millions of lives tomorrow. The TSFRE’s partnerships with the National Heart, Lung, and Blood Institute and the National Cancer Institute are critically important initiatives to further our knowledge and capabilities against these diseases, while strongly supporting very talented surgeon-scientists within the specialty.

Further, thoracic surgeons face a changing health care system. The TSFRE recognizes that education plays a vital role in the future of our specialty. Thus, the TSFRE will continue to support thoracic surgeons in acquiring the transdisciplinary skills necessary for success in the years and decades ahead, develop new training programs that will utilize simulation activities for thoracic surgery, and create an emphasis on patient safety within the specialty. The TSFRE will also remain active in assuring that thoracic surgeons continue to develop the skills necessary to remain in the forefront as health care policy leaders.

The Thoracic Surgery Foundation for Research and Education is an organization that will continue to steer the future of thoracic surgery through the sponsorship of surgical research and the education of surgeons in health care policy. TSFRE is your foundation for the future; by supporting TSFRE you are investing in the future of our specialty now.

GIVING OPPORTUNITIES:
Because TSFRE is a charitable organization with IRS 501 (c)3 classification, your gift to TSFRE qualifies as a tax deduction. For some, an outright gift of cash, securities or other property is the best means of contributing. Other giving options are outlined as follows:

Gifts of Cash
A gift of cash is the simplest method of giving. It is not subject to gift or estate taxes. You may be able to deduct the gift amount from your taxable gross income.

Gifts of Securities or Real Estate
A tax-wise gift of stock or real estate can provide generous support for the Thoracic Surgery Foundation for Research and Education. Almost any type of real property—a personal residence, a farm, a vacation home, a commercial building or a parcel of land—can constitute a gift. Gifts of securities or real estate are tax deductible and free of capital gains tax.

Life Income Gifts
Perhaps you would like to make a significant gift to TSFRE right now but believe that you cannot because you need the income your assets earn. If so, you may want to consider a “life income gift.” A life income gift allows you to donate, yet retain life income for yourself and another, if you wish. These gifts frequently increase your income, save income tax, capital gains and estate tax and also benefit the Foundation.

Bequests
You may wish to make a gift to TSFRE by utilizing one of the easiest, most frequently used methods—a bequest in your Will. Tax laws favor bequests, and consequently, they are an excellent way to provide support. If you would like to make a pledge or receive more information about giving to TSFRE, please complete and return the form included in this report, visit www.tsfre.org or call the Executive Director of the Thoracic Surgery Foundation for Research and Education at 978-927-8330.

TSFRE ensures that research and education, the foundations for progress within the medical specialty, remain at the forefront and that innovative, new endeavors receive the support and commitment necessary to advance thoracic surgery in future years.

