About

Nicolas Contreras, MD, is a fellowship-trained cardiothoracic surgeon with a special interest in robotic thoracic surgery, thoracic oncology, esophageal surgery, complex esophageal reconstruction, and lung transplantation. He graduated top of his class at Gonzaga University, majoring in Biochemistry, and received his MD at the Mayo Clinic in Rochester, Minnesota, where he also completed his General Surgery Residency. Dr. Contreras completed his fellowship in Cardiothoracic Surgery at the University of Utah. His clinical specialties include thoracic oncology, robotic thoracic surgery, benign and malignant diseases of the esophagus, lung cancer, mediastinal tumors, chest wall reconstruction, thoracic outlet syndrome, and lung transplantation. His research areas of interest encompass esophageal cancer, thoracic oncology, lung transplantation, and bioethics. He has received multiple awards recognizing excellence in clinical and surgical care during his education and residency. From Bogota, Colombia, Dr. Contreras speaks English and Spanish. He has dedicated part of his career to working with underserved communities in Central and South America.

Research topics

• Surgery
• Computer Security
• Machine Learning
• Medicine
• General surgery
• Artificial Intelligence
• Computer Science
• Philosophy
• Operating system

Selected publications

• ISDE guidelines on the management of cT2N0 esophageal cancer

  Diseases of the Esophagus · 2026-02-16

  articleOpen access

  Esophageal cancer incidence is rising globally, with at least 500,000 new cases diagnosed annually. Management options for non-metastatic disease include primary resection, neoadjuvant or perioperative therapies, or definitive non-surgical treatment, with the choice being guided by tumor staging, histology, patient fitness, and available resources. However, even with the use of advanced diagnostic modalities, preoperative clinical staging is challenging with respect to accuracy of both tumor and nodal assessment. Early-stage esophageal cancer may be managed with local therapies, such as endoscopic mucosal resection or submucosal dissection, while for more advanced tumors managed with curative intent neoadjuvant oncologic therapy is commonly recommended. However, between these two groups lies an infrequent but important subgroup of patients, clinically staged cT2N0M0 esophageal cancer. Guidelines such as the NIH's National Cancer Institute recommends either surgery alone or neoadjuvant therapy followed by surgery for AJCC Stage I cancers, and add the option of definitive chemoradiation for Stage II disease. With cT2N0 disease straddling both AJCC classifications, management guidance is lacking. This guideline will provide an evidence-based recommendation from the International Society For Disease Of The Esophagus on the management of cT2N0 esophageal cancer, of all types. The recommendations are intended to support surgeons, oncologists, and patients in decisions about the best practice preoperative oncologic management of cT2N0M0 esophageal cancer. A Working Group within the International Society for Diseases of the Esophagus (ISDE) Guidelines Committee performed a systematic review of the literature. Results of the systematic review were presented to a panel of experts and these results informed the panel discussion about the guideline. This panel used Grading of Recommendations Assessment, Development, and Evaluation approach to deliberate and formulate recommendations. The panel agreed on a conditional recommendation for the use of neoadjuvant therapy followed by surgery over primary surgical resection (PSR) for adult patients with cT2N0M0 esophageal cancer. Preoperative clinical staging of esophageal cancer is uncertain, with deficiencies in all diagnostic modalities. However, when all modern staging techniques are utilized, the ISDE recommends neoadjuvant therapy followed by surgical resection as the favored treatment of cT2N0 esophageal cancer. Certain patient groups may still be offered PSR, particularly those unable to tolerate neoadjuvant therapies, or those patients with very low risk of lymph node metastasis as suggested by histological features, small tumor size, and other features.

  PublisherDOI

• Transcervical Enucleation of a Giant Cervicothoracic Intramural Esophageal Spindle Cell Tumor

  Annals of Thoracic Surgery Short Reports · 2026-04-01

  articleOpen accessSenior author
  PublisherDOI

• P90. Comparison of Composite Allocation Score and Lung Allocation Score

  Journal of Thoracic and Cardiovascular Surgery · 2026-04-24

  article
  PublisherDOI

• Adult Pectus’ Augmented Reality

  Journal of the American College of Surgeons · 2026-04-01

  article1st authorCorresponding
  PublisherDOI

• The Preoperative Role of Right-Sided Heart Function in Primary Graft Dysfunction After Bilateral Lung Transplantation

