Content from the Journal of the American Neurological Surgeons.
E-vita Open was the first commercially available hybrid graft for frozen elephant trunk (FET) surgery (1). Fifteen years after the first implantation in Essen, a new generation of grafts were developed to address the requirements of treatment according to the different aortic arch and descending aorta pathologies and anatomical morphologies. The E-vita Open NEO (Jotec/Cryolife)…
Aortic root and arch replacement after a previous operation on the aortic valve (AV), root, or ascending aorta remains a major challenge. Indications for reoperation include true and false aneurysms, dissection or re-dissection, structural valve dysfunction, and prosthetic valve-graft infection (1). The authors present the case of a patient with aneurysmal root dilatation and persistent…
The authors present the surgical management of an emergent, ruptured, chronically dissected aortic arch aneurysm. The surgical reconstruction was facilitated by the use of left axillary artery cannulation, the utilization of total arch replacement, and a “sandwich” frozen elephant trunk technique utilizing two thoracic aortic stent grafts to obtain hemostasis. Disclaimer The information and…
This is the case of a 65-year-old woman who presented with exertional dyspnea, fatigue, and a long history of chronic hemolytic anemia. She had a complex cardiac surgical history with four previous sternotomies to address mitral valve (MV) pathology. The patient had three previous MV replacements with mechanical prostheses (St. Jude twice and Starr Edwards…
Mara Antonoff, Melanie Edwards, Brian Mitzman, and Erin Gillaspie delve into why wellness matters during crises, strategies to achieve wellness, and obstacles to overcome so members of the healthcare team can support one another during challenging times.
Mara Antonoff, Brian Mitzman, Michael Maddaus, and Mehran Amirizadeh discussed crisis management and resilience, including leadership, maintaining personal well-being, and coming back stronger in the face of the pandemic.
Atrial fibrillation is the most common cardiac arrhythmia, affecting more than 33 million individuals worldwide (1). Anticoagulation is frequently needed to decrease the risk of stroke, but nearly 20-40% of patients at risk of stroke do not receive anticoagulation due to contraindication, bleeding, or patient/physician preferences (2, 3). Greater than 90% of cardiac emboli in…
A 59-year-old man presented to a local hospital with fever, a nonproductive cough, and dyspnea. He tested positive for COVID-19. Prior to his progressive respiratory failure, computed tomography of the chest was performed. After reaching maximum ventilator support, he was transferred to the authors’ institution for ECMO. Using software from Surgical Theater, a 360-degree virtual…
Introduction The coronavirus disease 2019 (COVID-19) pandemic has not left anyone untouched. By the end of June 2020, over 10 million people were confirmed to have been infected with COVID-19, resulting in national and regional lockdowns and other contingency measures across the globe. Since March 2020, elective surgical procedures have been postponed or cancelled in…
The authors show the case video of homograft aortic root replacement for prosthetic valve endocarditis. The case is a 59-year-old man on chronic oral steroid who underwent biological aortic valve replacement six months ago. He came back with heart failure symptoms and an echocardiogram showed severe aortic regurgitation with root abscess. With this finding, he…
A 34-year-old woman with type II dyspnea was diagnosed by echocardiography for partial anomalous vein connection with sinus venosus atrial septal defect, confirmed by an MRI. A two-patch repair technique through a video-assisted minimally invasive approach (MICS) was performed with excellent results. This video tutorial shows how the authors were able to repair this pathology…
Filmed at the 2020 STS Annual Meeting in New Orleans, Louisiana, Mara Antonoff of the University of Texas MD Anderson Cancer Center in Houston, USA, moderates a discussion on maintaining physical health to prevent burnout in cardiothoracic surgery. She is joined by Robert J. Cerfolio of NYU Langone Health in New York, Lisa M. Brown…
The lungs are a common target-organ for metastases in most of cancers. Pulmonary metastasectomy can potentially be a curative surgical option as long as selection criteria of patients are rigorously met. These essential requirements include control of the primary tumor, no other distant metastatic disease, a limited number of pulmonary metastases so that a complete…
This video details the operative steps and technique of root and total arch replacement with frozen elephant trunk for aortic dissection, as described by Dr Sun (1). Right axillary cannulation with selective antegrade cerebral perfusion for brain protection and moderate hypothermic circulatory arrest at 25 °C is used. A special open-stented graft, endowed with a…
Reduced availability of the homograft makes it very important that one uses alternatives for surgical reconstruction of the right ventricular outflow tract (RVOT) while operating for trunus arteriosus. Bovine jugular venous valved conduit (Contegra) is a bioprosthesis consisting of a glutaraldehyde-preserved bovine jugular vein with a trileaflet venous valve. It is a viable choice in…
In this CTSNet Interview, Dr Mara Antonoff discusses the background, inspiration, and stepping stones to the career of the formidable Dr Yolonda Colson. Dr Colson is the chief of Thoracic Surgery at Massachusetts General Hospital and the Hermes C. Grillo Professor of Surgery at Harvard Medical School. She completed a degree in biomedical engineering prior to attending medical school at Mayo. …
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