Content from the Journal of the American Neurological Surgeons.
The visceral pericardium covers the heart and the great vessels. It is mentioned in embryology textbooks, but it is rarely described in surgical textbooks. It is a distinct layer that provides additional strength to the ascending aorta, especially in acute aortic dissection and impending rupture. In this video, I will dissect out the visceral pericardium…
The visceral pericardium is a defined layer of connective tissue that covers the heart and the great vessels. It provides additional strength to the ascending aorta and can be regarded as the last line of defense in acute type A aortic dissection and impending rupture. It may well be the only layer of tissue holding…
The search for an ideal cardiac valve substitute continues. Homografts have the advantages of resistance to infection, superior hemodynamic profile, and avoidance of anticoagulation compared to the conventional prosthetic valves (1). However, their durability and availability are a concern. At this center, the donor selection, procurement, sterilization, and preservation process is based on the recommendations…
In this short video, Dr. Andrew Owens talks through and gives a few good tips for a safe redo sternotomy. First, external defibrillator pads were placed and the patient was prepped. A discussion was had with the team as to the plan for a large bleed or ventricular injury. The sternal wires were then cut…
At the 2024 ESTS Conference in Barcelona, Spain, Editor in Chief Joel Dunning interviewed some of the most knowledgeable thoracic surgeons from around the world to highlight the fascinating work they are doing. Stay tuned for more interviews from the meeting. CTSNet Editor in Chief Joel Dunning spoke with Diego Gonzalez Rivas about his upcoming…
This video presents a case of minimally invasive mitral valve replacement, left atrial appendage closure and left atrium plication. The patient is a sixty-eight-year-old woman with a history of rheumatic heart disease. She had symptoms of dyspnea and permanent atrial fibrillation. On the echocardiograph, surgeons observed severe mitral valve stenosis. Her ejection fraction was 45…
The patient is a twenty-year-old female who was born with congenital bilateral branch pulmonary arteries hypoplasia and severe stenosis. She developed suprasystemic right ventricular pressure and underwent transcatheter balloon dilation and multiple stent placement that failed to demonstrate any growth in her branch pulmonary arteries or improvement in her right ventricular pressure. Echocardiography did not…
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ERAS Cardiac Society once more conducted a joint webinar with CTSNet on May 30, 2024, bringing about presentations, discussion, and questions on, “Chest Tube Management in Cardiac Surgery.” The session included presentations from Dr. Marc Gillinov, Dr. Jurij Kalisnik, and Dr. Lenard Conradi, with Dr. Kevin Lobdell and Dr. Marc Gerdisch serving as the webinar’s…
This video presents a robotic diaphragm plication procedure using the Versius robotic surgical system. The patient is a fifty-eight-year-old man with a history of mitral valve regurgitation who underwent mitral valve repair surgery in June 2022. Following surgery, he experienced progressive dyspnea on exertion and imaging revealed an elevated left hemidiaphragm. Evaluation included a transthoracic…
This video shows the case of a patient in Ghana who underwent a redo sternotomy and then a Bentall’s operation for a dilated aortic root with severe regurgitation. The patient was thought to have only aortic regurgitation four years prior, when only a transthoracic echocardiogram was available to surgeons. Upon opening the chest in this…
A seven-month-old, 8.5 kg infant was followed clinically for a large ventricular septal defect (VSD) until an echocardiographic evaluation raised concerns regarding aortic valve (AV) regurgitation secondary to a new prolapse of the aortic cusps into the large defect. The combination of a large subaortic VSD, AV cusp (especially the right and/or non-coronary cusps) prolapse,…
The Patient The patient is a seventy-two-year-old male with stage 3 chronic kidney disease, a BMI of 35, and prior RCA stent placement who presented with symptomatic severe aortic stenosis and a CT angiogram demonstrating aneurysmal dilation of the aortic root and ascending aorta. The CTA highlighted the 4.5 cm sinus of Valsalva, 4.5 cm…
At the 2023 International Coronary Congress, four surgeons presented their biggest mistakes in CABG surgery and how they went about fixing them. They emphasized the importance of surgeons sharing their mistakes so others can learn from them. After the presentations, the participants engage in a discussion with audience members on each case. Disclaimer The information…
This video demonstrates the construction of a felt Dacron plug, which was used to close the ventriculotomy in the left ventricle following explantation of a Heart Mate 3 LVAD device. The plug was constructed with material which is readily available in most operating theatres. The method for creating this plug was simple and thus should…
This young patient had his aortic dissection missed on multiple occasions. First, he experienced classic symptoms described in this video. He then underwent a CT angiogram and 3D reconstruction that missed the large dissection cavity. Finally, he was identified as having this large abnormality but was unable to undergo the complex surgery in his home…
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