Partners Gifts of $1,000,000 or more cumulatively American Association for Thoracic Surgery Eugene Braunwald, M.D. Datascope Corporation Edwards Lifesciences David S. Sheridan The William J. von Liebig Foundation Grand Benefactors Gifts of $500,000 to $999,999 The Graham Foundation Maquet Cardiovascular The Society of Thoracic Surgeons The Starr Foundation Lazlo N. Tauber Charitable Foundation, Inc. Benefactors Gifts of $100,000 to $499,999 Lawrence H. Cohn, M.D. Frederick Cross, M.D. The Cross-Jones Research & Education Fund Foundation for Advancement of Cardiac Therapies, Inc. Genentech, Inc. Richard D. Jones, PhD Dr. & Mrs. Jack M. Matloff Dr. & Mrs. Martin F. McKneally Medtronic, Inc. St. Jude Medical, Inc. Patrons Gifts of $50,000 to $99,999 Bristol-Myers Squibb Company CHMC Cardiovascular Surgical Foundation Richard E. Clark, M.D. Roy H. Clauss, M.D. Ethicon, Inc. W.L. Gore & Associates, Inc. The Heart & Lung Surgery Foundation Robert W. Jamplis Charitable Trust LUNGevity Foundation Dr. & Mrs. W. Gerald Rainer Southern Thoracic Surgical Association Sulzer Carbomedics, Inc. Synovis Life Technologies Dr. & Mrs. Robert Wallace The Western Thoracic Surgical Association Sponsors Gifts of $25,000 to $49,999 American College of Surgeons Dr. Lenox D. Baker Dr. & Mrs. John H. Bell John R. Benfield, M.D. Drs. Lawrence I. & Rita Boncheck Gerald D. Buckberg, M.D. Columbia University, Department of Cardiothoracic Surgery Edgar L. Feinberg, II, M.D. Dr. Kathryn Quadracci Flores & Dr. Raja M. Flores J. William Gaynor, M.D. Richard A. Jonas, M.D. Harold V. Liddle, M.D. George J. Magovern, M.D. Mary C. Mancini, M.D. Massachusetts General Hospital Douglas J. Mathisen, M.D. General Thoracic Surgery Constantine Mavroudis, M.D. Northern Illinois Heart Institute Alec Patterson, M.D. Christian Pizzarro, M.D. Respironics, Inc. Thomas G. Sharp, M.D. Alfred Tector, M.D. Dr. & Mrs. Harold C. Urschel, Jr. James M. Wilson, M.D. James L. Zellner, M.D. Heritage Society Members have made provisions for an estate gift John R. Benfield, M.D. Eugene Braunwald, M.D. Richard E. Clark, M.D. Vincent R. Conti, M.D. David A. Fullerton, M.D. Dr. & Mrs. Martin F. McKneally Dr. & Mrs. W. Gerald Rainer David S. Sheridan Dr. & Mrs. Harold C. Urschel, Jr. Dr. & Mrs. Robert B. Wallace James M. Wilson, M.D. Life Members Cumulative Gifts of $10,000 to $24,999 Abbott Laboratories Fund David Adams, M.D. Arvind Agnihotri, M.D. Cary Akins, M.D. William Alford, Jr., M.D. Nasser K. Altorki, M.D. The American Board of Thoracic Surgery Abbas Ardehali, M.D. Atrium Medical Corporation W. Gerald Austen, M.D. Dr. & Mrs. Carl L. Backer Lenox D. Baker, M.D. Hendrick Barner, M.D. William A. Baumgartner, M.D. Joseph E. Bavaria, M.D. David P. Blake, M.D. Edward L. Bove, M.D. John Burkholder, M.D. John H. Calhoon, M.D. David Campbell, M.D. Cardiovascular and Thoracic Surgeons, Inc. Robert J. Cerfolio, M.D. Dr. & Mrs. W. Randolph Chitwood Jr. John V. Conte, M.D. Vincent R. Conti, M.D. Denton A. Cooley, M.D. Coordinating Committee for Continuing Education in Thoracic Surgery A. Robert Cordell, M.D. Joseph Coselli, M.D. Delos Cosgrove, M.D. James L. Cox, M.D. Fred A. Crawford Jr., M.D. Harry