  The Annals of Thoracic Surgery · 2026-03-01

  articleOpen access

  BACKGROUND: There are conflicting reports on the role of hyperdynamic right ventricular (RV) function contributing to ischemia-reperfusion injury and the development of primary graft dysfunction (PGD) after lung transplantation (LTx). We evaluated preoperative right atrial (RA) and RV strain in LTx patients and tested their predictive role in development of PGD and overall survival. METHODS: Preoperative echocardiography of patients who underwent bilateral LTx at a single center from 2014 to 2025 was analyzed for RA strain as well as for RV free wall and global longitudinal strain. The presence of PGD grade 3 was defined as a partial pressure of arterial oxygen/fractional inspired oxygen ratio <200 mm Hg at 48 or 72 hours after the operation. RESULTS: Overall, we analyzed 157 patients; PGD developed in 46 (29.3%). Patients with PGD demonstrated worse preoperative RV function, shown by decreased RV free wall strain (-19.5% ± 6.5% vs -15.2% ± 7.3%; P < .001) and RV global longitudinal strain (-16.5% ± 4.8% vs -12.3% ± 5.2%; P < .001). Patients with PGD had decreased preoperative cardiac index (P = .014), increased pulmonary vascular resistance (P = .020), and increased mean pulmonary arterial pressure (P = .038). None of the RV or RA strain variables were predictive of all-cause mortality. The presence of PGD was significantly associated with increased mortality, with 2-year mortality of 20.1% and 48.0% for patients without and with PGD, respectively. CONCLUSIONS: Our study suggests that preoperatively reduced RV and RA function along with decreased cardiac index is associated with the development of PGD. The reduced right-sided heart function was not predictive of long-term survival.

  PublisherDOI

• Equity and Opportunities in Lung Cancer Care—Addressing Disparities, Challenges, and Pathways Forward

  Cancers · 2025-04-17 · 4 citations

  reviewOpen access

  BACKGROUND: Lung cancer is the leading cause of cancer-related mortality in the United States, which disproportionately affect racial and ethnic minorities. Disparities in lung cancer screening, diagnosis, treatment, and survival outcomes are due to a complex interplay of socioeconomic factors, structural racism, and limited access to high-quality care. This review aims to examine the underlying causes of these disparities and explore potential mitigation strategies to improve lung cancer care equity. METHODS: A review of the literature was conducted, evaluating racial and ethnic disparities in lung cancer care. Disparities in lung cancer screening, genomic testing, surgical and systemic treatment, and survival were explored. Additionally, interventional strategies such as risk-based screening, patient navigation programs, and policy reforms were examined. RESULTS: Racial and ethnic minority patients are diagnosed at younger ages with fewer pack-years yet are less likely to qualify for screening under current guidelines. They receive lower rates of guideline-concordant treatment, including surgery, radiation, chemotherapy, and biomarker testing, and have reduced access to specialty care. Socioeconomic barriers, medical mistrust, and geographic disparities further contribute to these inequities. Targeted interventions, including mobile screening programs, financial assistance initiatives, and culturally competent care, have shown promise in improving lung cancer outcomes. CONCLUSION: A multi-level approach, incorporating healthcare policy changes, improved screening criteria, and an enhanced community engagement strategy, is essential for achieving equitable lung cancer care, ultimately improving outcomes for racial minority populations.

  PublisherOA PDFDOI

• Reduced left atrial compliance exacerbates primary graft dysfunction after lung transplantation

  Journal of Thoracic and Cardiovascular Surgery · 2025-05-04 · 1 citations

  article
  PublisherDOI

• Targeting leukocytes, neutrophil extracellular traps and cytokines: A conceptual review to prevent primary graft dysfunction after lung transplantation

  Transplantation Reviews · 2025-12-26

  articleOpen access

  Even with the advances of perioperative management and surgical techniques, the outcomes of lung transplantation remain inferior to other solid organ transplantations, in part due to the high occurrence of primary graft dysfunction (PGD) which occurs in up to 30-50 % of lung transplant recipients. Ischemia-reperfusion injury (IRI) is one of the main causes of PGD. Neutrophils play an important role in the mechanism of IRI. Recent studies showed that neutrophil extracellular traps (NETs) also play an important role in development of PGD. There are also some studies about the innovative devices which can remove NETs and pathogenic cytokines. In this review, we discuss the effects of a leukocyte-depleting filter, NETs disruption with Deoxyribonuclease, NETs removal with filter (NucleoCapture), cytokine adsorption filter (CytoSorb), and neutrophil elastase inhibitor for the prevention of PGD. All of these techniques have been studied mainly in animal lung transplant models or ex vivo lung perfusion models, and have shown to have a potential to prevent PGD after clinical lung transplantation. However, clinical trials are needed to critically assess these novel therapies.

