Content from the Journal of the American Neurological Surgeons.
Objective Bicuspid valves with fusion of both the right-left and right-noncoronary commissures generally are called Sievers type 2 or unicuspid aortic valves (UAV). This anatomy can be difficult to repair with existing techniques. Methods A 32-year-old athlete with fatigue and class II congestive heart failure presented with severe aortic insufficiency (AI) and early left ventricular…
In this video, the authors show a two-stage hybrid treatment strategy for DeBakey type I aortic dissection. The patient was a 70-year-old man who arrived from another institution with a diagnosis of chronic aortic dissection type I of the DeBakey classification. The computed tomography (CT) scan showed an aortic wall hematoma in the ascending aorta…
The authors present the repair of a ruptured sinus of Valsalva aneurysm via a right anterior minithoracotomy. The patient presented with sinus tachycardia, a grade 4/6 pansystolic murmur, and bilateral lower extremity edema. Transesophageal echocardiogram (TEE) was performed, which revealed an 8 mm fistulous communication between the right sinus of Valsalva and the right atrium…
Abdelhadi Ismail of the Southampton University Hospitals Trust in the UK presents an educational series on cardiopulmonary bypass in which he discusses some of the fundamental concepts underlying cardiopulmonary bypass and reviews techniques. The optimal way to memorize a topic is to first classify it, then understand it, then forget it. Once you forget and…
The authors present a case of congenital coronary artery to right ventricle fistula that was treated successfully by direct ligation without the use of cardiopulmonary bypass. An 11-month-old boy was hospitalized because of a complaint of mild dyspnea and continuous cardiac murmur. A chest x-ray revealed heart shade enlargement. Multidetector computed tomography and coronary angiography…
Between February 23 and March 1, 2019, Dr Enoch Akowuah led a heart surgery team from the James Cook University Hospital in Middlesbrough, UK, on a mission to Kumasi, Ghana, to perform adult heart surgery and to place pacemakers. The Middlesbrough team members were also tremendously lucky to be joined by Dr Emily Farkas, who…
Filmed at the 2018 STS Annual Meeting in Fort Lauderdale, Florida, Douglas Wood of the University of Washington in Seattle moderates a discussion on the disparities in access to lung cancer screening. Dr Wood is joined by Elizabeth David of the University of Southern California in Los Angeles, Betty Tong of Duke University in Durham,…
Bil Kirmani of the Liverpool Heart and Chest Hospital in the UK compares minimally invasive and open surgical approaches for aortic valve replacement. He presents a review comparing full to limited sternotomy and discusses the available data on anterior right minithoracotomy. This presentation was originally given during the SCTS Ionescu University program at the 2018…
Introduction Figure 1. Preoperative chest CT scan. Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by proximal pulmonary artery thromboembolic occlusion or obstruction. Patients present with shortness of breath, early fatigue, and decreased exercise capacity. Once the obstruction sets in, it is accompanied by remodeling of the branches of the pulmonary artery. This causes pulmonary artery hypertension…
In this video, the authors present a novel technique for the correction of mitral regurgitation associated with degenerative disease of the posterior leaflet, called posterior leaflet remodeling or free margin running suture. This technique has been developed in the setting of minimally invasive surgery, although it can be employed through sternotomy. In the first procedure…
Om P Yadava and Paul Sergeant discuss the relevance of tacit versus codified learning in medicine and the basic tenets of mentoring. Professor Paul Sergeant from Leuven, Belgium, deliberates on learning techniques and differentiates between tacit learning and codified learning. He laments that proctoring has become more of a social visit with a view to…
Introduction Chylothorax is a rare but potentially morbid complication following thoracic surgery. Nontraumatic chylothorax is even less common and typically is due to malignancy, congenital or idiopathic disorders of the lymphatic system, systemic diseases, and infection [1]. Here, the authors present a case of nontraumatic chylothorax due to central venous stenosis. Case Presentation Figure 1. Oblique…
Filmed at the 2018 STS Annual Meeting in Fort Lauderdale, Florida, Tsuyoshi Kaneko of the Brigham and Women’s Hospital in Boston, Massachusetts, moderates a discussion on the future of transcatheter mitral valve repair and replacement. Dr Kaneko is joined by Wilson Szeto of the University of Pennsylvania in Philadelphia, Michael J. Mack of the Baylor…
Lars G. Svensson of the Cleveland Clinic in Ohio, USA, discusses Barlow’s mitral valve disease. He reviews the definition of Barlow’s valve, discusses the Cleveland Clinic experience with mitral valve surgery, and presents different strategies to repairing these valves. This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting…
The authors review axillary artery cannulation indications and technique. They focus on the relevant anatomy, surgical preparation, and cannulation technique. They also show their approach for reoperative axillary artery cannulation and discuss potential complications and pitfalls. > This video is part of the Cardiac Surgery Essentials Series, brought together by CTSNet Guest Editor Dr Tsuyoshi…
Perclose ProGlide® suture mediated closure is a common technique for the percutaneous delivery of a suture for closing the common femoral artery access site at the conclusion of transcatheter interventions. This technique is considered a basic skill for performing transcatheter procedures, and it is one of the must-learn skills for graduating cardiac surgery residents. In…
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