DePan, M.D. Dr. & Mrs. James DeWeese Richard N. Edie, M.D. Robert G. Ellison, M.D. Elsevier Science, Inc. Dr. & Mrs. Richard Engelman L. Penfield Faber, M.D. Thomas B. Ferguson, M.D. Victor A. Ferraris, M.D. Thomas J. Fogarty, M.D. Gregory P. Fontana, M.D. Richard G. Fosburg, M.D. Dr. & Mrs. William H. Frist Timothy J. Gardner, M.D. J. William Gaynor, M.D. Farid Gharagozloo, M.D. Glaxo Wellcome, Inc. Scott Goldman, M.D. L. Michael Graver, M.D. Frederick L. Grover, M.D. John W. Hammon, M.D. Frank L. Hanley, M.D. Bradley J. Harlan, M.D. Alan Hartman, M.D. Hovald Helseth, M.D. Dr. & Mrs. George L. Hicks Jr. Alan Hilgenberg, M.D. Charles B. Huddleston, M.D. O. Wayne Isom, M.D. Leigh I. Iverson, M.D. Jeffrey P. Jacobs, M.D. Stuart Jamieson, M.D. G. Gilbert Johnston, M.D. The Joyce Foundation Lyle Joyce, M.D. George Kaiser, M.D. P. V. Kamat, M.D. Kirk R. Kanter, M.D. The Kealy Family Foundation Paul Kelly Jr., M.D. A. Hassan Khazei, M.D. The Larry King Cardiac Foundation Marvin M. Kirsh, M.D. Nicholas T. Kouchoukos, M.D. Irving L. Kron, M.D. Hillel Laks, M.D. John J. Lamberti, M.D. James M. Levett, M.D. Sidney Levitsky, M.D. Ralph Lewis, M.D. George G. Lindesmith, M.D. Joseph LoCicero III, M.D. Bruce Lytle, M.D. Thomas E. MacGillivray, M.D. Michael J. Mack, M.D. James W. Mackenzie, M.D. Joren Madsen, M.D. James R. Malm, M.D. Christopher T. Maloney, M.D. William T. Maloney Dr. & Mrs. James B. D. Mark P. Michael McFadden, M.D. Joseph S. McLaughlin, M.D. Roger B. Mee, M.D. Robert M. Mentzer, Jr., M.D. Lynda Mickleborough, M.D. D. Craig Miller, M.D. Joseph Miller Jr., M.D. Gregory A. Misbach, M.D. Robert L. Mitchell, M.D. Steve Mourning, FAHP Gordon Murray, M.D. John L. Myers, M.D. Hassan Najafi, M.D. Stanton P. Nolan, M.D. The Northern Trust Company William Nugent, M.D. John Ochsner, M.D. Gordon N. Olinger, M.D. Mark B. Orringer, M.D. Peter Pairolero, M.D. Grant V. S. Parr, M.D. Patricia A. Penkoske, M.D. D. Glann Pennington, M.D. Dr. & Mrs. Gosta B. Pettersson Dr. & Mrs. Richard N. Pierson, III Edward J. Planz, Jr., M.D. Marvin Pomerantz, M.D. Richard L. Prager, M.D. Pratt Surgical Associates, Inc. Walter Purcell Joseph B. Putnam, Jr., M.D. Ronald Quinton, M.D. Michael J. Reardon, M.D. Carolyn E. Reed, M.D. Stancel M. Riley, Jr., M.D. W. Steves Ring, M.D. Eric A. Rose, M.D. Jack Roth, M.D. Valerie Rusch, M.D. Robert M. Sade, M.D. Frank W. Sellke, M.D. Francis L. Shannon, M.D. Baljit K. Sharma, M.D. Richard J. Shemin, M.D. Dr. & Mrs. Peter M. Sidell Mark Slaughter, M.D. Herbert E. Sloan, M.D. Craig R. Smith, M.D. Frank C. Spencer, M.D. Thomas L. Spray, M.D. Quentin R. Stiles, M.D. Valavanur A. Subramanian, M.D. Thoralf M. Sundt, M.D. Francis P. Sutter, M.D. James Symes, M.D. Stanley K. C. Tam, M.D. Christo I. Tchervenkov, M.D. Thoracic & Cardiovascular Surgery at University of Virginia David Torchiana, M.D. Gregory D. Trachiotis, M.D. Alfredo Trento, M.D. Bernard L. Tucker, M.D. Donald A. Turney James Tweddell, M.D. U.S.C. Cardiothoracic Surgeons University of Iowa Hospitals & Clinics Vascutek, Ltd., a Terumo Company Gus Vlahakes, M.D. John Waldhausen, M.D. Jennifer D. Walker, M.D. William Wallace Henry L. Walters, III., M.D. Andrew S. Wechsler, M.D. Benson R. Wilcox, M.D. Douglas E. Wood, M.D. Women in Thoracic Surgery George L. Zorn, Jr., M.D.

