Content from the Journal of the American Neurological Surgeons.
The authors demonstrate a video-assisted minimally invasive mitral valve repair via an anterolateral right minithoracotomy. The patient was a 54-year-old man who was referred to the authors’ department with severe dyspnea. Echocardiography revealed impaired left ventricular function and severe mitral valve regurgitation due to posterior mitral leaflet and posteromedial commissure prolapse, in addition to ruptured…
The use of both internal thoracic arteries (ITAs) has been shown to provide a decreased risk of death, need for reoperation, or need for percutaneous coronary intervention when compared with one ITA in combination with vein grafts. Inadequate length of the free right ITA (RITA) has often limited the ability to bypass the posterior marginal…
Clifford W. Barlow of the Southampton General Hospital in the United Kingdom presents a discussion on the optimal treatment for failing surgical prosthetic valves within the context of aortic valve disease. This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great…
Mark Ferguson of the University of Chicago presents a discussion on technical innovations in minimally invasive thoracic surgery. He is joined by Thomas D’Amico of Duke University Medical Center in Durham, North Carolina; Gaetano Rocco of the National Cancer Institute, Pascale Foundation in Naples, Italy; Robert Cerfolio of the University of New York University Langone…
A 53-year-old man with no comorbidity was referred to the authors’ unit because of a multifocal wild-type adenocarcinoma of the right lung. A positron emission tomography scan was negative for metastasis and an endobronchial ultrasound-guided transbronchial needle aspiration staging of the mediastinum showed no lymph node involvement. After a multidisciplinary meeting, a right pneumonectomy indication…
The patient was a 35-year-old woman. She had a cardiovascular history of obesity and an ischemic stroke with a right brachiocrural focus and expressive aphasia in 2012-2013. She continues to have a slight sequel in speech. The transthoracic echocardiogram showed a pedicled image adhered to the ventricular surface of segment P2 of the mitral valve…
Objective The authors present a video-assisted thoracoscopic surgical (VATS) technique for diaphragmatic plication due to phrenic nerve paralysis. The primary goal of this procedure is to decrease abdominal compression over not only the lower pulmonary lobe, but also the pericardial sac. The authors believe that the pericardial compression is also responsible for these patients’ decreased…
The 2018 Annual Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) took place in Vancouver, Canada, in June. Among the meeting sessions were the Subramanian Innovation Award Presentations, where three finalists presented minimally invasive cardiothoracic surgery innovations in competition for $5,000 to support the implementation of their innovation. The Subramanian Innovation Award…
Alan J. Bryan of the Bristol Heart Institute in the UK argues that on-pump coronary bypass surgery is as good an option as off-pump surgery for patients with high surgical risk. He focuses on the evidence available to compare on-pump and off-pump coronary bypass grafting and also comments on the application of hybrid robotic approaches.…
This video highlights the use of the Konno procedure to safely expose the root of the aorta in a patient with an aortic root abscess and a history of multiple cardiac surgeries. The patient was a 28-year-old man with endocarditis, complicated by four prior cardiac surgeries. The original pathology was Shone’s syndrome with an aberrant…
This video demonstrates the minimally invasive Ozaki technique for aortic valve reconstruction, including thoracoscopic harvesting of the pericardium and Ozaki aortic valve repair technique via an upper ministernotomy. The Ozaki technique basically replaces all three aortic cusps using glutaraldehyde-treated autologous pericardium. The advantages of this method are that there is no foreign material implanted and…
A 41-year-old woman developed high output (2 L/day) left chylothorax following the resection of a bronchogenic cyst. Treatment with octreotide (100 mcg SC bid) and nothing by mouth status with total parenteral nutrition was unsuccessful after seven days. The patient underwent a right robotic thoracic duct ligation using the da Vinci Xi robot. In the…
Filmed at the 2018 STS Annual Meeting in Fort Lauderdale, Florida, Juan P. Umana of the Fundacion Cardioinfantil in Bogota, Colombia, interviews Jose Navia of the Cleveland Clinic in Ohio, USA, about the “hemi-commando” procedure for double-valve endocarditis. They discuss the history of the commando operation, the development of this complex variation, and Dr Navia’s…
This lecture by Alan Sihoe of the University of Hong Kong was given during the Fourth Assiut VATS Workshop in Assiut, Egypt, in February 2018. In this lecture, Professor Sihoe gives an overview of trends in thoracic surgery literature and what editors and reviewers are looking for in submitted manuscripts. This lecture focuses primarily on…
This video demonstrates a central cannulation in a step-by-step fashion, using diagrams and surgical video to illustrate key technical elements. Step 1 Aortic cannulation is always done prior to atrial cannulation. At this step in the video, you can see partial thickness purse string sutures being placed into the aorta, which are then snared. Next,…
Direct Gerbode defects (GD) are rare, especially those secondary to endocarditis. Only 10.7% involve both the aortic and tricuspid valves. The authors present a direct GD secondary to aortic and tricuspid valve endocarditis and discuss the surgical management of the defect with sliding tricuspid valve annuloplasty. The preoperative echocardiogram shows what was thought to be…
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