Content from the Journal of the American Neurological Surgeons.
Redo median sternotomy, total arch replacement, and the frozen elephant trunk procedures for chronic aortic dissection comprise a complex operation. In this video, Professor Yan first explains his operative approach. Then, three tips and tricks for redo total arch and frozen elephant trunk are highlighted: 1. Electro-evaporative technique for adhesiolysis.2. Left axillary artery extra-anatomic bypass.3. …
“Get down,” said the colonel, “and turn out your light.” The train was slowing through the dark countryside. I could barely make out a building far across a field in the moonlight. I was not sure what the alarm was about, but I trusted the colonel and so I minded his directions and sat quietly…
CTSNet continued its webinar series with ASAIO Journal on June 20, 2024 by enrolling cardiac surgery and heart failure professionals to discuss the topic, “LVADs and RV Dysfunction: Is It Manageable?” Panelists included Dr. Jennifer A. Cowger, Section Head of Advanced Heart Failure, Transplant, and Mechanical Circulatory Support and Member of the Shock, Structural, Sarcoid,…
At the 2024 AATS Annual Meeting, CTSNet senior editors set out to interview the most knowledgeable CT surgeons from around the world. Stay tuned for more interviews from the meeting. Senior Editor Mara Antonoff spoke with Dr. Marc de Perrot about the recent results of the SMARTER trial, which involved a lower dosage of radiation…
In this video, the patient is a six-month-old, 6.4 kg infant with a new diagnosis of dilated cardiomyopathy. The patient was at home and presented at the hospital in extremis. The patient had increased work of breathing, distressed respirations, and poor distal perfusion (capillary refill > 4s). The patient was initially stabilized with epinephrine, milrinone,…
This video shows the case of a forty-year-old man who presented with a large 6 cm pear-shaped dilated aortic root. He was offered valve sparing root replacement or a mechanical root replacement and he chose the mechanical valve. A percutaneous femoral vein cannula was used along with a high aortic cannula. To begin, the patient…
This is a video of a sixty-five-year-old man who presented with atrial fibrillation, a critical LAD lesion, and heart failure with severe aortic regurgitation and a root dilated to 48 mm. To begin, the SVC was cannulated and a percutaneous IVC cannula was placed from the femoral vein. The IVC was then clamped off in…
A sixty-five-year-old woman developed double vision and the investigation she underwent revealed an 11 cm thymoma. Subsequently, she had a median sternotomy and thymectomy, but the left phrenic nerve was injured, which resulted in left diaphragmatic paresis. The surgery was followed by radiation of the anatomic area of the thymus, as histology showed a type…
An eighty-four-year-old woman presented with acute type A aortic dissection and blood in the pericardial sac. The dissection was contained by the visceral pericardial layer (i.e. the last line of defense). The patient underwent a successful emergency aortic repair at the Royal Prince Alfred Hospital, Sydney, Australia. First, a midline incision was performed from the…
This video demonstrates how the surgical team managed to save an elderly woman who presented initially with tamponade and contained aortic rupture, but subsequently developed frank aortic rupture. The patient underwent aortic root and hemi-arch replacement under this critical circumstance. The patient had a full recovery without any neurological complications. First, a sternotomy was performed…
Many studies demonstrate the superiority of the bilateral internal thoracic artery (BITA) versus single internal thoracic artery (SITA) grafting technique when it comes to early and late survival and decreased need for repeat revascularization (1). Despite this, adherence to BITA grafting remains low in most centers. This is thought to be attributed to a longer…
Dr. Vince Gaudiani introduces his series on different techniques for aortic root reconstruction. The patient is a sixty-year-old man who presented with collapse and was found to have a 7 cm dilated aortic aneurysm with severe aortic regurgitation. Femoral vein cannulation was performed, followed by aortic cannulation and retrograde cardioplegia. The author describes his logic…
This video shows surgical repair of pentalogy of Fallot in a thirteen-year-old boy. A team of British surgeons assisted the team at the National Cardiothoracic Centre in Accra, Ghana with this operation. The patient had a delayed diagnosis for this condition. In addition, it was thought to be a tetralogy of Fallot until intraoperative TOE…
The patient is a thirty-year-old woman who underwent an aortic valve replacement in 2021, aortic prosthesis and mitral valve replacement in 2022 for endocarditis, and a redo operation for dysfunction/dehiscence of the mitral valve in February 2023. She was affected by systemic lupus erythematosus and suffered from chronic renal insufficiency requiring dialysis waiting renal transplantation. …
Endobronchial carcinoid tumors require bronchoplasty, which can control the resection margins and subsequent postobstruction secretions and potential infection focus. For the classical open thoracotomy cases, bronchoplasty is performed with classical direct straightforward surgical knotting of interrupted sutures. However, in the era of minimally invasive surgery, this technique can be time consuming, which makes intra or…
At the 2024 STS Annual Meeting, CTSNet Editor in Chief Joel Dunning and CTSNet senior editors set out to interview the most knowledgeable CT surgeons from around the world. CTSNet Editor in Chief Joel Dunning spoke with Professor Justin Blasberg about a recentstudy on longitudinal follow-up with esophageal cancer patients. The study linked STS database…
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