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 transition toward minimally invasive cardiac surgery is no longer solely about reducing incision size; it is about creating a standardized, versatile, and sustainable concept. The direct-view transaxillary approach represents a significant evolution that is ready for widespread clinical adoption. It provides a simplified surgical setup that enhances the experience for both patients and surgeons.…
This educational video reviews the anatomy of the aorto-mitral junction and demonstrates how the aorto-mitral angle influences mitral valve geometry, surgical exposure, and repair strategy. Using a custom valve model and pathological specimens, the video illustrates the spatial relationship between the aortic valve, mitral valve annulus, and aorto-mitral continuity, highlighting the transition from traditional anatomical…
A 69-year-old female smoker (82 pack years) was incidentally diagnosed with a left lung tumor. Imaging revealed an 18×18×10 mm lower-lobe nodule and a 24×30 mm hypermetabolic interbronchial lymph node infiltrating the upper lobe parenchyma. Positron emission tomography-computed tomography (PET-CT) showed intense uptake in both lesions (maximum standardized uptake value [SUVmax] 13.8 and 21.4). Endobronchial…
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…
CTSNet Editor-in-Chief Joel Dunning speaks with Drs. Michael Mack and Tom Nguyen about the proposed US Centers for Medicare & Medicaid Services changes to how cardiologists and cardiac surgeons interact during transcatheter aortic valve replacement (TAVR) procedures. Dr. Mack explained the current heart team system, established in 2011 through collaboration with the US Food and…
This video illustrates the case of a 10-day-old female neonate (2.8 kg) with antenatal diagnosis of Type A interrupted aortic arch (IAA). Preoperative echocardiography showed Type A interrupted aortic arch, large perimembranous and mid-muscular ventricular septal defects (VSDs), large constricting patent ductus arterios (PDA) continuing as the descending aorta, and good biventricular function. Operative Steps…
The patient was a 43-year-old man with a background in endurance sports who presented with exertional chest pain. His medical history included a cervical disc herniation in 2020, anxiety disorder, and depression. Computed tomography angiography (CTA) revealed a peripheral pulmonary embolism and a sinus venosus defect (SVD) with partial anomalous pulmonary venous connection (PAPVC), with…
This video demonstrates central cannulation for surgical closure of a secundum atrial septal defect via a right transaxillary approach. The patient was positioned in a left lateral decubitus position with the right arm elevated to optimize exposure of the axillary region. A limited incision was made in the fourth intercostal space along the midaxillary line,…
Partial endocardial cushion defects, presenting as an ostium primum atrial septal defect associated with a cleft in the anterior mitral valve leaflet, traditionally requires a conventional median sternotomy. While sternotomy provides excellent exposure, it is associated with significant surgical trauma, prolonged recovery times, and less desirable cosmetic outcomes. This video presentation demonstrates a sophisticated, totally…
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.…
Minimally invasive cardiac surgery (MICS) frequently requires peripheral cannulation strategies. Femoral cannulation remains the standard approach; however, it is associated with potential complications such as lymphorrhea, hematoma, infection, and an increased risk of embolic stroke in patients with significant atherosclerotic burden due to retrograde perfusion during cardiopulmonary bypass (CPB) (1, 2). Axillary artery cannulation represents…
A 45-year-old man presented with a self-inflicted stab wound to the chest, near the left lower parasternal area. He was evaluated at an outside facility, where the knife was removed carefully and the laceration wound was closed with a nylon suture. A computed tomography (CT) scan of the chest revealed hemopericardium and a mild to…
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…
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…
welcomes you to the new, improved website!