Content from the Journal of the American Neurological Surgeons.
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…
Gilbert Massard of the Centre Hospitalier in Strasbourg, France, discusses difficult treatment decisions in lung cancer. He reviews the different treatment approaches for oligometastasis, ground glass opacities, and multiple primary lung cancers, and discusses surgery for recurrence. This presentation was originally given during the SCTS Ionescu University program at the 2017 Annual Meeting of the…
A 29-year-old man with massive bilateral pulmonary embolisms sustained a cardiac arrest. He was transferred to the operating room with ongoing chest compressions. Emergent sternotomy was performed, and central cannulation was performed for venoarterial extracorporeal membrane oxygenation. His sternotomy was off the midline, through the right costal cartilages. He was referred to thoracic surgery after…
The authors present an urgent procedure that was performed to treat an aortoesophageal fistula, which developed after a thoracic endovascular aortic repair (TEVAR) for an extensive aortic arch aneurysm. The patient was a 69-year-old man who had undergone abdominal aortic replacement for aortic rupture three years before. Two years previously, TEVAR using a Najuta stent…
This video demonstrates a robotic right upper lobectomy, performed using the Cerfolio method of port placement. All vessel and pulmonary divisions were performed using the Signia™ powered stapler (Medtronic, Dublin, Ireland), with the use of a leader catheter on the majority of occasions.
Dr Claudio Ronco, senior author of the study. Research published recently in The Annals of Thoracic Surgery suggests a new approach for evaluating a patient’s risk for acute kidney injury before they undergo cardiac surgery. Acute kidney injury (AKI) is a major complication of cardiac surgery, occurring in up to a third of patients (Kuitunen,…
Gianni Angelini of the Bristol Heart Institute in the UK discusses the persisting need for a randomized controlled trial evaluating minimally invasive extracorporeal circulation (MiECC). He also presents the design of the COMICS trial (conventional versus minimally invasive extracorporeal circulation in patients undergoing cardiac surgery: a randomized trial), an international trial comparing adverse outcomes following…
Anatomical sublobar resections, both segmental and subsegmental, are becoming more and more common. They are used to treat benign lesions and pulmonary metastasis, but they are especially used because they have shown comparable oncologic outcomes in early stage adenocarcinomas with lepidic growth [1,2] and better postoperative profiles by preserving more lung parenchyma when compared to…
A 65-year-old man, who had a previous type A aortic dissection in 2011, developed a pseudoaneurysm at the proximal and distal aortic anastomoses of this prior ascending aortic repair. At the time of previous aortic repair, he had also undergone a mechanical aortic valve replacement. Echocardiogram demonstrated moderate paravalvular regurgitation of the aortic valve. He…
This video describes robotic-assisted decortication for a recurrent pleural effusion secondary to fibrothorax. Technical aspects of the decortication are demonstrated, including port placement, robot docking, and closure. Decortication is occasionally needed for an infected pleural space or recurrent pleural effusion caused by a trapped lung resulting from fibrothorax or malignant process (1). Outcomes of video-assisted…
Marco Ranucci of the IRCCS Policlinico San Donato in San Donato Milanese, Italy, discusses the association between hemodilution, oxygen delivery, and acute kidney injury during and after cardiopulmonary bypass. He presents results of previous retrospective trials and gives a brief overview of the now recently-published goal-directed perfusion trial. This presentation was originally given during the SCTS Ionescu…
Objectives Aortopulmonary window is a rare form of congenital heart disease that can be seen in isolation or with associated other complex cardiac lesions. Although aortopulmonary window has been associated with other complex cardiac lesions, only a few cases of this condition associated with transposition of the great arteries with an intact ventricular septum have been…
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