Introduction.

This issue of Seminars in Vascular Surgery is the first of a two-part series focusing on the impact of coronavirus disease 2019 (COVID-19) on vascular surgery and patients with vascular disease. As we write this Editorial, worldwide COVID-19 deaths range between 3.2 and 6.9 million, with at least 157 million infections [1,2]. All-cause mortality during the pandemic is increased by >20% (US data). This number not only measures documented COVID-19 deaths, it includes deaths from unrecorded infections, as well as deaths related to other interruptions of care and services [3,4]. During this time of immense death and suffering, it is imperative that we keep our hearts open and think about the loss associated with each death and illness.

We remember the vascular surgeons who died from COVID-19 infection, including, but not limited to, Dr. Erwin Spannagl, Dr. Giancarlo Piano, Dr. Mel Williams, and Dr. Mohan Adiseshiah. We remember the members of the vascular community who died in the past year of other causes, including Herbert Dardik, MD, Noor Gul Shah, MD, Victor M. Bernhard MD, and William R. Hiatt, MD [5], [6], [7], [8] and, no doubt, others we are not immediately aware of as well. Each of these lives had a tremendous personal impact on those around them. We send our condolences to all who are mourning.

We take a moment to celebrate the life of William R. Hiatt, MD, who died on December 8, 2020. He was a renowned vascular medicine physician, cardiovascular researcher, and a prolific mentor. Dr. Hiatt was an advocate and teacher with tremendous energy and dedication who leveraged his positions of experience and authority to advance each mentee's research career. He was a physician-scientist guided by principle. Dr. Wohlauer experienced these attributes firsthand. Dr. Hiatt and Dr. Wohlauer employed a team approach in clinic, reserving some of the most challenging and complex patients with vascular disease, offering a precision-medicine approach and clinical trials for patients without a clear roadmap for surgical cure. He was an advocate and teacher with tremendous energy and dedication. The two spoke on the phone and e-mailed regularly, with conversations shifting between the details required to advance research projects, to discussions about patients in the hospital, to inquiring about family, personal wellbeing, triumphs, trials, and tribulations. He was instrumental in moving the Vascular Surgery COVID-19 Collaborative (VASCC) forward and was the first member of the Advisory Board. Dr. Hiatt made the time to participate as an invited guest at the International Consortium of Vascular Registries (ICVR) virtual meeting when Dr. Wohlauer presented “VASCC: COVID-19 Research” on November 23, 2020. Few would have expected that these remarks would occur just 2 weeks before his death.

John P. Cooke, MD, PhD, and Alan B. Lumsden, MD, interviewed Dr. Hiatt in 2017, and he spoke about the power of mentorship: “I feel like I'm a fortunate and blessed person. I really mean that. I went to medical school at University of Colorado, where I'm born and raised, and Bob Rutherford was Chief of Vascular Surgery. He took me under his wing. He became my first mentor. Bob Rutherford is a giant in Vascular Surgery. He wrote the textbook, he developed all of the vascular lab standards we currently use now. He unfortunately died a few years ago. He became a father figure to me. During medical school I did research in his vascular lab. I went away to Boston to do my residency, and came back to join the faculty at University of Colorado. I continued to work with Bob Rutherford. That (research) went into the TASCC guidelines, the first set of international guidelines to treat peripheral vascular disease. Bob was the mentor that you wanted to work for. He was excited about science. He was excited about his discipline. He made an impact. He changed my life [9].

We also remember Dr. Hiatt's mentor, Robert B. Rutherford. Dr. Rutherford, the founder of Seminars in Vascular Surgery, was a visionary who created this platform for vascular surgeons to discuss current topics. He was the editor of Seminars from 1998 until 2012, one year before his death. Dennis Bandyk, MD, became the Seminars Editor-in-Chief in 2013 and served until 2020 [10].

Like current Seminars Editor-in-Chief, Dr. Caitlin Hicks, who assumed leadership of the journal in 2021, Dr. Rutherford was born in Canada and trained at Johns Hopkins University. He completed his undergraduate and medical degrees and surgical internship at Johns Hopkins. He was a Fulbright Scholar at Lund University in Malmo, Sweden. He completed surgical residency at the University of Colorado. He served on the faculty at Johns Hopkins and the University of Colorado. He developed the definitive textbook, published more than 400 peer-reviewed articles, and received numerous awards. He was a director of the American Board of Surgery (ABS) and chaired the ABS Vascular Surgical Committee. He was the co-editor of the Journal of Vascular Surgery and a president of four vascular surgical societies, including the Society for Vascular Surgery (SVS). He led the development of reporting standards and disease-specific scoring systems vital to the advancement of the vascular surgery field. He received the first SVS lifetime achievement award [6]. K. Wayne Johnston, MD, and Jack L. Cronenwett, MD, remember him as a “surgeon-scholar and a teacher's teacher” [11,12].

Bob Rutherford and Will Hiatt shared a love for the outdoors. If the two of them were alive today, they would relish in the progress made by vaccinations and other initiatives allowing many of us to venture more comfortably and frequently outside of our homes. We speak for many in expressing gratitude for their contributions to our field, stellar both in quantity and magnitude. May we all strive to follow in their footsteps and be force multipliers advancing the care of patients with vascular disease.

In this issue of Seminars, we present a group of outstanding authors, moving our vascular community forward with their meaningful contributions. Jamal Hoballah, MD, and colleagues reflect on their experience managing the Beirut Port explosion on August 4, 2020, in “Mass Casualty Management During a Pandemic Surge: The American University of Beirut Medical Center Experience.” Dr. Nicholson et al describe a novel “In-Home Vascular Testing Program During the COVID-19 Pandemic.“ Dr. Lemmon and colleagues describe the pandemic's disruption of research and registries in “The Impact of COVID-19 Pandemic on Vascular Registries and Clinical Trials.” Nicole Ilonzo, MD, and colleagues describe arterial thrombotic events in patients infected with severe acute respiratory syndrome coronavirus 2, in “A Review of Acute Limb Ischemia in COVID-Positive Patients.” Dr. Sica et al. discuss “The Strength of the Online Vascular Community During the COVID-19 Pandemic.” Dr. Drudi and co-authors talk about “The Impact of the COVID-19 pandemic on Wellness Among Vascular Surgeons.” Dr. Bissacco and colleagues explore the “Impact of COVID-19 on Aortic Operations.” Dr. Levitt et al. consider “The Impact of the COVID-19 Pandemic on Cerebrovascular Disease.” We appreciate all of the hard work invested into these articles. We hope that you enjoy them as much as we do.