Content from the Journal of the American Neurological Surgeons.
In the United States, transcatheter aortic valve replacement (TAVR) has become a common treatment strategy in patients with aortic stenosis who have an estimated moderate-to-high STS risk of mortality if undergoing surgical aortic valve replacement. With advanced age and multiple comorbidities, only around 80% to 90% of these patients are candidates for a transfemoral access…
Aortic root reoperation represents a great challenge for the cardiovascular surgeon, with a hospital mortality that ranges between 8% and 15% in the literature [1-4]. Arch repair interventions with zone 0 (or zone 1) distal anastomosis and arch vessel reimplantation with separate branches are increasingly performed. On the one hand, this technique both simplifies distal…
Neil Moat of the Royal Brompton Hospital in London, UK, discusses current devices for transcatheter mitral valve repair and replacement. This presentation was originally given during the SCTS Ionescu University program at the 2017 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This content is published with the permission of SCTS.…
This video shows one of the first totally endoscopic mitral valve repairs using the lateral endoscopic approach with robotics (LEAR) technique performed in the UK, and it follows a patient’s remarkable recovery from this procedure. It has been known for many years now in a variety of surgical specialties that as the degree of surgical…
Introduction Since the early 1990s, minimally invasive cardiac surgery (MICS) has evolved worldwide. It started with mitral valve procedures and then gradually expanded toward other valve procedures, coronary artery bypass grafting, and various types of simple congenital heart operations. There has been a growing interest for MICS, given the association of this technique with decreased…
Objective The authors’ uniportal video-assisted thoracoscopic pneumonectomy approach focuses on controlling the main pulmonary artery (MPA) first, to decrease lung congestion. Performing the most difficult step first ultimately decreases the chance of vascular accidents. Method Patients must undergo proper evaluation of resectability and operability according to international guidelines. The authors routinely perform a radical lymphadenectomy.…
Filmed at the 2018 STS Annual Meeting in Ft Lauderdale, FL, Joel Dunning of the James Cook University Hospital in London, UK, interviews Raja Flores of the Mount Sinai School of Medicine in New York, USA. They discuss the importance of mesothelioma prevention and the persisting risk from asbestos exposure, as well as which surgical…
Objectives Pediatric patients with atrioventricular (AV) septal defects represent a congenital population that may require repeat operations on the AV valves over time. The authors present a previously repaired patient who also required left AV valve replacement after failed left AV valve repair and discuss Konno aortoventriculoplasty in conjunction with mitral re-replacement as a fourth…
The author presents an endotracheal repair, performed for a 72-year-old woman who was mechanically ventilated for a heart failure due to lung edema and hypoxia. She developed severe mediastinal and subcutaneous emphysema due to a 4.5 cm iatrogenic tracheal laceration. A completely endotracheal repair with a running suture was performed using the optical needle holder…
Introduction Although the routine use of the internal thoracic artery (ITA) and great saphenous vein (SV) is well established among cardiac surgeons (1, 2), there is considerable debate regarding the optimal harvesting technique for these conduits (3, 4). The ITA can be harvested either by itself or as a pedicle. Likewise, the SV vein can…
Mitral valve repair is shown to have better survival, better preservation of ventricular function, and decreased thromboembolic complications compared to mitral valve replacement for mitral regurgitation (1-2). The Cardiovascular Institute of Buenos Aires in Argentina is a center with extensive experience in mitral repair, with a 98% success rate in posterior valve. The authors present…
Francis Charles Wells of the Papworth Hospital in Cambridge, UK, compares transcatheter and conventional surgical mitral valve interventions. He focuses on the questions that need to be answered regarding surgical outcomes in order to properly compare the two approaches. This presentation was originally given during the SCTS Ionescu University program at the 2017 Annual Meeting…
The patient was a 26-year-old woman with a 6-year history of myasthenia gravis. She did not tolerate steroids and treatment with intravenous immunoglobulin was ineffective. She was maintained on Imuran (azathioprine) and weekly plasmapheresis to control her symptoms. She was subsequently referred for a video-assisted thoracoscopic thymectomy.
Introduction Since the first reports of the off-pump technique and minimally invasive access (1, 2), coronary artery bypass grafting (CABG) performed through a small anterior lateral thoracotomy without cardiopulmonary bypass has become an increasingly popular technique worldwide. The minimally invasive direct coronary artery bypass (MIDCAB) has been used for patients with a single vessel disease…
This video demonstrates a repair performed for a 7-year-old boy, who was referred from Mali with a suspected diagnosis of an atrial septal defect and ventricular septal defect. The echocardiogram showed a very dilated proximal right coronary artery, with a fistulous connexion to the right ventricle just above the tricuspid annulus. This was confirmed with…
Objectives Bronchial neuroendocrine tumors are an uncommon neoplasm of the lungs characterized by an endobronchial mass that mostly arise in the proximal airways. This video demonstrates successful management of an LC2 carinal carcinoid tumor through a minimally invasive, parenchymal-sparing approach. Methods A 34-year-old welder presented with a two- to three-year history of wheezing with progressive…
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