Content from the Journal of the American Neurological Surgeons.
Filmed at the 2015 STS Annual Meeting in San Diego, California, this roundtable discussion focuses on the use of stereotactic body radiation therapy (SBRT) in the treatment of lung cancer. Stephen Hazelrigg moderates this discussion with Neil Christie and Hiran Fernando. The panelists discuss how thoracic surgeons can take an active role in SBRT programs,…
Santi Trimarchi of the University of Milan, Milan, Italy, discusses re-intervention following acute type-A aortic dissection repair. Dr. Trimarchi draws on data from the International Registry of Acute Aortic Dissection (IRAD) to report on extended versus limited arch replacement, and the predictors of future intervention after initial treatment for acute aortic dissection. This presentation was…
Summary Rib reconstruction is often mandatory after chest wall resection. This video shows how to use orthopedic screws and bone cement molded in a latex drain for a very strong rib reconstruction. The procedure is easy to implement and versatile. It can be used even if the posterior end of the rib has been resected…
Coronary ostia re-implantation is a key stage of aortic root replacement. Currently, the button technique is the most widespread method, and is considered the standard approach. However, there are still concerns about the incidence of coronary pseudoaneurysm formation, bleeding, and distortion of the coronary geometry, especially when the coronaries are hard to mobilize (as in…
Work/life balance and good rhythm are possible in cardiothoracic surgery! Faculty members from the University of Washington show off their moves at a recent WTSA event. In the comments, let us know what you do for fun when you are not in the OR.
A 52-year-old female smoker presented to the ER with pneumonia. Her chest x-ray showed consolidation of the right upper lobe (RUL). Flexible bronchoscopy revealed that the orifice of the right upper bronchus was fully occluded by a tumor mass, and biopsy confirmed a typical carcinoid tumor. Her chest CT scan showed the right upper lobe…
2015 Resident Video Competition Award Winner Objectives The authors describe their experience using a percutaneous left ventricular assist device (LVAD) as a bridge to transplant in a morbidly obese pediatric patient with severe heart failure due to viral myocarditis. Prior similar reports are extremely limited. This video demonstrates a minimally invasive, effective, and well-tolerated treatment…
Pectus excavatum is a congenital deformity of the chest. Several surgical techniques have been used for the repair of pectus excavatum to avoid postural, cardiac, lung, and psychosocial developmental disorders. Many incision techniques have been introduced to reduce scar formation and keloid development. In the authors’ clinic, a crescent-shaped periareolar incision is utilized for minimally…
John Elefteriades of Yale University School of Medicine, New Haven, United States, shares ten tips for circulatory support during aortic surgery. Dr. Elefteriades discusses basic and advanced principles for the management of aneurysms and dissections. This presentation was originally given during the SCTS Ionescu University program at the 80th Annual Meeting of the Society for…
Introduction Transcatheter aortic valve replacement (TAVR) has emerged as a successful treatment for patients deemed unsuitable for open aortic valve replacement (1). Well-described TAVR access approaches such as transfemoral (TF), transapical (TA), transsubclavian, and transcarotid have been successful (2, 3, 4, 5). However, despite multiple approaches, some patient’s aortic anatomy necessitates alternate strategies. One of…
A 78-year-old patient was admitted to the authors’ department for a left upper lobe nodule resection. The patient had a past history of smoking and comorbidities, including hypertension and COPD. He had no symptoms, but an x-ray revealed a nodule in the left upper lobe. The CT scan confirmed that there was an 11 mm…
This video demonstrates the case of a 47-year-old male patient who was diagnosed with severe mitral valve regurgitation and prolapse in P2. The patient was in NYHA functional class II, and a mitral valve repair was performed by P2 quadrangular resection, plus annuloplasty. A superior septal approach was used to address the mitral valve. Critical Surgical…
In this STSA President’s Invited Lecture given at the 2014 STSA Annual Meeting, David Shahian discusses Ernest Codman’s vision of enhancing quality in health care, noting that 100 years later some of Dr. Codman’s key principles still remain strongly relevant. Dr. Shahian currently serves as Professor of Surgery at Harvard Medical School, Vice President of…
To what extent must surgeons be required to have residents operate on their patients to satisfy board requirements? Richard Ohye of the University of Michigan and James Jaggers of the University of Colorado debate this complex question, including the issues of patient safety, public reporting, and commitment to training residents. Robert Sade moderates the debate,…
In a previous study, the author reported the application of single-port thymectomy through an infrasternal approach. In this video, the surgical technique is shown. The patient was placed in the supine position with his legs spread, and the surgeon stood between the patient’s legs. First, a 3 cm transverse incision was made below the xiphoid…
This video documents the author’s technique for robotic diaphragm plication. The robot is docked below the patient. Ten horizontal mattress sutures are placed in the chest under CO2. A 4-port technique is used. Figure 1: Pre-operative CXR of the patient shows a left-sided paralyzed diaphragm. Figure 2: Post-operative day two CXR of the patient after…
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