Content from the Journal of the American Neurological Surgeons.
An 11-month-old boy presented with features of congestive cardiac failure. On clinical examination, the lower limb pulses were feeble when compared to the upper limb pulses. The baby was investigated for coarctation of aorta. Echocardiography made the diagnosis of coarctation of aorta, with severe pulmonary arterial hypertension. The patient also had a small atrial septal…
Betsy Evans of Leeds General Infirmary in the United Kingdom presents a discussion on TAVI and surgery for prosthetic valve failure. She discusses the background of biological valve implant rate, rate of TAVI, and structural valve deterioration and treatment options. She focuses on two treatment techniques: redo AVR surgery and the TAVI valve-in-valve procedure. This…
This video demonstrates the first VATS left upper lobectomy using ArtiSential® wristed instruments. For the first time in VATS, there are now instruments that are as versatile as robotic instruments. These instruments have the additional advantage of tactile feedback, the ability to do one’s own staple firings, and allow the surgeon to be with the…
Case The patient is a 59-year-old woman with severe tricuspid regurgitation from a septal leaflet restriction by a pacemaker lead implanted for sick sinus syndrome. The patient complained of fatigue and leg swelling. Workup demonstrated normal coronaries, normal left ventricular ejection fraction, and good function of the mitral valve. She was offered a fourth space…
The patient was a 23-month-old, 11.7 kg girl with an antenatal diagnosis of hypoplastic left heart syndrome (mitral stenosis/aortic stenosis). Transthoracic echocardiogram demonstrated a hypoplastic, non-apex forming left ventricle with moderate dysfunction and evidence of extensive endocardial fibroelastosis (EFE). Initial left ventricular volume was measured at 17 ml/m^2. The mitral valve was hypoplastic and stenotic.…
In this Giants of Cardiothoracic Surgery interview, Joel Dunning speaks with James L. Cox, creator of the Cox maze procedure for the treatment of atrial fibrillation. Dr Cox recounts the creation of the Cox maze operation and the evolution to modern atrial fibrillation surgery, as well as the future of this treatment. He also calls…
Case PresentationsThis guide shows two groups. The first group is mitral valve repair, including: Posterior prolapse Barlow disease Commissure fusion Mitral annular dilatation There are associated procedures, such as how to make the loop, automated suturing device, 3D technology, and atrial fibrillation ablation. The second group is mitral valve replacement, including: Endocarditis Rheumatic disease Redo-MVR…
IntroductionThe radial artery has been considered a conduit for coronary surgery for more than 30 years. Its use has steadily increased over the years, especially in light of the benefits of arterial revascularization. The usual method of harvesting the radial artery has been by an open technique with an incision extending from the wrist to…
Thoracic outlet syndrome is a pathology caused by compression of the subclavian artery, subclavian vein, and/or brachial plexus. Its most effective treatment is the section of the scalene muscles, along with the removal of the first rib and section of adjacent ligaments. The authors show the first rib resection technique by videothoracoscopy. A 35-year-old woman…
Wasat Mansoor of The Christie NHS Foundation Trust in the United Kingdom presents a discussion on the management of bronchial neuroendocrine tumors. He focuses on the current treatment strategies for these tumors and ongoing studies that are addressing issues with these treatments, as well as how to manage patients who have received surgery. This presentation…
This is the case of an elderly woman with significant tracheobronchomalacia (TBM) who presented with exertional dyspnea and cough. The patient underwent awake fiberoptic bronchoscopy, which confirmed posterior malaria with >90% narrowing of the trachea and right mainstream bronchus. The patient was treated conservatively with bronchodilators for six months without symptomatic improvement. She was referred…
The patient is an 80-year-old woman with severe mitral valve regurgitation and moderate-severe mitral valve stenosis who was evaluated for mitral valve replacement. The patient had a mitraclip procedure performed two years prior and her mitral regurgitation had recurred. Her symptoms included fatigue and dyspnea on exertion. She had prior coronary stents and her imaging…
This video demonstrates a left VATS diaphragm plication using the ArtiSential® wristed instruments. These instruments allow for robotic-like movements with instruments for VATS procedures. The author used an automated camera holder, which allows the surgeon to control the camera, negating the need for an assistant, and again replicating one of the benefits of robotic surgery.…
Prakash P. Punjabi of the National Heart and Lung Institute and the Imperial College Healthcare NHS Trust in London, United Kingdom, presents a discussion on using midline sternotomy for mitral surgery. He discusses the different types of mitral surgery, while also discussing minimally invasive methods and how they compare to midline sternotomy. This presentation was…
In this video, Alaaddin Yilmaz performs a totally endoscopic aortic valve replacement with a 2 cm utility incision and totally endoscopic suturing. This was performed at the A. V. Vishnevsky National Medical Research Center of Surgery, Ministry of Health of Russian Federation, Moscow, and was broadcast live as part of the AMICS meeting 2019, directed…
Peripartum cardiomyopathy is a disease that can lead to death. Peripartum cardiomyopathy (PPCM) is a rare, often dilated, cardiomyopathy with systolic dysfunction that presents in late pregnancy or, more commonly, the early postpartum period. Women with PPCM typically present with symptoms of congestion, including dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, and edema of the…
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