Content from the Journal of the American Neurological Surgeons.
This video shows the reconstruction of the pulmonary artery in an 8-year-old girl, who had undergone repair of truncus arteriosus at the age of one. The patient presented with Class II/III dyspnea, and CT imaging revealed that the conduit and stent were severely calcified and stenosed. The conduit and branch were replaced and the pulmonary…
The authors present a video showing a VATS left lower lobectomy for bronchiectasis. Recurrent infections affecting the left lower lobe of the patient brought about stiff and highly vascularized adhesions, in particular on the diaphragm, and enlarged lymph nodes within the fissure. In a case such as this, pathological enlargement of the bronchial arteries may…
Click below to view the full protocol. This protocol is provided by James Cook University Hospital.
Computer-assisted surgery and intraoperative navigation are novel tools used to enhance patient treatment and surgical safety. Computer-assisted technologies allow for optimal planning of complex surgeries in a multidisciplinary setting. 3D models can also be created from pre-chemotherapy MRI and pre-surgery CT-scan data. The surgery can then be performed in an enhanced reality modus where the…
Philippe Kolh of the University Hospital of Liege, Belgium, poses the question: what effect has the SYNTAX trial had on coronary artery disease intervention in Europe? He reviews the trial, examines its guidelines, and discusses the importance of risk models. For information on how the SYNTAX trial has influenced practice in the United States, click…
Objective: This video demonstrates the technique for performing a trans-thoracic robot-assisted esophageal diverticulectomy and Heller myotomy. Technique: The patient was a 68-year-old gentleman with Parkinson’s disease who had difficulty swallowing. A barium esophagogram and CT scan of the chest revealed a 4 cm epiphrenic esophageal diverticulum. Pre-operative EGD revealed the diverticulum arising at 32 cm…
The SVR trial showed that coronary perfusion pressure might be better supported by the Sano modification of Norwood stage 1 palliation of hypoplastic left heart syndrome. However, the Sano modification to stage I palliation carries its own downsides: the ventriculotomy required for this conduit may negatively impact late ventricular function and survival, and there is…
Click below to view the full protocol. This protocol is provided by the University Hospital Southampton.
Introduction The authors performed a combined atrial myxoma resection with bypass grafting, using a right minithoracotomy approach. The case demonstrates the feasibility of combined minimally invasive heart surgery procedures (MICS). Case Report Figure 1: Following suspension of the RV acute margin. The visibility and access to the RCA through the right minithoracotomy is unobstructed and easy.…
Joseph Bavaria, current President of The Society of Thoracic Surgeons and Vice Chief of Cardiovascular Surgery at the University of Pennsylvania, Philadelphia, Pennsylvania, delivers an informative talk on hybrid approaches to aortic arch aneurysm repair. Dr. Bavaria stresses that hybrid procedures, employing a combination of open and endovascular techniques, are constantly evolving. He discusses the…
This video shows a uniportal subxiphoid lobectomy in a patient with a proven adenocarcinoma of the middle lobe. The author demonstrates patient positioning, how to make the port, the lobectomy, lymphadenectomy of station 4R and station 7, and how to close the subxiphoid port. Novel pieces of equipment to make the operation easier are also…
Quadricuspid aortic valve (QAV) is a rare congenital cardiac defect that was first classified by Hurwitz and Roberts following autopsy studies in 1973 (1). Because of its rarity and characteristics, the natural history and long-term outcomes are still poorly defined. Recently, Tsang et al. demonstrated a quadricuspid aortic valve diagnostic frequency of 0.006% (2). In…
In this STS-sponsored webinar, an expert panel of speakers presents on a broad spectrum of issues regarding readmission following cardiac surgery in general, and coronary bypass surgery in particular. Gaetano Paone of Henry Ford Hospital, Detroit, Michigan, moderates, and the panelists include David Shahian of the Massachusetts General Hospital, Boston, Massachusetts; Frank Shannon of William…
Apostolos Nakas of Glenfield Hospital, Leicester, United Kingdom, provides a detailed overview of the surgical treatment options for malignant pleural mesothelioma. Citing experience from his high-volume clinic and trial data, Dr. Nakas concludes that extended pleurectomy decortication should be used for appropriate patients, as it spares the lung and achieves macroscopic clearance. Dr. Nakas also…
Introduction: Marginal ulcers (MUs) occur in approximately 1% of patients after bariatric surgery, especially Roux-en-Y gastric bypass. Rarely, MUs are refractory to maximal medical management and may require operative intervention. Presentation of Case: The authors present the case of a 32-year-old woman with intractable MUs after Roux-en-Y gastric bypass, which were refractory to maximal medical…
Inferior vena cava (IVC) filters, while efficacious when used appropriately, have come under a great deal of federal scrutiny due to their over utilization and failure to remove them in a timely fashion. Although most can be removed using commercially available devices, there remain some filters which resist removal. This is usually due to the…
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