Content from the Journal of the American Neurological Surgeons.
Objectives In the past, atrial septal defects (ASD) have been repaired via open heart surgery through a median sternotomy. Recent advances have allowed ASD closure via catheter inserted devices and also via minimally invasive surgical techniques utilizing endoscopy and robot-assisted surgery. Described below is a minimally invasive approach to ASD closure that is performed without…
Anterior segment resection of the left upper lobe is rarely performed. It is, however, usually incorporated within resection of the upper three segments of the left upper lobe. A 56-year-old patient, with a known oropharyngeal carcinoma and otherwise amenable to curative treatment, was admitted to the authors’ clinic for a 1 cm nodule in the…
This video demonstrates the surgical treatment of a patient with a right heart angiosarcoma who underwent radical resection followed by composite reconstruction of the right atrium and the superior vena cava (SVC), with bovine pericardial patches and a polytetrafluoroethylene (PTFE) vascular prosthesis. The right atrium is the structure most often affected by cardiac sarcoma. The…
Introduction Multifocal lung cancer is an increasingly common clinical scenario, but there is a lack of high-level evidence for its optimal treatment [1]. Staging is an important first step in the management of such pathologies. As many as six percent of patients may present with unsuspected cranial metastases [2]. Minimally invasive resections, parenchymal-sparing approaches, and…
Mr Sridhar Rathinam of the Glenfield Hospital in Leicester, UK, discusses the surgical treatment of emphysema. He focuses on the risks and benefits of lung volume reduction surgery, taking a historical perspective, as well as comparing the surgical approach to other approaches that are currently available. This presentation was originally given during the SCTS Ionescu…
Filmed at the 2017 EACTS Annual Meeting in Vienna, Austria, Leanne Harling of Imperial College in London, UK, moderates a discussion on the future of coronary revascularization with David Taggart of the University of Oxford in the UK and Philippe Kolh of the University Hospital of Liege in Belgium. They discuss selecting patients for surgical…
Dr Om Prakesh Yadava of the National Heart Institute in New Delhi, India, interviews Professor Vinayak Bapat of Columbia University in New York, USA. They discuss transcatheter approaches and sutureless valves implanted by minimally invasive approaches. When asked to name three disruptive technologies, Prof Bapat picks transcatheter aortic valve replacement (TAVR), transcatheter mitral valve replacement…
Phrenic nerve paralysis is not an uncommon problem (1), and it can cause diaphragm paralysis. This gentleman had a thoracotomy and diaphragm plication four years previously. Unfortunately, the plication failed, and he had quite significant pain and remained short of breath. Thus, the author accepted him for redo diaphragm plication. Due to the high risk…
Objectives Mitral annular calcification during mitral valve replacement can result in significant complications. Surgical decalcification with atrial plasty or pericardial patch can lead to atrioventricular disruption. Here the authors show a novel technique using a transcatheter valve deployed during open surgery in the mitral valve position. Methods An 83-year-old female presented with a two-month history…
This patient was a 7-year-old female child evaluated for cyanosis and failure to thrive since birth. She had an arterial saturation of approximately 70% on room air. She was diagnosed with dextro-transposition of the great arteries (D-TGA) with a large subaortic ventricular septal defect (VSD) and severe pulmonary valve stenosis (PS). Her ventricles were both…
This video demonstrates the closure of a median sternotomy using stainless steel wires in a step-by-step fashion. The authors include both diagrams and surgical video to illustrate key technical elements. 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…
Carcinoid tumors are often located at the origin of a lobar or segmental bronchus. Stapling the bronchus, as is usually done during a thoracoscopic lobectomy or segmentectomy, creates the risk of damaging or crushing the tumor. This video demonstrates a right basilar segmentectomy for an obstructive carcinoid tumor located at the origin of the basilar…
G. Alexander Patterson from the Washington University School of Medicine in St Louis, Missouri, discusses lung transplantation. He reviews the criteria used to select candidates for the procedure, changes in patient outcomes, and opportunities for further improvement. While Dr Patterson focuses on transplantation for chronic obstructive pulmonary disease, he also discusses pediatric transplantation rates and…
Introduction Invasive thymic tumors with superior vena cava infiltration are rare and aggressive clinical entities. For these patients, chemotherapy, radiotherapy, or both may be indicated, but when surgical intervention is feasible, en bloc resection of the tumor followed by vascular reconstruction represents the best treatment. Vascular reconstruction can be performed using a venous autograft, an…
This video demonstrates a left anterior descending coronary artery aneurysm excision and the removal of a previously placed stent in a 64-year-old man with diabetes. After standard midline sternotomy, adhesions were found between the aneurysmal sac, the chest wall, and the surrounding tissue. Adhesiolysis was done using blunt and sharp dissection. A previous vein graft…
Find it here: The SCTS “Take on the Experts” Video Competition On Tuesday, March 20, at 2:00 pm GMT, the best four general thoracic and best four cardiac videos submitted for the 2018 SCTS Annual Meeting will be presented to a team of experts, who will question the presenters and probe their techniques. Have a…
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