Book excerpt: Over the last 23 years our identity and mission of the TSRA have expanded to meet the needs of our members by providing peer-based resources and support for cardiothoracic surgery residents to succeed throughout training and launch successful careers. The prior edition of this book, TSRA Clinical Scenarios in Cardiothoracic Surgery, published in 2013 was tremendously successful. The first edition of this book aimed to augment available resident educational resources. It focused on knowledge application in a dynamic decision-making capacity highlighting surgical technique, practical knowledge and clinical acumen based on a variety of different clinical case scenarios. This edition aims to update this review resource while simultaneously expanding the scope of clinical scenarios to keep pace with the ever-changing clinical cardiothoracic training environment.The aim of this book is to review common, high-yield clinical scenarios that may surface during a cardiothoracic surgeon's practice in congenital, thoracic, or adult cardiac surgery. It was written by residents for residents. We meticulously reviewed and edited all previous clinical case scenario chapters focusing on updated clinical and scientific evidence. The first edition contained 72 chapters authored by over 50 residents and faculty from across the country. The new edition contains 19 new chapters (36-chapter revisions) with 91 chapters authored by 159 residents and faculty nationwide! We have maintained the structure and flow of the book utilizing the three major sections of cardiothoracic surgery: General Thoracic Surgery, Adult Cardiac while expanding the congenital section to be Congenital Cardiothoracic Surgery.