Content from the Journal of the American Neurological Surgeons.
This video demonstrates a simplified ring-only mitral valve repair technique for patients with symmetrical bileaflet mitral valve prolapse, annular dilatation, and centrally directed multiple jets of mitral regurgitation. The technique is particularly suitable for minimally invasive mitral valve repair and serves as an alternative to sliding plasty in selected cases. The operative strategy was based on the implantation of the largest available annuloplasty ring to…
A 9-day-old neonate weighing 2.2 kg, who had passed the neonatal screen for critical congenital heart disease, was re-admitted with heart failure symptoms, including lethargy and failure to thrive. A murmur was heard, and a transthoracic echocardiogram confirmed a large aortopulmonary window (APW) and the origin of the right coronary artery (RCA) from the main pulmonary artery (ARCAPA). Through standard median sternotomy, cardiopulmonary bypass was initiated. After achieving…
Robotic thoracic surgery provides superior precision and enhanced ergonomics compared to video-assisted thoracoscopic surgery, primarily due to its three-dimensional visualization and wristed instruments. These advantages facilitate meticulous dissection and more comprehensive lymphadenectomy in complex resections, ultimately contributing to improved surgical outcomes (1). As an advanced evolution of minimally invasive surgery, single-port robotic surgery offers several advantages over multiport robotic…
At the 2026 American Association for Thoracic Surgery (AATS) Annual Meeting, CTSNet Editor-in-Chief, Dr. Joel Dunning, a cardiothoracic surgeon at James Cook University Hospital in Middlesbrough, UK, engaged in a discussion with Dr. Husam Balkhy, Professor of Surgery and the Director of Robotic and Minimally Invasive Cardiac Surgery at the University of Chicago Medicine in Chicago, Illinois, USA. Joining them were Drs. Sarah Nisivaco, a research assistant at the University of Chicago Medicine, and Bob Kiaii, a…
At the 2026 American Association for Thoracic Surgery (AATS) Annual Meeting, CTSNet JANS Editor Dr. Mateo Marin-Cuartas, a cardiac surgeon at Leipzig Heart Center, Germany, spoke with Dr. Michael Borger, Chair of the University Clinic for Cardiac Surgery and the Medical Director at the Leipzig Heart Center. Their conversation focused on the effects of mitral surgery on ventricular arrhythmias in patients with arrhythmic mitral valve prolapse. During their discussion, they explored what mitral valve…
Diaphragmatic defects involving the central tendon are uncommon and may present diagnostic uncertainty, particularly when identified incidentally on imaging. Surgical management can be technically challenging due to attenuated tissue quality and close proximity to vital structures, including the liver and inferior vena cava. The authors present a video case report with intraoperative footage of a patient undergoing robotic repair of diaphragmatic herniation through a fenestrated…
At the Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting, leading surgeons presented on challenges in the management of locally advanced non-small cell lung cancer (NSCLC). Dr. Enrico Ruffin, Professor of Thoracic Surgery at the University of Torino, Italy, delivered a presentation on “Defining Resectability in Non-Small Cell Lung Cancer.” He explored TNM stage groups, resectability by stages, and the definition of resectability in current guidelines. Additionally, he discussed the European Organization for…
Tricuspid valve endocarditis with extensive leaflet destruction presents a major surgical challenge, particularly when durable valve repair is no longer feasible and conventional prosthetic valve replacement may be undesirable. In this video, the authors demonstrate their technique for the surgical treatment of destructive tricuspid valve endocarditis using a self-constructed tubular valve fashioned from bovine pericardium. After radical debridement of all infected and devitalized…
The authors report a redo robotic-assisted mitral valve replacement (MVR) in a 50-year-old male with prior bioprosthetic MVR via sternotomy, presenting with New York Heart Association (NYHA) class III dyspnea and significant prosthetic mitral inflow obstruction (mean/peak gradient 10/20 mmHg) with preserved biventricular function. The procedure was performed using a robotic platform with del Nido cardioplegia for myocardial protection, and a mechanical prosthesis…
This clinical video provides a detailed, step-by-step overview of the robotic-assisted convergent (ROK AF) procedure for the treatment of atrial fibrillation. The technique combines minimally invasive epicardial ablation with endocardial catheter-based ablation to achieve durable rhythm control, particularly in patients with persistent or long-standing persistent atrial fibrillation. This how-to video is designed to serve as a practical guide…
In this video, the authors present the case of a 65-year-old female diagnosed with a central squamous cell carcinoma of the left upper lobe with nodal involvement in stations 5 and 6, initially detected during the evaluation of a persistent cough. Computed tomography revealed a 57 mm centrally located mass in the left upper lobe with involvement…
This video demonstrates a robotic left lower lobectomy using bedside stapling to improve efficiency and assist with the rapid flow of the operative procedure. Interestingly, with the Si system, this was the routine way of performing the operation, but with the advent of robotic stapling, interest in bedside stapling has declined. However, the advantages of bedside stapling are numerous. First, with more junior surgeons or trainees, if the senior surgeon is scrubbed, they can significantly speed the cadence of the operation by…
The 79-year-old male patient had a transcatheter aortic valve replacement (TAVR) placed at another institution in another state, although he presented with more complex issues than only aortic stenosis. The patient was a retired internist who originally had a bicuspid valve with aortic regurgitation (AR) and aortic stenosis (AS). A transcatheter 29 mm valve was placed. However, he was subsequently admitted with acute heart failure due to acute mitral valve regurgitation and anemia. Additionally, he had aortic insufficiency, and the team was concerned about hemolysis. He underwent a TAVR computed tomography (CT) scan in addition to a transesophageal echocardiogram (TEE) to clarify his diagnosis. The 3Mension program was used…
A gentleman in his 60s with advanced oesophageal cancer (cT4bN1M0) and extensive nodal disease developed a malignant tracheoesophageal fistula (TEF). Due to the presence of the fistula, he was not a candidate for radiotherapy given the high risk of exacerbating the defect. He completed five cycles of 5-fluorouracil (5-FU)-based chemotherapy and was on maintenance pembrolizumab administered every six weeks. Clinically, he…
At the Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting, leading surgeons presented on various cardiac topics, including mitral annular calcification (MAC), mitral regurgitation (MR), reverse remodeling in ischemic mitral regurgitation (IMR), and several rapid-fire case debates. Dr. Gianluca Lucchese, a consultant cardiac surgeon at Guy’s and St Thomas’ NHS Foundation Trust in London, UK, and a senior clinical lecturer at King’s College London, delivered a presentation titled “The Big MAC: Contemporary Treatment Strategies and the…
This video presents a case of an older patient with severe pectus who had only one Nuss bar. Over four months, the bar fractured the thin sternum and migrated over it, exiting the thoracic cavity. This video demonstrates this complication, the removal of the bar, and how the surgeons subsequently performed the Ravitch procedure, and using two Stryker Variax plates to elevate the sternum and stabilize the fracture. Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material…
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