New Century Society Summa Cum Laude Gifts of $5,000 to $9,999 Erie H. Austin, III, M.D. Thomas V. Bilfinger, M.D. Frederick Bowman, Jr., M.D. Byung-Chul Chang, M.D. Richard P. Cochran, M.D. John V. Conte, M.D. Eduardo Otero Coto, M.D. Willard M. Daggett, M.D. Benedict D. T. Daly, M.D. Tirone E. David, M.D. Thomas E. Deal, M.D. Verdi J. DiSesa, M.D. Mark K. Ferguson, M.D. Otto Gago, M.D. Thomas E. Gaines, M.D. Joseph J. Garamella, M.D. Michel N. Ilbawi, M.D. John H. & Amy Bowles Lawrence Foundation Harold L. Lazar, M.D. Robert S. Litwak, M.D. Yousuf Mahomed, M.D. Richard B. McElvein, M.D. Roger B. Mee, M.D. Walter H. Merrill, M.D. Keith S. Naunheim, M.D. Mehmet C. Oz, M.D. Robert L. Replogle, M.D. Stancel M. Riley, M.D. Robert M. Sade, M.D. Henry L. Walters, III, M.D. Winfield J. Wells, M.D. James L. Zellner, M.D. New Century Society Magna Cum Laude Gifts of $2,500 to $4,999 Mark S. Allen, M.D. G. Hossein Almassi, M.D. Seth Bekoe, M.D. John W. Brown, M.D. Andrea J. Carpenter, M.D. Thomas A. D’Amico, M.D. Davis C. Drinkwater Jr, M.D. Aubrey C. Galloway, Jr., M.D. Robert A. Gustafson, M.D. David R. Jones, M.D. John A. Kern, M.D. George J. Magovern, Jr., M.D. Peter P. McKeown, M.D. R. Scott Mitchell, M.D. Eduardo Otero Coto, M.D. Frederick B. Parker, Jr., M.D. John D. Puskas, M.D. Robert T. Reichman, M.D. Hartzell V. Schaff, M.D. Alan J. Spotnitz, M.D. William D. Spotnitz, M.D. Gene E. Tullis, M.D. Edward D. Verrier, M.D. John C. Wain Jr., M.D. James Miller Wilson, M.D. New Century Society Cum Laude Gifts of $1,000 to $2,499 A Reza Abrishamchian James S. Allan M.D. Joseph J. Amato, M.D. Emile A. Bacha, M.D. Keith D. Bowersox, M.D. R. Curtis Bryan, MD. Nora L. Burgess, M.D. Larry J. Cardoza, M.D. Aldo R. Castaneda, M.D. Chalit Cheanvechai, M.D. Yolonda L. Colson, M.D. Jack G. Copeland, M.D. Ralph J. Damiano, M.D. Pedro J. del Nido, M.D. Todd L. Demmy, M.D. Robert A. Dion, M.D. Fred H. Edwards, M.D. Anthony L. Estrera, M.D. James I. Fann, M.D. Richard H. Feins, M.D. Andrew C. Fiore, M.D. Francis M. Fontan, M.D. Gregory P. Fontana, M.D. Suresh C. Ghosh, M.D. Miles S. Guber, M.D. Kristene Gugliuzza, M.D. W. Clark Hargrove, III, M.D. Daniel P. Harley, M.D. Robert S. Higgins, M.D. Keith A. Horvath, M.D. Frederick M. Howden, M.D. Marshall L. Jacobs, M.D. Robert E. Jones, M.D. Tom R. Karl, M.D. Shreekanth V. Karwande, M.D. Nevin M. Katz, M.D. Deborah Kollar Robert J. Korst, M.D. Vassyl A. Lonchyna, M.D. James D. Luketich, M.D. Hope S. Maki, M.D. M. Blair Marshall, M.D. Ambrish P. Mathur, M.D. John E. Mayer Jr, M.D. F. Neil Mckenzie, M.D. Richard J. Mellitt, M.D. Shari L. Meyerson, M.D. Daniel L. Miller, M.D. Rodrigo M. Miranda, M.D. Gregory A. Misbach, M.D. David S. Mulder, M.D. Yoshifumi Naka M.D. Lee Chuen Neng, M.D. Richard K. Parker, M.D. Homayoon Pasdar, M.D. Benjamin B. Peeler, M.D. Steven J. Phillips, M.D. Frank A. Pigula, M.D. Thomas W. Rice, M.D. Benson B. Roe, M.D. Todd K. Rosengart, M.D. John A. Rousou, M.D. Edward Y. Sako, M.D. Steven S. Scott, M.D. Significance Foundation-Quinton Family Foundation Norman J. Snow, M.D. Lars G. Svensson, M.D. Paul