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.…
The video begins with an interview featuring thoracic surgeon and CTSNet Editor-in-Chief Joel Dunning and Dr. Leanne Ashrafian, a cardiothoracic surgeon at Guy’s Hospital in London, United Kingdom, interviewing the author of this complex case Dr. Jakraphan Yu, a cardiothoracic surgeon at Vajira Hospital, Bangkok, Thailand. They discuss the intricacies of this case and the…
Congenital diverticulum of the ventricle is a rare cardiac malformation and is usually associated with other congenital abnormalities, including intracardiac, midline thoracic, diaphragmatic, and anterior abdominal wall defects, first described by Cantrell, Haller and Ravitch (1). In this video, the authors describe a single-stage repair of an apical left ventricular diverticulum with ventricular septal defect…
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…
Ectopic parathyroid adenomas in the anterior mediastinum are rare and present significant diagnostic and surgical challenges. This video shows the case of a 49-year-old male with a history of hypertension who presented with severe hypercalcemia (17.9 mg/dL) and acute kidney injury. Diagnostic evaluation, including 18F-choline positron emission tomography-computed tomography (PET-CT) (1), identified an ectopic parathyroid…
This video highlights the case of a 55-year-old female who presented with facial swelling, breathlessness -NYHA class 3 and cough for 15 days. She had a known case of hypertension and a cerebrovascular accident (CVA) in the past, though she recovered without any neurological deficit. She required diuretics and noninvasive ventilation (NIV) support on admission.…
This video demonstrates a robotic-assisted resection of the left fifth rib for oligometastatic melanoma involving the chest wall. An 83-year-old man with a history of cutaneous melanoma presented with progressive left posterior chest wall pain that required escalating analgesia. Preoperative computed tomography (CT) demonstrated two areas of lytic disease involving the left fifth rib, with…
This clinical video demonstrates the preservation of a replaced left hepatic artery during the creation of a gastric conduit in a robotic-assisted minimally invasive esophagectomy (RAMIE) for post-neoadjuvant esophageal adenocarcinoma. The patient was a 61-year-old male with cT3N0M0 (Stage IIA) lower-esophageal adenocarcinoma. He completed neoadjuvant therapy with four cycles of fluorouracil, leucovorin, oxaliplatin, and docetaxel.…
Redo tricuspid valve surgery after previous cardiac operations remains technically challenging and is associated with increased operative risk, particularly in elderly patients with extensive vascular calcifications and prior device-related complications. Minimally invasive and endoscopic approaches may reduce surgical trauma while maintaining procedural safety and effectiveness. Case Presentation This case demonstrates a 78-year-old male with previous…
The clinical case presented in this video concerns a 67-year-old female patient who came to the authors’ attention in 2021 after undergoing a computed tomography (CT) scan that revealed the incidental finding of a 16 mm ground-glass opacity (GGO) located in the left lower lobe. As the lesion was well localized and adequate surgical margins…
This video presents a Ross procedure with internal and external reduction annuloplasty using autologous tissue rings. The patient was a 41-year-old previously healthy male who presented after a syncopal episode. Workup showed complete heart block, a bicuspid aortic valve with leaflet thickening, and a large vegetation on the non-coronary cusp, and 4+ aortic insufficiency (AI).…
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…
A 57-year-old man presented with a two-year history of progressively worsening exertional dyspnea. Computed tomography revealed a 50 mm fusiform ascending aortic aneurysm. Echocardiography showed a heavily calcified bicuspid aortic valve with severe stenosis (peak/mean gradient 87/60 mmHg, aortic valve area 0.6 cm²) and preserved left ventricular ejection fraction (55 percent). Surgical Technique …
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…
Background Congenital absence of the midline sternum is a rare chest wall anomaly that exposes mediastinal structures and causes paradoxical respiration, leading to respiratory and feeding difficulties. This report describes the successful surgical management of an infant with complete absence of the midline sternum using a chondral flap technique to restore stable native tissue coverage. Case Description…
A 52-year-old old male was diagnosed with acute coronary syndrome, specifically anterior wall myocardial infarction (MI) with moderate left ventricular (LV) dysfunction, and without congestive heart failure (CCF). He had a history of hypertension, diabetes, and an ischemic cerebrovascular accident (CVA) affecting the right cerebellum, but he exhibited no deficits. A coronary angiogram performed in…
welcomes you to the new, improved website!