Content from the Journal of the American Neurological Surgeons.
Sir Magdi Yacoub of the Imperial College London in the UK and Patrick Serruys of the Thoraxcenter Erasmus University in Rotterdam, Netherlands, discuss the use of tissue-engineered valves versus endogenous tissue restoration. This debate was presented at the Heart Valve Society (HVS) Annual Meeting 2019 in Sitges, Spain, and is presented here with permission from HVS. For…
Current American Heart Association/American College of Cardiology guidelines state that mitral valve repair for asymptomatic patients with preserved left ventricular function is reasonable when the likelihood of a successful and durable repair is greater than 95%, with an expected mortality rate of less than 1% when performed at a Heart Valve Center of Excellence (1).…
Zenker’s or pharyngoesophageal diverticulum is the most common diverticulum of the esophagus. It is herniation of the esophageal mucosa and submucosa through a weak point in the muscle layers of the hypopharynx. The most common herniation site, known as Killian’s triangle, is bordered by the inferior constrictor muscle or thyropharyngeus superiorly, and by the cricopharyngeus…
Sridhar Rathinam of Glenfield Hospital in Leicester, United Kingdom, discusses surgical approaches for pulmonary neuroendocrine tumors. He focuses on the role of the surgeon in caring for patients with neuroendocrine tumors, reviewing tumor staging, endobronchial interventions, and techniques for resection. This presentation was originally given during the SCTS Ionescu University program at the 2019 Annual…
Enhanced Recovery After Surgery (ERAS) is a perioperative protocol that places the patient at the center of all medical decisions. It is designed to reduce stress for the patient, alleviate the amount of pain they experience, and crucially, speed up the recovery and mobilization process, where removing invasive lines and drains as soon as possible…
The transapical artificial chord implantation technique using the NeoChord DS1000™ (NeoChord, Inc., St. Louis Park, MN, USA) system allows re-establishment of normal leaflet motion under real-time two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography guidance. With this technique, chord implantation and adjustment of their length is achievable without the use of cardiopulmonary bypass and without sternotomy.…
This video was recorded in the operating room of the cardiovascular surgery department of Shanghai 10th People’s Hospital in China. In this video, the authors present a modified no-touch technique of the saphenous vein harvesting and also the use of this kind of pedicle vein graft in an off-pump coronary artery bypass (CABG) procedure. The…
This video demonstrates the drainage of a subcarinal collection via mediastinoscopy in a patient who had recently undergone esophagectomy. The chyle leak was localized over the gastric conduit and unsuccessfully drained percutaneously. However, computed tomography imaging showed a 4.9 mm margin inferior to the carina whereby drainage could be accomplished via mediastinoscopy. Postoperative chylous leakage…
Filmed at the 2019 STS Annual Meeting in San Diego, California, Mara Antonoff of the University of Texas MD Anderson Cancer Center in Houston, USA, moderates a discussion on how immunotherapy is changing the landscape of surgical lung cancer care. Dr Antonoff is joined by Boris Sepesi of the University of Texas MD Anderson Cancer…
In times of expanding indications for transcatheter aortic valve replacement—justified or not—consistent implementation of minimally invasive strategies is needed to meet patients’ growing demands for improved quality of life and quicker postprocedural recovery. The main access routes for minimally invasive aortic valve surgeries do have their particular limitations, eg, sternal instability, lung herniation, rib luxation,…
This video provides a step-by-step guide for performing a minimally invasive mitral valve repair using adjustable Gore-tex neochords via a right minithoracotomy, with emphasis on technical pearls and pitfalls. The authors address critical steps during patient positioning, cannulation, valve exposure, neochord height determination, and testing the repair.
The authors present the care provided to a 40-year-old man, a smoker, with a nonrelevant past history, experiencing chronic irritative cough and bloody sputum since one month before consultation. During the medical examination, stridor was noticed. Flexible bronchoscopy was performed and found an exophytic lesion in the upper trachea. Biopsy demonstrated an adenoid cystic carcinoma.…
In this Giants of Cardiothoracic Surgery interview, Vaibhav Gupta of the University of Toronto in Ontario, Canada, speaks with Gail Darling, Professor of Surgery and the Crest Family Chair in Esophageal Cancer Research at the University of Toronto. Dr Darling shares her path to thoracic surgery, and to esophageal surgery in particular. They discuss her…
Objectives Transcatheter aortic valve replacement (TAVR) has become the standard of care for high-risk patients and is growing in popularity for lower risk patients. The authors report a case of early migration of a self-expanding transcatheter aortic valve prosthesis causing coronary obstruction and myocardial infarction. Methods A 76-year-old woman with renal failure underwent an uncomplicated…
IntroductionA 56-year-old man status post repair of a descending thoracic aortic aneurysm after type B aortic dissection presented with acute type A dissection. The patient had a long history of drug abuse and disclosed using cocaine two days prior to presentation. MethodsA median sternotomy was performed. The right subclavian artery was cannulated using the graft…
Objectives Left ventricular aneurysm repair has been performed for nearly four decades, yet no surgical approach has been identified as the most effective. The authors describe their approach to repairing anterior and inferior aneurysms. Methods Figure 1A. The surgical repair is illustrated in two patients, a 67-year-old woman and a 51-year-old man, with a beating…
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