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…
Surgery of the aortic arch has advanced significantly in recent years. The gold standard technique for treating arch aneurysms remains moderate to deep hypothermia with circulatory arrest of the lower body, coupled with cerebral protection. Recently, some authors have developed various techniques for normothermic arch surgery without cardiopulmonary arrest (1, 2). Here, the authors present…
This case involved a 74-year-old woman who complained of dyspnea on exertion for the past three weeks. She also reported dysphagia for solids without experiencing weight loss. The patient had a history of hypertension and dyslipidemia, and a previous occurrence of deep vein thrombosis. During a cardiac evaluation, a transthoracic ultrasound revealed a large mass…
This instructional video demonstrates techniques for managing adhesions and preventing air leaks during right upper lobe lung volume reduction surgery (LVRS) in patients with severe emphysema. In Case 1, a 79-year-old patient with significant comorbidities presented with extensive adhesions between the right upper lobe and the chest wall. Careful adhesiolysis was performed using cauterization while…
Primary tracheal tumors are rare, with adenoid cystic carcinoma being a common subtype with a tendency for submucosal spread (1). Surgical resection with primary anastomosis is the standard treatment. Minimally invasive techniques, including uniportal video-assisted thoracoscopic surgery (VATS) and non-intubated surgery, aim to reduce perioperative morbidity (2). However, their use in complex airway procedures like…
A 74-year-old male with hypertension, hyperlipidemia, paroxysmal atrial fibrillation, and a previous transcatheter bioprosthetic aortic valve of less than one year presented to an outside facility with repetitive embolic phenomenon to the lower extremities, requiring open incisions and embolectomy. The patient was diagnosed with sepsis secondary to transcatheter aortic valve endocarditis, aortic root abscess, and…
Esophageal leiomyoma is the most common benign tumor of the esophagus. Surgical enucleation is indicated for symptomatic or large lesions and is typically performed via a right-sided approach. Case Presentation A 42-year-old, non-smoking, otherwise healthy male presented with abdominal discomfort. An abdominal computed tomography (CT) scan was performed and demonstrated no intra-abdominal pathology; however, a…
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…
Tetralogy of Fallot is the most common cyanotic congenital heart disease. In patients with a small pulmonary annulus, repair often requires a transannular patch, resulting in progressive pulmonary regurgitation and eventual right ventricular dilation and dysfunction. To address these limitations, valve-sparing and right ventricular outflow tract reconstructive techniques are increasingly being used. Pulmonary valve reconstruction…
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…
The authors present a video demonstrating the double-inclusion Ross technique in a 36-year-old patient with severe bicuspid aortic valve stenosis, aortopathy, and a significant mismatch between the aortic anulus/left ventricular outflow tract (LVOT) and the pulmonary autograft. Considering the mismatch and aneurysmal aorta, downsizing of the annulus and LVOT was performed to create appropriate media…
Bronchogenic cysts are congenital foregut malformations that commonly arise within the mediastinum. Surgical resection is recommended due to risks of infection, compression of adjacent structures, and potential complications. Minimally invasive thoracoscopic approaches have become the preferred method for resection. This video demonstrates the uniportal video-assisted thoracoscopic surgical (VATS) resection of a large posterior mediastinal bronchogenic…
A 56-year-old woman with no significant past medical history presented with progressive dyspnea on exertion and intermittent back pain. Computed tomography (CT) of the chest demonstrated a markedly dilated main pulmonary artery measuring 7 x 6 cm, consistent with a giant pulmonary artery aneurysm. Transesophageal echocardiography confirmed severe aneurysmal dilation of the pulmonary artery, severe…
A 28-year-old female initially presented in 2022 with a persistent cough. Computed tomography (CT) imaging demonstrated features consistent with pulmonary sarcoidosis, which was subsequently confirmed by bronchoscopic biopsy. She was evaluated for lung transplantation and subsequently listed under the super-urgent category. Her past medical history was unremarkable. As part of the preoperative assessment, CT imaging…
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