A. Thomas, Jr., M.D. Dirk E. M. Van Raemdonck, M.D. Darryl S. Weiman, M.D. Y. Joseph Woo, M.D. Stephen C. Yang, M.D. Contributors Gifts up to $999 Tomio Abe, M.D., Ph.D Kevin D. Accola, M.D. David H. Adams, M.D. Gorav Ailawadi, M.D. Ottavio R. Alfieri, M.D. Zohair Y. Al-Halees, M.D. Atsushi Amano C. E. Anagnostopoulos, M.D. Michael Argenziano, M.D. John M. Armitage, M.D. Giorgio M. Aru, M.D. James W. Asaph, M.D. Raimondo Ascione, M.D. Safuh Attar, M.D. Frank A. Baciewicz, Jr., M.D. Faisal G. Bakaeen, M.D. Ko Bando, M.D. Richard J. Battafarano, MD, PhD Eric L.R. Bedard, M.D. Alon Ben-Nun, M.D. Frederick D’Oench Bergen, M.D. Alvise F. Bernabei, M.D. Eugene H. Blackstone, M.D. Robert Blais, M.D. Matthew Blum Phil Bongiorno Uberto Bortolotti, M.D. Preben Brandenhoff, M.D. Berkeley Brandt, III, M.D. Charles R. Bridges, M.D. Paul S. Brown, Jr., M.D. James M. Brown, M.D. Alessandro Brunelli, M.D. Aart Brutel De La Riviere, M.D. David A. Bull, M.D. Thomas A. Burdon, M.D. Robert J. Burnett, M.D. Antonio M. Calafiore, M.D. Thomas R. Calhoun, M.D. Phillip C. Camp, Jr., M.D. Charles D. Campbell, M.D. Marcelo G. Cardarelli, M.D. Thierry-Pierre Carrel Michel Carrier, M.D. Filip P. Casselman, M.D., Ph.D Alan G. Casson, M.D. Andrew C. Chang, M.D. Woon-Ha Chang, M.D. Alain R. Chapelier, M.D. Frederick Y. Chen, M.D. K. Mammen Cherian, M.D. Sertac Cicek, M.D. Robert E. Cline, M.D. Adnan Cobanoglu, M.D. David J. Cohen, M.D. Gordon A. Cohen, M.D., Ph.D Gregory S. Couper, M.D. F.G. Crouch Jose Pedro Da Silva, M.D. Willem J. Daenen Richard C. Daly, M.D. Gail E. Darling, M.D. Philippe G. Dartevelle, M.D. Hiroshi Date, M.D. R. Duane Davis, Jr., M.D. Paul De Leyn, M.D. Marc De Perrot, M.D. Abe DeAnda, Jr., MD Malcolm M. DeCamp, M.D. Giacomo A. DeLaria, M.D. Nicholas J. Demos, M.D. Jatinder S. Dhillon, M.D. Gabriele Di Giammarco, M.D. James T. Diehl, M.D. Wadih R. Dimitri, M.D. Dean M. Donahue, M.D. Elizabeth Dooley John R. Doty, M.D. Dimitrios Dougenis, M.D. James M. Douglas, Jr., M.D. Gilles D. Dreyfus, M.D. Alex Duarte, M.D. Brian W. Duncan, M.D. Cornelius M. Dyke, M.D. Martin J. Elliott, M.D. Robert W. Emery, M.D. Barry C. Esrig, M.D. Aaron S. Estrera, M.D. Volkmar Falk, M.D. Roberto R. Favaloro, M.D. Christopher M. Feindel, M.D. Felix G. Fernandez, M.D. Angel L. Fernandez-Gonzalez, M.D. Raja M. Flores, M.D. David M. Follette, M.D. Joseph Forbess, M.D. Robert W. M. Frater, M.D. Thomas M. Fulcher, M.D. Alex J. Furst, M.D. Paul G. Gannon, M.D. Lisardo Garcia-Covarrubias, M.D. Robert M. Gasior, M.D. Gino Gerosa, M.D. A. Marc Gillinov, M.D. Thomas G. Gleason, M.D. Donald D. Glower, M.D. Daniel Goldstein, M.D. Hugo Gomez-Engler, M.D. Adalberto C. Gonzalez, M.D. Allan H. Goodman, M.D. Patricia Grant, M.D. Roy K. Greenberg, M.D. Tomasz Grodzki, M.D. Donna S. Gurnett George B. Haasler, M.D. Raja E. Haddad, M.D. M. LaWaun Hance, M.D. David H. Harpole, Jr., M.D. James E. Harrell, M.D. John A. Hawkins, M.D. Paul J. Hendry, M.D. J. Donald Hill, M.D. Gregory M. Hirsch, M.D. Wayne Hofstetter, M.D. Thomas M. Holder, M.D. Alan R. Hopeman, M.D. Yasuyuki Hosoda, M.D. Shengshou Hu, M.D.

