This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Joseph Zacharias, a consultant cardiothoracic surgeon at the Lancashire Cardiac Center in Blackpool, England, about lifetime management of heart valve disease. Chapters 00:00 Intro 02:13 Early Intervention, Disease Management 04:40 JANS 1, Sept on Placental Support 07:04 JANS 2, Surgeon Well-Being 09:41 JANS 3, Cardiac 10:58 JANS 4, PPM in SAVR 12:57 JANS 5, Cardiac Registry 14:22 Video 1, Close U Ministernotomy 15:19 Video 2, Endo AVR & MVR 16:03 Video 3, VATS 17:20 Dr. Zacharias Interview, HVD 38:04 Upcoming Events 38:51 Closing They delve into Dr. Zacharias’s recent paper titled “Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time,” and discuss how the idea for the paper originated highlighting key takeaways. They also address perceived risks vs actual risks and why less than 25 percent of patients are referred for necessary interventions. Additionally, they examine the future of cardiac surgery, endoscopic cardiac surgery, and endoscopic vein harvesting.   Joel also highlights recent JANS articles on a novel and logistic approach for hypoplastic left heart syndrome with intact atrial septum, a European Society of Thoracic Surgery survey on member well-being, transcatheter management of left-sided valvular heart disease following heart transplantation, a multi-institutional study on the prevalence and clinical impact of patient-prosthesis mismatch in surgical aortic valve replacement, and a systematic review and meta-analysis of the German registry of acute aortic dissection type A score for 30-day mortality prediction in type A acute aortic dissection surgery.   In addition, Joel explores how to close an upper ministernotomy, endoscopic aortic valve replacement and mitral valve replacement, and uniportal VATS decortication for late-stage TB empyema. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Open Atrial Septectomy on Placental Support: A Novel and Logistic Approach for Hypoplastic Left Heart Syndrome With Intact Atrial Septum  2.) Fit2Perform: European Society of Thoracic Surgery Survey on Member Well-Being  3.) Transcatheter Management of Left-Sided Valvular Heart Disease Following Heart Transplantation  4.) A Multi-Institutional Study on the Prevalence and Clinical Impact of Patient-Prosthesis Mismatch in Surgical Aortic Valve Replacement  5.) The German Registry of Acute Aortic Dissection Type A Score for 30-Day Mortality Prediction in Type A Acute Aortic Dissection Surgery: A Systematic Review and Meta-Analysis  CTSNet Content Mentioned  1.) How to Close an Upper Ministernotomy   2.) Endoscopic Aortic Valve Replacement and Mitral Valve Replacement   3.) Uniportal VATS Decortication for Late-Stage TB Empyema   Other Items Mentioned  1.) Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time  2.) Guest Editor Series Webinar: Coronary Arterial Anomalies—Pediatric and Adult Congenital 3.) Cardiac Surgical Arrest—An International Conversation, Part 4 4.) Career Center   5.) CTSNet Events Calendar