Content from the Journal of the American Neurological Surgeons.
A twenty-year-old woman presented with a severe left ventricular outflow tract (LVOT) obstruction secondary to prosthetic aortic valve dysfunction. She was born with a bicuspid aortic valve and had undergone four previous operations: a left thoracotomy with left subclavian artery flap for repair of aortic coarctation and three sternotomies (resection of a subaortic membrane, resection…
A ninety-one-year-old man presented with shortness of breath and exercise intolerance because of a bioprosthetic aortic valve degeneration with severe regurgitation and moderate stenosis. He also had a history of a surgical implantation of an aortic bioprosthetic valve (Sorin Mitroflow 21mm in 2012) because of a severe fibro-degenerative aortic valve stenosis. The patient was refused…
This video demonstrates a redo aortic root procedure and homograft replacement for a thirty-year-old woman who was diagnosed with PTA at birth. She also had surgical repairment and reconstruction of the right ventricular outflow track with a homograft when she was six. The computed tomography angiography (CTA) showed an aortic root aneurysm beneath her sternum…
This article and accompanying video present a case of a robotic assisted Ivor-Lewis esophagectomy after gastric band placement. The patient was a sixty-seven-year-old man who had previously undergone placement of laparoscopic gastric band for weight loss approximately twenty years prior to this procedure. Under a routine surveillance esophagogastroduodenoscopy, he was found to have a long…
Across the globe, coronary artery disease is a leading cause of morbidity and mortality. In December 2021, the American Heart Association (AHA), American College of Cardiology (ACC), and Society for Cardiovascular Angiography and Interventions (SCAI) released a new coronary artery revascularization guideline. While the American Association of Thoracic Surgery (AATS) and The Society of Thoracic…
The patient was a twenty-eight-year-old man with an upper abdominal discomfort and dyspepsia with no comorbidities and no significant family history. Upon examination, his performance status was good. On initial assessment, a USG abdomen showed a well-defined retrohepatic mass. A CT scan showed a heterogenous pleural based mass in the right hemithorax abutting the inferior…
The development of cardiopulmonary bypass (CPB) has revolutionized cardiac surgery (1). To improve the outcome of patients undergoing cardiac surgery, a task force has developed evidence-based guidelines for the use of CPB, which contributed to the optimization and standardization of CPB techniques (2). However, to ensure safe and effective practice, surgeons need to be adequately…
A sixty-three-year-old male patient was newly diagnosed with intralobar bronchopulmonary sequestration. It was found in the right lower lobe after a diagnosis of COVID-19 prompted a CT scan of the chest. He had reported recurrent pneumonia since he was a child growing up in eastern Europe. He had a seven-pack-a-year smoking history and last smoked…
Left ventricular assist device (LVAD) implantation has two approaches. Of the two, the right mini thoracotomy is the less invasive, as it is sternal sparing. This approach assists with chest stabilization, mobility, virgin tissues for bridge to transplant, and retained pericardium for the right heart support. The preferred lie of the outflow graft is also…
This novel 360-degree video tutorial demonstrates mitral valve repair through a right antero-lateral minithoracotomy approach. Using integrative technology, the viewer can immerse themselves into the procedure by manipulating the directional viewpoint and magnification online via their computer’s mouse or finger scrolling on a tablet or smartphone device. The Procedure To start the procedure, anesthesia is…
The David procedure with an upper hemisternotomy approach is feasible and provides an excellent outcome, particularly in young patients. In this case, a preoperative chest CT showed aortic root dilatation measuring 5.8cm. An echocardiogram demonstrated a bicuspid aortic valve (BAV) without significant aortic valve insufficiency (AI). A 6cm upper hemisternotomy incision extending to the right…
Previous reports have demonstrated the safety and efficacy of the robotic platform in minimally invasive atrial myxoma resection (1,4). This video presents possibly the least invasive reported atrial myxoma resection and the first to utilize an endoscopic robotic approach with an 8mm working port. There are various technical aspects of the procedure, including the use…
This video shows a right S3 segmentectomy completely planned and preoperatively assisted by 3D reconstruction imaging. This model can also be used intraoperatively to assist the surgery and dissection planes in order to increase patient safety and adequate resection margins. References Chaari Z, Baste J-M, Peillon C. Robotic S9-S10 Segmentectomy Assisted by Multimodal Reconstruction Imaging…
Surgical Technique Identical to the authors’ approach to robotic mitral valve surgery, robotic AVR—or RAVR—was developed utilizing a three robotic port technique accompanied by a fourth intercostal space 3 to 4cm mini lateral thoracotomy primary working incision at the level of the anterior axillary line (1,2). Peripheral cardiopulmonary bypass (CPB) with bicaval drainage is utilized…
Esophageal stents are useful for palliation of dysphagia in patients who are not candidates for other therapy modalities either because of their comorbidities or because of tumor characteristics that classify the lesion as unresectable. Stenting is also indicated in patients with recurrent disease after completion of primary treatment. Stents are also used in the treatment…
A sixty-six-year-old man underwent investigation for a recent onset of shortness of breath and was found to have a chronically occluded LAD, a severely dilated left ventricle, reduced ejection fraction, and a large anterior aneurysm. There had been a contained rupture at some stage, and a large false aneurysm had developed. Dor repair (endoventricular circular…
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