The landscape of adult cardiac surgeryis evolving at a rapid pace. The proliferation of endovascular techniques, minimallyinvasiveandtranscathetervalvetherapies,andvarious deviceoptionsformechanicalcirculatorysupporthasadded exponentially to the requisite skill set, knowledge base, and clinical volume for ‘‘expertise’’ in any of these designated niche areas. As such, the days of any single cardiac surgeon capable of adeptly treating all facets of heart failure, structural heart diseases, and coronary artery disease in accordance with modern technologic standards are numbered at best, if not already a historical footnote. The advent and continued expansion of public reporting initiatives by the Society of Thoracic Surgeons 1 and consumer advocate agencies will subject our field to an unprecedented level of public scrutiny. 2 Individual surgeon performance, including granular specifics related to outcomes and procedure type, will be cataloged and disseminated to the general public. These widely circulated physician report cards could foreseeably affect remuneration, referral patterns, and scope of practice for individual cardiac surgeons. Despite these and other challenges that lie on the horizon, the future of surgery for acquired cardiac disease is quite promising, especially from a supply and demand perspec