Content from the Journal of the American Neurological Surgeons.
We are presenting the case of minimally invasive repair of large left ventricle inferior pseudoaneurysm and concomitant CABG procedure. The patient was a 63-year-old man who presented with shortness of breath and severe angina pectoris. The operation plan consisted of left anterior minithoracotomy in 4th intercostal space, left internal mammary artery harvesting, peripheral cannulation for…
We describe the subtle nuisances needed to perform a robotic right upper lobectomy using a fissure less technique to cut down on airleaks. We also describe and discuss the evolution of our technique which has helped us perform over 1000 robotic procedures at Moffitt Cancer Center. The description of lymph node dissection and removal is…
The authors present an off pump extracardiac non-fenestrated Fontan in a child with pulmonary atresia and intact ventricular septum. This is a 6-year old, 16-kg girl with a functional single ventricle. Her previous two palliations were a left MBT shunt followed by a bidirectional cavopulmonary anastomosis (Glenn). She presented with cyanosis (saturation of low-mid 70%)…
In these two videos, the authors present two demonstrations of near infra-red imaging technology to provide visualization of pulmonary anatomical segments for segmentectomy. Pulmonary segments are anatomically and functionally independent units of the lung but are macroscopically indistinguishable from other segments with the naked eye, making their isolated resection difficult.(1) This technique combines the use…
We previously described using a “Y” incision and rectangular patch to enlarge the aortic annulus by 2-3 valve sizes for aortic valve replacement (AVR) with bioprosthesis (1) or mechanical valve (2) in patients with trileaflet aortic valve (TAV). As we are becoming more experienced, we are able to enlarge the aortic annulus by 4 valve…
In this video, we show in a step-by-step fashion how we could perform what is, to the best of our knowledge, the first total arch replacement with Frozen Elephant Trunk (FET) without circulatory arrest (CA) in a patient with type A acute dissection. Our concept, based on the recognition of CA as the last important…
Repair of aortic coarctation in infants and small children is associated with high rates of reintervention due to recurrent coarctation and other aortic pathologies [1]. Use of a curved, geometrically optimized patch during extensive aortic reconstruction may decrease the risk of re-coarctation by minimizing kinking and anastomotic torsion. This video captures the conduct of a…
In this video, we present a patient with a recurrent paraesophageal hernia who underwent robot-assisted laparoscopic re-do paraesophageal hernia repair with Nissen fundoplication. The patient is a 76M with a past medical history significant for longstanding and symptomatic GERD, status post laparoscopic paraesophageal hernia repair and Stamm gastrostomy. He had a series of workups that…
Left ventricular outflow tract aneurysm compressing the left main. A 44 –year-old male patient presented with shortness of breath and chest pain. ECG showed ST depression in the lateral leads. Echocardiogram showed subaortic aneurysm below the left coronary and non-coronary cusp with impaired LV function. Left coronary angiogram revealed 90% obstruction of Left Main due…
Introduction Valve sparing operations provide excellent long term results but are technically demanding and time consuming (1,2). An alternative approach is the “sleeve” technique (3). Since 2006, the authors have addressed aortic root disease with a modified sleeve procedure and have performed 180 interventions in such a way (3,4). Patient selectionThe procedure addresses aortic root…
Pulmonary sequestration is a rare lung malformation comprising 0.15-6.4% of all congenital pulmonary malformations (1). The anomalous lung segment has systemic arterial supply, various forms of venous drainage and no connection to the tracheobronchial tree. The lung segment can be within the native pleura lining (intralobar) or have its own pleural investment (extralobar). The systemic…
Background Obesity is often considered as a contraindication to minimally invasive coronary artery bypass grafting. Our concept has been that all incoming patients for isolated surgical coronary revascularization are eligible for a coronary artery bypass grafting through the left anterior minithoracotomy. For this purpose TCRAT procedure (Total Coronary Revascularization via Left Anterior Thoracotomy) was developed.…
We present to you a complete repair of double outlet right ventricle (DORV) with pulmonary atresia (precisely a single outlet) in an 8-year-old girl. This is a demonstration of the Rastelli procedure. The patient was palliated with a central shunt followed by stent placement in a right sided major aortopulmonary collateral artery (MAPCA) which was…
The technique of aortic valve reconstruction with neoaortic tricuspidization (Ozaki technique) is relatively well established and studies have shown excellent midterm results. The authors adopted the Ozaki technique to create a valved conduit inside of the Dacron graft (Ozaki valved conduit). They have used the Ozaki valved conduit during total repair of tetralogy of Fallot…
The authors present a 59-year-old woman with a history of asthma, episodes of bronchospasm, and multiple ICU readmissions requiring orotracheal intubation. After a trial period with a tracheobronchial Y-shaped silicone stent (DumonTM stent), a tracheobronchoplasty was indicated as a definitive surgical treatment. The objective of surgery was to stabilize and add rigidity to the membranous…
In this CTSNet Deep-Dive, Dr Brian Mitzman of the University of Utah in Salt Lake City, UT, interviews thoracic outlet syndrome expert Dr Bryan Burt of the Baylor College of Medicine. They discuss Dr Burt’s latest publication currently in-press with the Journal of Thoracic and Cardiovascular Surgery, entitled “Safety of Robotic First Rib Resection for…
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