Timothy J. Hunter, M.D. Manly R. Hyde, M.D. Timothy B. Icenogle, M.D. John S. Ikonomidis, M.D. Michael T. Ingram, M.D. Tadashi Isomura, M.D. Tom D. Ivey, M.D. Erik W. L. Jansen, M.D., Ph.D Robert D. Jaquiss, M.D. Alfred Jaretzki, III, M.D. Victor A. Jebara, M.D. Michael R. Johnston, MD Blanding U. Jones, M.D. James C. Jones, M.D. George Kafrouni, M.D. Donald R. Kahn, M.D. Vinayak Kamath, M.D. Riyad C. Karmy-Jones, M.D. Mark R. Katlic, M.D. Yasunaru Kawashima, M.D. Teruhisa Kazui, M.D. Robert J. Keenan, M.D. Kenneth A. Kesler, M.D. Randolph M. Kessler, M.D. Gyanchand J. Khicha, M.D. Fareed A. Khouqeer, M.D. Teresa M. Kieser, M.D. Sang Hyung Kim, M.D. Karen M. Kim, M.D. Ki-Bong Kim, M.D. R. C. King, M.D. James K. Kirklin, M.D. William C. Kitchens, M.D. Robert R. Klingman, M.D. Ronald W. Knight, M.D. Junjiro Kobayashi, M.D. Tadasu Kohno, M.D. Argiris N. Kontaxis, M.D. George J. Kontos, Jr., M.D. Arvind Koshal, M.D. Benjamin Kozower Guillermo O. Kreutzer, M.D. Christian Kreutzer, M.D. Bahirathan Krishnadasan, M.D. Hiromi Kurosawa, M.D. Jaroslaw Kuzdzal, M.D. Francois G. Lacour-Gayet, M.D. Javier A. Lafuente, M.D. Rudiger S. Lange, M.D. Steven L. Lansman, M.D., Ph.D Charles S. LaPunzina, M.D. Christine L. Lau, M.D. Chuen-Neng Lee, M.D. Scott A. LeMaire, M.D. George V. Letsou, M.D. A. Norman Lewin, M.D. Harald L. Lindberg, M.D. Michael Liptay, M.D. Virginia R. Litle, M.D. Jinfen Liu, M.D. Ugolino Livi, M.D. James W. Long, M.D. James Longoria, M.D. James E. Lowe, M.D. Michael P. Macris, M.D. Mitchell J. Magee, M.D. Edward J. Malec, M.D. Juan Martinez-Leon, M.D., PhD David P. Mason, M.D. Thomas L. Matthew, M.D. James M. Maxwell, M.D. Kenneth McClain M. Terry McEnany, M.D. Robert J. McKenna, Jr., M.D. Daniel R. Meldrum, M.D. Hugo Mendonca, Jr., M.D. Lorenzo A. Menicanti, M.D. Thierry G. Mesana, M.D. Bruno J. Messmer, M.D. Carlos A. Mestres, MD, PhD Michael P. Metke, M.D. Dominique R Metras, M.D. Bryan F. Meyers, M.D. Tomislav Mihaljevic, M.D. J. Scott Millikan, M.D. Jeffrey C. Milliken, M.D. Carmine Minale, M.D. Shinichiro Miyoshi, M.D. Dennis L. Modry, M.D. Richard A. Moggio, M.D. Friedrich W. Mohr, M.D. Hitoshi Mohri, M.D. Laureano Molins, M.D. Thomas A. Molloy, M.D. Marc R. Moon, M.D. Rainer G. H. Moosdorf, M.D. Anthony L. Moulton, M.D. William G. Murison A. John Neerken, M.D. Hassan W. Nemeh, M.D. Tuan Nguyen-Duy, M.D. Takashi Nitta, M.D. William F. Northrup, III, M.D. Chukumere E. Nwogu, M.D. Richard G. Ohye, M.D. Yukikatsu Okada, MD Chukuma I. Okadigwe, M.D. Yutaka Okita, M.D., Ph.D R. Charles Oldfield, M.D. Sergio A. Oliveira, M.D. Bassam O. Omari, M.D. Jose G. O’Neill, M.D. Martin J. O’Neill, Jr., M.D. David A. Ott, M.D. Albert D. Pacifico, M.D. Soon J. Park, M.D. Jeffrey