Content from the Journal of the American Neurological Surgeons.
Rajamiyer Venkateswaran of the Wythenshawe Hospital in Manchester, UK, asks whether it is possible to predict when a patient undergoing high-risk cardiac surgery will need postoperative mechanical circulatory support. He also discusses his institution’s approach to transfering a patient to mechanical circulatory support. This presentation was originally given during the SCTS Ionescu University program at the…
Filmed at the 2017 Annual STS Meeting in Houston, Texas, Dr Robert Sade of the Medical University of South Carolina moderates a debate on the appropriate course of care in the fictional case of a child who cannot be weaned from bypass following mitral valve surgery. Dr Minoo Kavarana of the Medical University of South…
The authors present a case of aortic valve, ascending aorta, and arch replacement, which included debranching of the supra-aortic vessels and a frozen elephant trunk procedure. Additionally, the authors performed an extra-anatomic bypass for the left axillary artery. The patient’s preoperative computed tomography (CT) angiogram showed an ascending aortic arch aneurysm. Steps: The authors placed…
Abstract Peroral endoscopic myotomy is a safe and effective palliative procedure with acceptable known complications for achalasia. With its continuous practice, cardiac arrest secondary to tension pneumopericardium-induced tamponade is another adverse event coming to light. The authors present the case of a 72-year-old gentleman who suddenly went into pulseless electrical activity during the procedure with…
Vipin Zamvar of the Royal Infirmary of Edinburgh in the UK discusses the barriers that reduce the use of bilateral internal mammary arteries (BIMAs) in coronary artery bypass surgery. Dr Zamvar focuses on the technical challenges inherent in using BIMAs, important aspects of the alternative options, how the political atmosphere influences the techniques surgeons might…
Filmed at the 2016 EACTS Annual Meeting in Barcelona, Joel Dunning and Shanda Blackmon discuss safety in minimally invasive general thoracic surgery. They focus on the importance of preparation, such that a surgical team knows its course of action for potential critical events ahead of their occurance. Mr Dunning and Dr Blackmon also discuss surgical…
In these diagrams, the authors explain the rationale for the different echocardiographic views using simple drawings. Understanding the position of the probe relative to the heart in the different views will hopefully make it easier for the reader to reconstruct the view in their mind. Also, the analogous transesophageal or transthoracic view is presented, with…
General thoracic surgeons are faced with challenges thrown at them from time to time. This video demonstrates accessing multiple nodal stations, including a contralateral nodal station. Meticulous study of the computed tomography (CT) scan suggested that the 4L left nodal station was, in fact, not far away from the midline, and an access from a…
Marc Moon of the Washington University School of Medicine in St Louis, Missouri, discusses the factors that define high risk for a cardiac surgery patient, and he reviews preoperative strategies that surgeons can employ to prepare such patients for optimal outcomes. This presentation was originally given during the SCTS Ionescu University program at the 2017…
Introduction Totally endoscopic two-stage (laparoscopic and VATS) esophagectomy for carcinoma of the lower third esophagus is a well-established procedure [1, 2]. There are currently many methods to perform an intrathoracic esophagogastric anastomosis by video-assisted thoracoscopic surgery (VATS) [3]. The technique described here is an extension of the technique used by T. Agasthian for VATS right…
Surgery of the thoracic aorta is a great challenge for cardiovascular surgeons. Refined surgical techniques and organ protection methods allow complex diseases of the thoracic aorta to be treated with favorable results. In this setting, a thorough assessment of the aortic anatomy and a patient’s comorbidities is mandatory to adequately decide upon the extent of…
In this discussion filmed at the 2017 STS Annual Meeting in Houston, Texas, two surgeons talk about their experiences using sutureless aortic valves. Dr Tom C. Nguyen of the University of Texas in Houston is joined by Dr Patrick McCarthy of Northwestern Memorial Hospital in Chicago, Illinois, and Dr Borut Gersak of the Ljubljana University Medical…
The recently-formed group Enhanced Recovery After Cardiac Surgery (ERACS) held its inaugural symposium on April 29, 2017. The session, which took place in Boston, MA, was called “ERACS: Best Practices, Cost-Effective Initiative.” It featured a consortium of forward-thinking leaders in cardiac surgery, who joined together to address the need to standardize best practices in cardiac surgery.…
John Puskas of the Icahn School of Medicine at Mount Sinai in New York, United States, discusses the evidence for using arterial grafts in coronary bypass surgery. He explores the reasons why overall usage of arterial grafts remains low. This presentation was originally given during the SCTS Ionescu University program at the 2016 Annual Meeting…
Robot-assisted thoracoscopic lobectomy is a feasible procedure, based on the authors’ previous experience. Their hospital has carried out robot-assisted thoracic surgery since May 2015, and accomplished over 400 cases of thoracic surgery through June 2017. This includes, but is not limited to, benign and malignant lung tumors, benign and malignant esophageal disease, mediastinal masses, and…
IntroductionMany thoracic surgeons are terrified to come anywhere near the recurrent laryngeal nerve (RLN), especially on the left side. The reason for this fear is the dreaded complication of damaging the nerve and causing loss of voice, among other serious complications. RLN palsy ranks among the leading reasons for medicolegal litigation of surgeons because of…
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