Content from the Journal of the American Neurological Surgeons.
An 80-year-old woman was diagnosed with a huge anterior and middle mediastinal cyst that was causing compression of the right atrium and ventricle. Computed tomography of the thorax and transthoracic echocardiography confirmed the diagnosis. She underwent complete excision of the cyst through a median sternotomy. She made an uneventful recovery and was discharged from the…
This video demonstrates the technique of the “Commando procedure.” Reconstruction of the aortomitral fibrous body for invasive double valve endocarditis is a technically challenging operation. It includes aortic valve or root replacement and mitral valve replacement, along with reconstruction of the aortomitral fibrous body. Disclaimer The information and views presented on CTSNet.org represent the views…
Background Standard of care for acute type A dissection remains the “hemiarch” technique with an open distal anastomosis. This operation is currently favored because of its simplicity and reproducibility, as it is believed to carry a lower operative risk than more aggressive treatment of arch pathology. Data for this claim remains limited, and there remains…
A 37-year-old woman with known congenital right-sided pulmonary venous stenosis presented with recurrent and symptomatic pleural effusions on the right side. She was diagnosed with pulmonary venous stenosis at the age of 22 when she had a self-limited episode of hemoptysis. She had undergone several radiologic vascular interventions to treat hemoptysis. These procedures mainly included…
Carmelo Milano, chief of cardiac surgery and the surgical director of the left ventricular assist device (LVAD) program at Duke University Medical Center in Durham, North Carolina, USA, discusses the current practice of destination therapy LVAD and future perspectives of mechanical circulatory support. This lecture was presented during the Glasgow Cardiopulmonary Transplantation and Mechanical Circulatory…
Jean-Philippe Verhoye of the Pontchaillou University Hospital in Rennes, France, discusses the decision between root replacement and root sparing approaches in the treatment of type A aortic dissection. He posits that this decision relies on the answers to three questions: first, what is the fate of a spared root; second, what is the risk carried…
In patients with hypertrophic obstructive cardiomyopathy, sparing the mitral valve can be a great challenge for the cardiac surgeon. In fact, the anatomy of this disease is greatly inconstant with the left ventricular outflow tract (LVOT) obstruction resulting from septal hypertrophy and from several abnormalities of the mitral valve apparatus that are variably expressed in…
Supravalvular aortic stenosis is usually diagnosed and corrected in childhood. An adult patient with Williams syndrome presented with shortness of breath and was found to have severe supravalvular aortic stenosis and significant stenosis of the left anterior descending artery from a myocardial bridge. In this video, the authors detail the surgical technique for correction of…
Hemothorax is second only to rib fractures as the most common complication in patients with chest trauma (1). Hemothorax following valve replacement utilizing a minithoracotomy approach on the opposite side is a rare complication of minimally invasive valve replacement. Retained clot with hemothorax can be evacuated by video-assisted thoracoscopic surgery (VATS), but 26.5% require a…
Solitary fibrous tumors (SFT) are rare neoplasms representing less than 5% of pleural tumors (1, 2). Sixty to eighty percent of SFTs arise from the visceral pleura (3, 4), but they can also arise from the parietal pleura and intrapulmonary (5). Primary therapy for SFT is wide surgical resection to reduce local tumor recurrence. Smaller…
Bentall surgery, often required in patients with an aortic valve prosthesis infection, represents a great surgical challenge. Extensive periannular abscess with annular destruction and friable infected tissues may hamper a solid root reconstruction. Graft dehiscence, mitral valve distortion or dysfunction, and tension or kinking at the reimplanted coronary arteries represent the major technical concerns in…
In this Giants of Cardiothoracic Surgery interview, Joel Dunning of the James Cook University Hospital in Middlesbrough, UK, speaks with Joel Cooper of the Hospital of the University of Pennsylvania in Philadelphia, USA. They discuss the road of research and learning that allowed Dr Cooper’s team to perform the first successful lung transplant, how this…
Objectives Retrosternal thyroid goiters may occur in the anterior, middle, and posterior mediastinum. Symptomatic retrosternal thyroid goiters are usually amenable to resection via a cervical incision. Sternotomy and thoracotomy are typically employed for retrosternal goiters not amenable to a cervical approach alone. The authors demonstrate a robot-assisted approach for the resection of a retrosternal thyroid…
Impaction of a foreign body in the bronchus is common. Flexible bronchoscopy with use of a cryoprobe can be conveniently used to remove an impacted foreign body in the bronchus. This video demonstrates this process. Sometimes the diagnosis can be missed. Surgeons should have a suspicion of a foreign body whenever there are atelectatic changes…
The authors demonstrate a robot-assisted lung volume reduction surgery (LVRS), performed for a 71-year-old man who was an ex-smoker with severe chronic obstructive pulmonary disease (COPD) (FEV1, 0.68 L or 22%; DLCO, 51%; MRC Dyspnea scale, 4). Extensive preoperative investigation included high resolution computed tomography with StratX lung report, bronchoscopy with Chartis balloon pressure assessment,…
This video demonstrates a totally thoracoscopic procedure for left atrial appendage closure in a patient with a contraindication to percutaneous left atrial appendage closure. The procedure highlights the videoscopic approach, procedural details, and postoperative echocardiographic control. Suggested Reading Caliskan E, Sahin A, Yilmaz M, et al. Epicardial left atrial appendage AtriClip occlusion reduces the incidence…
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