Content from the Journal of the American Neurological Surgeons.
This 2-year-old girl was evaluated for a recurrent respiratory tract infection and palpitations. She was further evaluated and diagnosed with a large secundum atrial septal defect (ASD) with dilated right atrium (RA) and right ventricle. However, the left pulmonary artery was not visible on the echocardiogram. A chest computed tomography scan showed that the left…
In this video, the authors present their approach for identifying the left anterior descending artery (LAD) target in minimally invasive robot-assisted CABG. They start with the robotic take down of the internal mammary artery (IMA), followed by a left minithoracotomy for the LAD anastomosis. The first step in this procedure is a robotic IMA harvest.…
Introduction Three-dimensional (3D) printing is a new modality which makes a true-to-life 3D model using sophisticated technology. The authors report its first use in a complex case of a large pulmonary arteriovenous (AV) malformation. Case Summary A 23-year-old patient presented with severe central cyanosis and clubbing. His echocardiogram was normal. A chest computed tomography (CT)…
Patrick Perier of the Herz und Gefäß Klinik in Bad Neustadt an der Saale, Germany, discusses the problem of excess tissue in mitral valve repair. He focuses on the posterior leaflet, presenting the strengths and limitations of approaches that preserve tissue and discussing tips for a quality repair. This presentation was originally given during the…
This patient was a 15-year-old male with hypoplastic left heart syndrome, status post extracardiac Fontan. The left pulmonary artery was stented and the tricuspid valve ring was placed years previously. This was the fifth time the authors re-entered the chest. A suitable donor became available, and the patient presented for orthotopic heart transplant.
A 54-year-old man presented three months after coronary bypass surgery with a large aneurysm from the left ventricle (LV). Transesophageal echocardiogram (TEE) showed a wide-mouthed aneurysm arising from the lateral wall of the LV. LV ejection fraction was 35% and the patient’s mitral and aortic valves were competent. Computed tomography (CT) showed a 6 x…
The Toronto Lung Transplant Program performs over 200 donor lung retrievals each year. The surgical approach is standardized to ensure the best quality lung preservation possible. Careful technique is used to ensure that all hilar structures are intact with adequate cuffs and that the lungs are removed without injury. This video demonstrates the lung retrieval…
Paul Van Schil of Antwerp University Hospital in Belgium discusses surgical approaches for various stages of non-small cell lung cancer. This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This content is published with the permission of SCTS.…
An otherwise healthy 58-year-old woman was evaluated for lower back and abdominal pain. She underwent a computed tomography scan of the abdomen, and the upper abdominal slices revealed a hypodense lesion occupying the left atrium (LA). The patient had no signs or symptoms of heart failure, but she did have a “positional” middiastolic murmur. A…
In the case shown in this video, a midline sternotomy was used, which is ideal for multiple procedures. However, a right thoracotomy can be done as a minimally invasive approach if tricuspid repair is being done in isolation. This procedure requires cannulation of both the superior (SVC) and inferior vena cavae (IVC) as well as…
Transoral incisionless fundoplication (TIF) is increasingly accepted as an effective management strategy for refractory gastroesophageal reflux, especially in patients with minimal or no hiatal hernia. All antireflux procedures have a failure rate, however, and TIF is no exception. Nevertheless, it has significant advantages and likely will continue to gain widespread adoption. One concern about the…
Filmed at the 2018 STS Annual Meeting in Fort Lauderdale, Florida, Tom Nguyen of the University of Texas Houston interviews former Navy SEAL Brian Ferguson of Arena Labs about the pursuit of performance excellence in medicine, and particularly in the realm of cardiothoracic surgery. They discuss how to handle high levels of stress and anxiety in…
Stephen D. Cassivi of the Mayo Clinic in Rochester, Minnesota, USA, presents a discussion on the indications for, limitations of, and future potential of energy devices in thoracic surgery. This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and…
A 65-year-old woman was referred from the otorhinolaryngology department to the thoracic surgery department for a prolonged high-volume chyle leak following neck dissection. She had undergone surgery for nodal recurrence of thyroid cancer. The chyle leakage from the neck drains was evident immediately after the procedure, producing 1.5 – 2.0 L/day. She was started on…
Introduction The least invasive approach to surgical aortic valve replacement is through a right anterior minithoracotomy incision. Most groups using this approach cannulate either the femoral artery and vein or the ascending aorta and femoral vein to establish cardiopulmonary bypass. The authors, however, routinely cannulate the ascending aorta and superior vena cava, avoiding any incisions…
The patient was a 16-year-old girl with a diagnosis of cystic fibrosis, with pancreatic insufficiency and diabetes. She was listed for lung transplant and she underwent a bilateral lung transplant. Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our…
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