Content from the Journal of the American Neurological Surgeons.
Patient Selection Superior vena cava syndrome (SCVS) is an obstruction of blood flow through the superior vena cava. It is a medical emergency usually manifesting a malignant disease process within the thorax in at least 60% of cases [1]. It requires immediate diagnostic evaluation and therapy. SVC obstruction was originally described by William Hunter in 1757 in…
Patient Selection Patients should be evaluated to confirm the diagnosis of primary achalasia. While a barium swallow can suggest the diagnosis, confirmation is best obtained with a motility study. In addition to confirming the diagnosis, the lower esophageal sphincter pressure measured on preoperative motility studies has been correlated with outcome after myotomy for achalasia (USC…
ANTICOAGULATION Patient Target INR Date PT (INR) Coumadin (mg) PTT Heparin (U/hr) …
By Anil M. Patwardhan, MS Video:
The left atrial cardioversion wire (yellow) is the first wire to be implanted on the heart. It is placed before the valve repair/replacement or after the distal circumflex grafting is performed. The heart is lifted in order to have adequate exposure of the left pulmonary veins. Operative Steps There are 4 wires implanted in the…
Patient Selection Certain patients who present following a transmural anterior wall myocardial infarct with an akinetic or dyskinetic wall segment, have been shown to benefit from endoventricular circular patch plasty as described by Dor. Reconstructive surgery of the altered left ventricular topography results in a permanent improvement in the ventricular wall function, including non-ischemic zones…
By Giles Dreyfus, MD Video:
By A. Sampath Kumar, MD and Carlos MG Duran, MD, PhD Editor’s Note This video demonstrates a very elegant technique of creating a trileaflet aortic valve utilizing the patient’s own pericardium. Although the technique is very impressive, its clinical application is questionable. The neo-aortic valve has no advantage over a stented or stentless bioprosthesis or a homograft,…
By J. Scott Rankin, MD, Ricardo E. Orozco MD and Calvin A. Burrichter, MD American Heart Association 2007 Video:
Introduction I have recently completed my cardiothoracic and vascular surgery (CTVS) residency. It not only taught me the techniques and art of surgery but also enriched me spiritually. There are many things which I think can make our training programmes highly successful and beneficial. We as residents should learn to take maximum benefit from our…
Patient Selection Three-field dissection (TFD) for squamous cell carcinoma of the esophagus has been practiced by Japanese surgeons since the early 1980’s. Several reports, exclusively from Japan, showed that approximately one third of patients had previously unsuspected metastases to the cervical nodes. In 1997, we initiated a small pilot trial to evaluate the feasibility of…
Epiphrenic diverticuli are acquired mucosal outpouchings protruding through the muscular wall of the distal 10 cm of the esophagus. Most are associated with an underlying esophageal motility disorder. Patient Selection Epiphrenic diverticuli are acquired mucosal outpouchings protruding through the muscular wall of the distal 10 cm of the esophagus [1]. Most are associated with an…
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