Content from the Journal of the American Neurological Surgeons.
ERAS Cardiac Society conducted a joint webinar with CTSNet on May 23, 2024, bringing about pivotal insights and questions on the topic, “Post Operative Complications Following Cardiac Surgery and Their Clinical Impact.” The session included presentations from Dr. Andrew D. Shaw and Dr. Rakesh C. Arora, with Dr. Daniel Engelman and Dr. Kevin Lobdell serving…
In this case, a four-month-old infant presented with cardiogenic shock. He had previously undergone repair of coarctation of the aorta through left thoracotomy at one month old. An aortogram revealed mild anatomical narrowing at the repair site with no gradient across the anastomoses. Aortic root injection revealed that the left anterior descending artery and circumflex…
The authors have been using left innominate vein cannulation for SVC drainage in mitral valve surgery instead of direct cannulation of the SVC or right atrium for more than 20 years. Advantages include improved access to the left atrium with no need for special pericardial retraction stitches for visualization of the entire mitral valve, and…
This video details how to enter the sternum when patients have undergone previous sternotomy. This patient was having his fourth sternal reentry and the CT scan showed the aorta was right next to the back of the sternum. First, the femoral vessels were cannulated. Most importantly, the carotid artery was accessed and a 14 Fr…
In this video, the authors present their technique with modifications to the peroral endoscopic myotomy for Zenker’s diverticulum (Z-POEM). They believe this leads to increased effectiveness, safety, and durability of results. The patient is a sixty-nine-year-old man with a significantly symptomatic Zenker’s diverticulum as shown on a preoperative barium swallow. The patient had limited mouth…
An aberrant right subclavian artery is the most common embryological abnormality of the aortic arch and is known clinically as arteria lusoria. In the case of this patient, there was complete absence of the brachiocephalic trunk and the right subclavian was seen branching distal or to the left of the left subclavian artery. To supply…
In an interview with legendary cardiothoracic surgeon Professor J. Donald Hill, CTSNet Allied Health Editor Jill Ley and Prof. Hill discuss his impact as a surgeon, mentor, and leader in the field. They talk about some of Prof. Hill’s own mentors in his early career, his most impactful accomplishments, and his ongoing interest in developing…
The patient is a sixty-two-year-old man who was in a motor vehicle collision that caused a thoracic spinal fracture and a refractory thoracic duct leak. The patient was initially managed conservatively with NPO, TPN, and octreotide. However, despite optimal medical treatment, the patient was still draining 1 to 3 liters of chylous fluid daily from…
At the time of publication, bedside percutaneous VA ECMO decannulations are performed exclusively with the MANTA closure device in the authors’ cardiovascular ICU. They are able to consistently deploy this device with a single attempt and achieve hemostasis with less blood loss overall than their experience with other devices. It is important to establish which…
At the 2023 International Coronary Congress, 10 experts presented their abstracts on coronary artery bypass grafting. Subjects included the impact of atrial fibrillation on long-term CABG outcomes, protection of coronary arteries in pericardiectomy, a case study in robotic-assisted CABG, and more. Disclaimer The information and views presented on CTSNet.org represent the views of the authors…
This patient required a double valve replacement, but she had grade V atheroma in the ascending aorta. This meant that the patient was at very high risk of stroke if routine techniques were used. Because of the patient’s high risk of stroke, the left carotid artery was cannulated and proximally clamped. The brain was perfused…
In this video, the authors demonstrate a modified convergent procedure for refractory atrial fibrillation using intraoperative three-dimensional epicardial voltage mapping. The patient is a seventy-four-year-old man who presented with recurrent symptomatic atrial fibrillation despite maximal medical therapy and three prior catheter ablations. 3D voltage maps from the patient’s most recent preoperative catheter ablation are shown…
The patient is a sixty-two-year-old male with notable past medical history of GERD who was diagnosed with T3N1 esophageal adenocarcinoma during an endoscopy for dysphagia. Endoscopic evaluation demonstrated gross changes and luminal narrowing of the distal esophagus. A PET CT scan further showed increased uptake at the distal esophagus and was concerning for a tumor.…
Watch Dr. John Sadeghi discuss his winning video with competition judge Dr. Lana Schumacher, who is the chief of thoracic surgery at Tufts Medical Center and serves as a member of CTSNet’s board of directors. Dr. Sadeghi’s winning submission to the 2023 CTSNet Resident Video Competition, “Open Cervical and Robotic First Rib Resections for Neurogenic…
The role of subsegmentectomies in thoracic surgery is still questionable, and the literature is rare (1). The complete resection of subsegment vascular hilum, coupled with the secure preservation of adjacent hilar segment structures, particularly in anatomically variant cases, could contribute to a significant improvement in recurrence results and postoperative recovery due to greater anatomic precision…
A ten-year-old girl with history of rheumatic fever for eight years presented with worsening dyspnea upon exertion in the prior four to five months with NYHA class III heart failure. Surgeons found that the patient’s anterior mitral valve leaflet was thickened, she had a doming posterior mitral valve leaflet with restricted mobility, and she had…
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