An 8 cm left sub-areolar thoracotomy was performed as the working port. The pericardium was opened vertically over the left ventricular apex and suspended with retraction sutures. Using 3-0 polypropylene pledgeted sutures, the apical cuff was secured to the left ventricular (LV) apex. The driveline was tunneled subcostally and exteriorized on the lateral abdominal wall.…
Three dimensional (3D) endoscopic aortic valve replacement combined with extended septal myectomy (the Morrow procedure) via right lateral minithoracotomy offers a safe and effective single-stage surgical solution for the rare and hemodynamically complex coexistence of severe degenerative aortic stenosis (AS) and hypertrophic obstructive cardiomyopathy (HOCM) with critical left ventricular outflow tract (LVOT) obstruction. The coexistence…
Mixed reality–guided anatomical segmentectomy represents an emerging strategy to improve intraoperative spatial understanding during sublobar lung resection. Accurate identification of segmental anatomy is critical in segmentectomy, particularly for ground-glass nodules, where lesion localization and margin assessment can be challenging. Conventional imaging review and intraoperative visualization may be insufficient to fully translate complex three-dimensional anatomy into…
Conventional transvenous pacing is standard care; however, patients with limited venous access often face a therapeutic dead end. The authors present a novel, minimally invasive thoracoscopic technique for right atrial access and septal lead implantation, targeting the left bundle branch (LBB) area—a solution that has not been previously described. The case involved a patient with…
This video demonstrates video-assisted thoracoscopic surgery lobectomies, providing step-by-step instructional videos that dissect important structures in a library format, organized by each specific lobe. 1. Left Upper Lobectomy A left upper lobectomy began with the dissection of the superior pulmonary vein. A ring forceps was used to safely pass behind the pulmonary vein. A 6…
In this video, the authors explain their technique for intrathoracic rib fixation as a treatment for rib pseudoarthrosis. They present the case of a 52-year-old female smoker with chronic obstructive pulmonary disease (COPD) who worked as a glassblower. She experienced a fall at home, impacting the left hemithorax, which resulted in fractures of the sixth to eighth left ribs. The patient was initially managed conservatively…
Background and Rationale Coronary artery bypass graft (CABG) surgery remains a cornerstone treatment for advanced coronary heart disease. However, the long-term efficacy of CABG is frequently compromised by the failure of saphenous vein grafts (SVGs). Unlike arteries, veins are not physiologically adapted to the high-pressure arterial environment, leading to pathological tissue remodeling, neointimal hyperplasia, and…
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…
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…
The Warden procedure (1) has been performed for partial anomalous pulmonary venous connection in which the right upper pulmonary vein (RUPV) drains into the superior vena cava (SVC). This involves transecting the SVC and performing an end-to-end anastomosis with the right atrial appendage (RAA). However, the Warden procedure raises concerns regarding SVC stenosis and anastomotic…
This video is the third-place winner from the 2025 Innovation Video Competition. Watch all entries into the competition, including the other winning videos. Objective Reoperative cardiac surgery is often viewed as a relative contraindication for robotic approaches. Here, the authors report a case of a robotic mitral valve replacement in a patient who underwent…
This video is the second-place winner from the 2025 CTSNet Innovation Video Competition. Watch all entries into the competition, including the other winning videos. Leaflet replacement is one of the techniques used in aortic valve repair to preserve the valve. It is frequently performed when a leaflet is damaged or destructed due to conditions such as…
This is the first-place video from the 2025 CTSNet Innovation Video Competition. Watch all entries into the competition, including the runner-up and third place winner. Click here to watch Dr. Sameh Said’s interview with CTSNet Editor-in-Chief Joel Dunning. Background Hypoplastic left heart syndrome (HLHS) represents a constellation of defects affecting the left side of the heart,…
This video is the third-place winner from CTSNet’s 2024 Innovation Video Competition. Watch all entries into the competition, including the other winning videos. Step 1: Left Anterior Minithoracotomy The authors demonstrate how to perform a MIDCAB using bilateral internal mammary arteries under direct vision (1). The authors performed a left anterior minithoracotomy (6-8 cm) through the…
This video is the second-place winner from CTSNet’s 2024 Innovation Video Competition. Watch all entries into the competition, including the other winning videos. This video demonstrates a novel surgical technique that combines minimally invasive coronary artery bypass grafting (CABG) and mitral valve replacement through a single approach: left anterior minithoracotomy in the fourth intercostal space. …
This is the first-place video from the 2024 CTSNet Innovation Video Competition. Watch all entries into the competition, including the second and third place winners. Watch Dr. Jessica Hungate’s interview with CTSNet Editor-in-Chief Joel Dunning. This video demonstrates a novel pericardial patch for mitral valve replacement in the setting of mitral annular calcification (MAC). MAC confers certain…
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