M. Pearl, M.D. F. Griffith Pearson, M.D. Louis P. Perrault, M.D. Ed Petrossian, M.D. Laurens R. Pickard, M.D. John D. Pigott, M.D. Alberto Pochettino, M.D. Jose L. Pomar, M.D. Mario F. Pompili, M.D. Nancy G. Puckett Jan Modest Quaegebeur, M.D. Jaishankar Raman, M.D. J. Scott Rankin, M.D. Kodem S. Rao, M.D. Vivek Rao, M.D. Jose Manuel Revuelta, M.D. Costante Ricci, M.D. David C. Rice, M.D. C. Swayze Rigby, M.D. John W. Riley John M. Robertson, M.D. Gaetano Rocco, M.D. Mark D. Rodefeld, M.D. Xavier F. Roques, M.D. Eric E. Roselli, M.D. David B. Ross, M.D. Giancarlo Roviaro, M.D. Marc Ruel, M.D., M.P. Joseph F. Sabik, III, M.D. Arkalgud Sampathkumar, M.D. Shunji Sano, M.D. George E. Sarris, M.D. Michael A. Savitt, M.D. Ralph A. Schmid, M.D. Joseph D. Schmoker, M.D. Stephan W. B. Schueler, Prof, M.D. Andrew Seely, M.D. Craig H. Selzman, M.D. Paul T. Sergeant, M.D. Daniel L. Serna, M.D. Alain Serraf, M.D. Suvro S. Sett, M.D. Frank J. Shepherd Yasuhisa Shimazaki, M.D. Hideto Shimpo, M.D. Yuji Shiraishi, M.D. Joseph B. Shrager, M.D. Robert L. Shuman, M.D. Dominique Shum-Tim, M.D. Hans-Henric Sievers, M.D. Nicholas G. Smedira, M.D. Peter K. Smith, M.D. Roger D. Soloway, M.D. Harry S. Soroff, M.D. Harold C. Spear, M.D. Alan M. Speir, M.D. David Spielvogel, M.D. Henry M. Spotnitz, M.D. Carmi Y. Stadlan, M.D. Joanne P. Starr, M.D. Bryan M. Steinberg, M.D. Giovanni Stellin, M.D. James R. Stewart, M.D. Stephen G. Swisher, M.D. Koichi Tabayashi, M.D. David P. Taggart, M.D. Shinichi Taguchi, M.D. Shinichi Takamoto, M.D. James P. Takara, M.D. James Tatoulis, MD Pascal A. Thomas, M.D. Norman W. Thoms, M.D. J. Kent Thorne, M.D. Vinod H. Thourani, M.D. Richard J. Thurer, M.D. Theodor Tirilomis, M.D. Thomas R. J. Todd, M.D. Luis A. Tomatis, M.D. Victor F. Trastek, M.D. Victor T. Tsang, M.D. Andrew C. Tsen, M.D. Marko I. Turina, M.D. Mark W. Turrentine, M.D. Yuichi Ueda, M.D. Ross M. Ungerleider, M.D. Helmut W. Unruh, M.D. Eric Vallieres, M.D. Timothy L. Van Natta, M.D. Paul E. Van Schil, M.D. G. Dennis Vaughan, III, M.D. Federico Venuta, M.D. Jakob Vinten-Johansen, Ph.D. Pascal R. Vouhe, M.D. Hiromi Wada, M.D. Thomas K. Waddell, M.D. Salim M. Walji, M.D. Garrett L. Walsh, M.D. Song Wan, M.D., PhD. Daniel Waters, M.D. Levi Watkins, Jr., M.D. Chris J. Wehr, M.D. Tracey L. Weigel, M.D. Francis C. Wells, M.D. Richard I. Whyte, M.D. Thomas E. Williams, Jr., M.D. Willis H. Williams, M.D. Christina Williamson, M.D. Robert F. Wilson, M.D. David W. Wormuth, M.D. Neil K. Worrall, M.D. Cameron D. Wright, M.D. Robert A. Wynbrandt, J.D. Toshikatsu Yagihara, M.D., Ph.D Kazuhiro Yasufuku, M.D. Hisataka Yasui, M.D. Sai Yendamuri, M.D. Alex T. Zakharia, M.D. Marian Zembala, MD, PhD Marco A. Zenati, M.D., FETC M. Nazih Zuhdi, M.D.