Content from the Journal of the American Neurological Surgeons.

Triangular Resection of the Mitral Valve Through an Upper Hemisternotomy and the Roof of the Left Atrium 

In this video, Dr. Vince Gaudiani demonstrates a simple triangular resection of the mitral valve for a sixty-eight-year-old male with P2 prolapse. He uses an upper hemisternotomy with a femoral vein cannula and direct aortic cannulation, and a left atrial vent with antegrade cardiolplegia. He also shows how to access the mitral valve through the roof of…

Surgical Extraction of a Watchman Device, Amplatzer Plug, and Failed Transcatheter Mitral Prosthesis

The patient is a seventy-eight-year-old male with a complex cardiac history, including a 3-vessel coronary artery bypass graft surgery (CABG), a Watchman device for atrial fibrillation, and a transcatheter mitral valve replacement for severe mitral regurgitation (MR). He also underwent an Amplatzer occluder replacement for iatrogenic atrial septal defect (ASD) creation. Over the last year,…

Minimally Invasive Resection of Subaortic Membrane via Vertical Right Axillary Thoracotomy

A three-year-old 14.6 kg child presented with a severe left ventricular outflow tract (LVOT) obstruction secondary to a subaortic membrane. Prebypass echocardiogram showed that the membrane was below the aortic valve with significant flow acceleration into the LVOT.  The Surgery  The procedure was performed through a vertical right axillary thoracotomy (VRAT). The right chest was entered,…

Apple Vision Pro Spatial Computing for Endoscopic Mitral Valve and VSD Surgery

Videos of the CT scan, transesophageal echocardiography, and coronary angiography were acquired with an iPhone 15 Pro and transferred to the Vision Pro device through the AirDrop application. Windows were opened in the space surrounding the endoscopic system. This made intraoperative consultation of imaging tests with gestures and sharing of the procedure via steaming possible. …

Robotic Complex Congenital Cardiac Surgery—Partial Atrioventricular Canal Defect Repair

The use of robotic surgical platforms in mitral valve surgeries is an established technique with excellent outcomes (1). However, its use in congenital heart surgery currently is very limited. This video demonstrates a case of partial atrioventricular canal defect (PAVCD) repair using a DaVinci X surgical robot.  The patient is a fifteen-year-old girl who presented…