Content from the Journal of the American Neurological Surgeons.
This is a video of thoracic surgeon Joel Dunning’s dream operating room. He was able to bring an intraoperative CT scanner called the Cios-Spin into his robotic theater so he could mark nodules himself prior to robotic resection. In addition, he has Innersight Labs 3D reconstruction of his CT scans as guidance for the surgery.…
This is the case of thirty-four-year-old woman who presented with a long-term history of left flank pain, groin pain, and proteinuria. She underwent a venography, angiography, and CT scan. The cause of her symptoms was identified as nutcracker syndrome (left renal vein entrapment). The Surgery The abdomen was entered via the laparoscopic approach. The dissection…
Atrial fibrillation (AF) is the most widely recognized cardiovascular arrhythmia related to expanded morbidity and mortality commonly caused by stroke or the intensification of heart failure (1,2). Over the decades, new nonpharmacological treatment modalities acquainted with the pulmonary vein isolation and exclusion of the left atrial (LA) appendage have become a reasonable option in contrast…
Urgent pneumonectomy for benign disease is rare but highly morbid, with a perioperative mortality approaching 50 percent. Late postpneumonectomy empyema (PPE) with bronchopleural fistula (BPF) poses a significant therapeutic challenge and carries a mortality risk of up to 40 percent. Case A forty-seven-year-old female underwent an Ivor Lewis esophagectomy for progressive achalasia, complicated by type…
Experience with routine minimally invasive coronary artery bypass grafting makes it possible to successfully and safely perform more complex procedures through the same incision. This video presents the authors’ routine approach for minimally invasive left ventricle aneurysm repair and coronary artery bypass grafting through the left minithoracotomy. The patient was a fifty-nine-year-old woman with…
This video offers a step-by-step approach to transcatheter aortic valve replacement (TAVR) using a self-expanding valve. It features the case of a patient at intermediate surgical risk who chose to undergo TAVR. Although many of the general principles and steps shown apply to the TAVR in general, this case specifically highlights the use of a…
The CTSNet Resident Video Competition continues to be a highlight for the cardiothoracic surgery online community. CTSNet is excited to announce the winner of the 2021 competition, Dr. Julia Coughlin. Her submission was titled “Successful Use of an Endobronchial Valve for Post-Operative Bronchocutaneous Fistula and Pneumothorax Necessitans,” and she recently discussed her video with CTSNet…
Sternal dehiscence without mediastinitis is a rare and relatively benign complication after cardiac surgery. However, it may cause severe discomfort for a patient. Traditional approaches include the Robicsek technique and its modifications, which require advanced dissection of the posterior surface of the sternum (1,2). In this video, the authors present a less invasive approach for…
The patient featured in this video is a seventy-seven-year-old asymptomatic woman with a history of hypertension who underwent computed tomography (CT) for a medical check. The CT revealed two peripheral consolidations in the right upper lobe (superior and posterior segment, respectively) and a 5 mm nodule in the middle lobe. Upper lobe posterior segment (S2)…
Radical thymectomy is the traditional surgical management of thymomas. With the advancement of technology, thymomectomy via a minimally invasive approach is gaining popularity, although evidence supporting comparable oncological outcomes remains limited. However, studies have shown a nonsignificant difference between five and ten year survival rates for those undergoing radical thymectomy or thymomectomy. This video demonstrates…
This video demonstrates the steps of iliac vessel cannulation that the authors use for redo pediatric cardiac surgery. The draping gives provides access to bilateral Iliac vessels and to the sternum. First, the incision is planned after palpating the femoral pulses. Then the skin is incised above and parallel to the right inguinal ligament. The…
Abstract The sternum is an important component of the axial skeleton. Its intactness and stability are important not only for respiratory or chest mechanics, but also for mediastinal and hemodynamic stability. Sternal reconstruction may be difficult with extensive tumor and resection of the sternum with a risk of morbidity after surgery. This article presents the…
Dextrocardia is a congenital cardiac anomaly in which the base-apex cardiac axis points to the right and may be associated to situs solitus, situs inversus, or situs ambiguous. In cases of dextrocardia with situs inversus totalis, the heart and all the other organs are in a mirror image position compared to the normal situation. Case…
The Ivor Lewis esophagectomy has remained the procedure of choice for localized middle or lower esophageal cancer since it was first introduced in 1946 (1,2). Despite its widespread use, the rate of complications remains high. Anastomotic leak is still reported as high as 25 percent, and esophageal strictures can be up to 40 percent. It…
In a previous video on CTSNet, published last year, the authors detailed how to use a “Y” incision and rectangular patch to enlarge the aortic annulus by three to four valve sizes for aortic valve replacement (AVR) with bioprosthesis (1). The video below demonstrates the same technique but for mechanical AVR. In the case…
Iatrogenic aortic dissection is a rare but catastrophic complication of cardiac surgery. This video shows two cases of extensive type A aortic dissection occurring during elective cardiac surgery. The first case occurred during a totally endoscopic mitral valve repair through a right mini-thoracotomy approach in a fifty-seven-year-old woman. A large sheared-off intimal flap was noted…
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