Content from the Journal of the American Neurological Surgeons.
A vital component of successful mitral valve repair surgery is accurate sizing of the mitral annuloplasty ring or band. In this video, several methods of mitral annular sizing are discussed. Prebypass measurement of the anterior mitral leaflet (AML) length via transesophageal echocardiography can be used to estimate the annular size. During direct visualization of the…
Coronary arteriotomy is utilized for coronary artery bypass grafting or, less frequently, coronary endarterectomy. The site of the arteriotomy is primarily dictated by the location of the stenotic or occlusive lesion, which can be determined by preoperative imaging in conjunction with manual intraoperative palpation. In general, ideal arteriotomy sites are distal to the stenosis or…
This video demonstrates a step-by-step technique for percutaneous and open femoral cannulation for peripheral cardiopulmonary bypass. Femoral cannulation is the authors’ preferred platform for cardiopulmonary bypass when performing minimally invasive cardiac operations. The authors hope to highlight useful tips and methods to avoid common pitfalls for others who are interested in adding these methods to…
In this video, the authors present a diaphragmatic plication. Diaphragm paralysis can have a wide variety of causes such as trauma, malignant pathologies, or infectious diseases. Sometimes it can be idiopathic. Usually, the patient presents with dyspnea, thoracic pain, and persistent dry cough. The investigations performed range from chest x-rays and computed tomography (CT) scans…
This video shows the basic technique of skeletonized left internal mammary artery (LIMA) harvesting. Skeletonization is an advanced technique of graft harvesting for coronary artery bypass grafting (CABG), and while it requires meticulous attention, it has many advantages. For example, skeletonization of the IMA can minimize sternal ischemia and lower the risk of mediastinitis, and…
For this cardiac-focused CTSNet Guest Editor Series, Cardiac Surgery Essentials, we asked Dr Tsuyoshi Kaneko of Brigham and Women’s Hospital to bring together videos from experts highlighting techniques that are foundational for cardiac procedures but that are often glossed over when demonstrating a full operation. Dear CTSNet Reader, This new series, Cardiac Surgery Essentials, focuses…
This video depicts the repair of an extremely rare congenital heart defect known as cor triatriatum dexter. In this condition, the right valve of the sinus venosus fails to involute and effectively separates the smooth and trabeculated portions of the right atrium. The degree of separation (ie, right atrial septation) will determine if the patient…
The authors have previously described a parenchymal-sparing sleeve resection of the bronchus intermedius for isolated strictures (1). Recently, they described a robotic parenchymal-sparing bronchus intermedius sleeve resection in a patient with a benign endobronchial lesion (2). In the video here, Caso and Marshall demonstrate the technical aspects of a complete portal robotic sleeve resection of…
The patient presented with bilateral adenocarcinoma, therefore an apical and posterior segmentectomy was the procedure of choice in order to conserve pulmonary tissue and function. A variance from normal anatomy was discovered intraoperatively, in that the superior pulmonary vein could not be identified. An aberrant vein was subsequently discovered draining directly into the innominate vein.…
Tom C. Nguyen of the University of Texas in Houson, USA, moderates a discussion on the changing medical publication world, with a particular focus on cardiothoracic journals. Dr Nguyen is joined by Friedhelm Beyersdorf of the University of Freiburg in Germany and Editor-in-Chief of the European Journal of Cardio-Thoracic Surgery, and Richard Weisel of Toronto…
Aung Ye Oo of The Barts Heart Centre in London, United Kingdom, discusses the use of endovascular stents in patients with connective tissue disorders. He concludes that substantial evidence on the topic is lacking and that stenting in these patients should be limited to bridging patients to open surgery or in patients for whom open…
This video demonstrates a right upper lobectomy through a subxiphoid biportal approach. The authors use a biportal approach, divided in a 4 cm working port through a paramedian incision and a second port, 15 mm long incision coming through diaphragmatic insertion, without any damage, and dedicated to an articulated grasper for exposition and a 30°…
A subxiphoid pericardial window is generally indicated for management of symptomatic pericardial effusion. Imaging Generally, the patient will have had some type of imaging study, most often an echocardiogram or a computed tomography scan of the chest. It is important to review these studies prior to surgery to get a sense of the size of…
Figure 1. Chest x-ray, suggestive of tension pneumothorax. A 45-year-old man came to the emergency department complaining of progressive shortness of breath for 10 days. He also complained of vomiting and absolute constipation for four days. He had a past history of left stab to the chest for 1.5 years. Examination revealed the patient was…
Shruti Jayakumar of St George’s University Hospital in London, UK, interviews Martin Elliott of the Great Ormond Street Hospital for Children in London and John McKenna of Edinburgh, UK, about the changes in cardiac surgery that have been most interesting and impactful during the course of their respective careers. They discuss the changes in the…
Giovanni Mariscalco of the University of Leicester Glenfield Hospital in the UK discusses the need for improved guidelines on screening patients for nonsyndromic thoracic aortic disease. He reviews the incidence of disease in relatives of patients, and he highlights the potential usefulness of determining underlying genetics. This presentation was originally given during the SCTS Ionescu…
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