  PublisherDOI

• Pre‐Operative Atrial Deformation Indices Predict Post‐Operative Atrial Fibrillation in Patients Undergoing Lung Resection Surgery

  Echocardiography · 2025-02-01 · 4 citations

  article

  ABSTRACT Background There are no established predictors of post‐operative atrial fibrillation (POAF) in non‐cardiac thoracic surgery. Pre‐operative left atrial imaging has been shown to identify patients with POAF undergoing cardiac surgery. The purpose of this study was to determine whether pre‐operative left atrial strain (LAS) predicts POAF in patients undergoing lung resection. Methods One hundred forty‐nine patients who underwent cancer lung resection were retrospectively analyzed. Pre‐operative imaging involved conventional transthoracic echocardiography with comprehensive speckle‐tracking strain. The additional advanced LAS analysis involved three components of atrial function: reservoir, conduit, and booster. Results POAF occurred in 17 (11.4%) patients. We found no differences in demographics and peri‐operative variables. Patients with POAF were more likely to have atrial fibrillation history (6.8% vs. 29.4%, p = 0.003). Preoperative imaging analysis revealed an increased LA volume index in patients with POAF (25.9 ± 8.8 vs. 32.3 ± 11.9 mL/m 2 , p = 0.046). All three components of LAS were reduced in the POAF group. The most prominent reduction was reservoir–compliance strain (35.5% ± 4.6% vs. 24.2% ± 6.6%, p &lt; 0.001), then conduit strain (–18.3% ± 8.7% vs. –12.6% ± 4.7%, p &lt; 0.001), and booster strain (–18.3% ± 8.7% vs. –12.6% ± 4.7%, p &lt; 0.001). On univariable analysis, LAS reservoir strain was associated with POAF status (OR: 0.86 [95% CI: 0.78–0.92]), with a c‐index of 0.81. Optimized multivariable model considering left atrial volume index, reservoir LAS, and atrial fibrillation history improved c‐statistic to 0.880. Conclusion Reduced LAS metrics are more specific and sensitive than conventional demographics and standard echocardiography in predicting POAF. Preoperative LA imaging might aid with identifying patients undergoing lung resection who are high‐risk and benefit from prophylactic therapy.

  PublisherDOI

• Pre‐Operative Reduced Atrial Compliance Is Predictive of Post‐Operative Atrial Fibrillation in Patients Undergoing Esophagectomy

  Echocardiography · 2025-09-01

  articleSenior author

  BACKGROUND: There are no established predictors of postoperative atrial fibrillation (POAF) in patients undergoing esophagectomy. This study aimed to determine whether pre-operative bi-atrial strain might predict POAF in patients undergoing esophageal resection. METHODS: Patients who underwent esophagectomy and had preoperative echocardiography underwent comprehensive myocardial strain analysis measuring left and right atrial (LA and RA) phase-specific strain and left and right global longitudinal strain (LV and RV GLS). Clinical and traditional variables were sampled and considered for multivariable models with the POAF serving as a primary outcome of the study. RESULTS: Fifty-nine patients constituted the study group and the incidence of POAF was 25.4% (N = 15). Patients who developed POAF were older and had a higher rate of anastomotic leak. LA strain analysis was overall suggestive of reduced LA compliance in the POAF group with decreased LA reservoir strain (33.9 ± 8.9 vs. 22.0 ± 8.8%, p < 0.001) and LA conduit strain (-18.4 ± 9.2 vs. -9.6 ± 5.5%, p < 0.001). RA reservoir strain was also reduced in the POAF group (36.9 ± 8 vs. 29.6 ± 8.1%, p = 0.006) together with reduced RA conduit strain (-20.6 ± 6.9 vs. -15.4 ± 7.6%, p = 0.042). LV GLS was decreased in patients with POAF (-16.2 ± 3.5 vs. -12.3 ± 7.5%, p = 0.036), along with RV GLS (-17.6 ± 3.4 vs. -14.4 ± 3.8%, p = 0.009). Reduced LA reservoir strain remained an independent predictor for POAF when combined with the presence of an anastomotic leak [OR: 0.85 (95% CI: 0.75-0.92), p < 0.001] yielding model with AUC of 0.86 with a sensitivity 60.0% and specificity 90.1%. CONCLUSION: Reduced bi-atrial compliance evidenced by standard echocardiographic strain analysis predicts POAF in patients undergoing esophagectomy. Comprehensive echocardiographic evaluation should be considered in surgical candidates before esophageal surgery, given the detected subclinical global myocardial dysfunction.

  PublisherDOI

Frequent coauthors

• Sara J. Pereira

  University of Utah

  4 shared

• Rachael Essig

  Twitter (United States)

  4 shared

• Thomas K. Varghese

  Northern Alberta Institute of Technology

  4 shared

• Brian Mitzman

  4 shared

• Donald H. Jenkins

  KHM-Museumsverband

  2 shared

• Sayeed Sajal

  Utah Valley University

  2 shared

• Monika A. Krezalek

  NorthShore University HealthSystem

  2 shared

• Imtiaz Parvez

  Utah Valley University

  2 shared

Awards & honors

• Awards as top surgical intern of his class
• Best overall surgical resident
• Chief Resident Teacher of the Year