Content from the Journal of the American Neurological Surgeons.
Operative repair for anomalous aortic origin of a coronary artery (AAOCA) has been described using various innovative techniques. Common to each report is the use of a full sternotomy. As demand for minimally invasive approaches to adult cardiac surgery has increased, the upper hemi-sternotomy has emerged as a safe and effective technique for aortic valve…
A 19-year-old male was referred to the authors’ department from another hospital because of a tight recurrent subglottic stenosis following tracheal resection and reconstruction for subglottic post-intubation stenosis. Several rigid bronchoscopies had already been performed without any effective result. The patient presented with left vocal cord palsy, probably due to previous treatments. On admission, a…
This video shows a female toddler with diagnosed idiopathic dilated cardiomyopathy. The patient presented with worsening symptoms of congestive heart failure, and was admitted to the critical care unit for observation and optimization of medical therapy. During the hospitalization, an echocardiogram was performed, and demonstrated severely depressed biventricular cardiac function, with ejection fraction less than…
Joel Dunning talks with Atiq Rehman about Dr. Rehman’s work to set up the first minimally invasive cardiac surgery program in Pakistan. Dr. Rehman is the Director of the Robotic and Minimally Invasive Cardiac Surgery & Transcatheter Valve Program at the Sarasota Memorial Hospital in Florida. Recently, Dr. Rehman has partnered with the Armed Forces…
This video demonstrates the technical details of performing a right video-assisted thoracoscopic sleeve lobectomy in a 42-year-old male smoker with a stage I adenocarcinoma of the right upper lobe of lung. The VATS sleeve lobectomy technique used is a totally endoscopic procedure. The following non-rib-spreading ports are placed: a 5mm 30-degree camera port placed over…
During the STS 50th Anniversary Meeting in Orlando, FL, CTSNet hosted a very informative video roundtable discussion with some of the leading surgeon educators in the field of surgical atrial fibrillation treatment. The discussion focused on the benefits of the Maze procedure in terms of procedural outcomes, patient satisfaction, and the development of stronger referral…
Introduction The most recent ACC/AHA guidelines (1) suggest that asymptomatic patients with degenerative thoracic aneurysm who are otherwise suitable candidates, and for whom the ascending aorta or aortic sinus diameter is 5.5 cm or greater, should be evaluated for surgical repair (Class I; LOE: C). Dilatation of the ascending aorta to an external diameter of 6…
Introduction Thoracoscopic decortication for stage 2 fibrinopurulent effusion has the advantage of using a minimally invasive technique in an already morbid patient where other modalities have failed (1,2,3). These patients usually have some degree of rib crowding due to a collapsed lung, along with a chest drain that has failed to clear the pleural content…
This video demonstrates construction of a mediastinal stoma after laryngotrachiectomy using a pectoralis major myocutaneous flap. The procedure was performed in a 53-year-old patient who had a past history of squamous cell carcinoma of the right piriform sinus treated by supraglottic hemipharyngolaryngectomy. In the postoperative course, a right pectoralis muscle flap was used to close…
Objectives: In this video, the authors demonstrate the surgical techniques for correction of anomalous aortic origin of the right coronary artery (RCA) with an interarterial and intramural course (AAORCA) or from the pulmonary artery (ARCAPA) in two young adults. Case 1: A 16-year-old boy presented with a long-standing history of chest discomfort, palpitations, and dizziness with…
Joel Dunning talks with Carlos Mestres, Senior Staff Surgeon at the University of Barcelona, member of the International Collaboration on Endocarditis, and Associate Editor of the European Journal of Cardiothoracic Surgery. In this interview, Mr. Dunning and Dr. Mestres take an in-depth look at the treatment of endocarditis. Dr. Mestres stresses that proper treatment requires…
The left upper lobectomy is considered by many surgeons to be the most difficult lobectomy performed using minimally invasive VATS approaches. Part of this difficulty is due to the frequent variability of the vascular anatomy of this region, especially when the interlobar fissure is incomplete or missing. In some cases of left upper lobectomies, in…
In this video, the authors show how to start veno-arterial ECMO support (VA-ECMO) through cervical cannulation, using the right internal jugular vein and right common carotid artery. This site is chosen over the femoral approach, as it avoids the associated complications, particularly in newborns and non-walking infants. In patients who require ECMO after a cardiac operation,…
The safety of thoracoscopic lobectomy has been demonstrated and minimally invasive techniques are seeing increasing use in general thoracic surgery. With minimally invasive techniques, postoperative outcomes can involve decreased pain, blood loss, shorter length of stay, and improved compliance with adjuvant therapy. More recently, thoracoscopic techniques have been used to supplement conventional open approaches and…
Joel Dunning, CTSNet Co-Editor, talks with W. R. Eric Jamieson, retired Professor of Surgery and former Director of Clinical Cardiac Surgery Research at the University of British Columbia. An active member of the Society of Heart Valve Disease, Professor Jamieson contributed to the Canadian Guidelines for Treatment of Valvular Heart Disease and has been involved…
Since video-assisted thoracoscopic surgery (VATS) was described for anatomic lobectomies, many technical variations have been published. The uniportal technique, which enables the entire procedure to be performed through a single port, was recently introduced. This video shows a uniportal VATS lobectomy for lung cancer treatment. Image 1: Computed tomography showing the 3 x 2.8 cm…
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