2,259 Works

Exploit the Internet and Be a Shining Star

Edward M. Bender, Mara Antonoff, Jessica G. Y. Luc &
Filmed at the 2020 STS Annual Meeting in New Orleans, Louisiana, Edward M. Bender of Stanford University in California, USA, moderates a discussion on how the internet plays a role in establishing and growing cardiothoracic careers. He is joined by T. Sloane Guy of Thomas Jefferson University in Philadelphia, Pennsylvania, USA, Jessica G. Y. Luc of the University of British Columbia in Canada, and Mara Antonoff of MD Anderson Cancer Center in Houston, Texas, USA....

Anterior Translocation of the Circumflex Aortic Arch

, , Lisa Hornberger & Mohammed Al Aklabi
This video demonstrates an anterior translocation of the circumflex aortic arch for the management of esophageal compression.A 9-year-old boy diagnosed with a 22q11 deletion had a longstanding history of swallowing difficulty. His parents noted that he always had to have a sip of fluid for solid ingestion. The rest of his medical history was unremarkable.An echocardiogram showed cervical right aortic arch with a probable aberrant left subclavian artery. Videofluoroscopic swallowing exam and upper gastrointestinal endoscopy...

From Conventional Circuit to MiECC

Ignazio Condello, Giuseppe Santarpino, Marco Moscarelli, Giuseppe Nass & Giuseppe Speziale
The major advantage of MiECC systems’ intrinsic characteristics is that they abet the best applying cardiovascular physiology to intraoperative perfusion, while they ultimately unify all three operative disciplinary techniques into a common strategy. This joined holistic effect of MiECC may be considered as a therapy in cardiovascular diseases. Many believe that using MiECC systems leads to an increase in the costs of cardiac surgery. This video explains in a simplified way how to transform a...

A Review of Surgical Ligation of Patent Ductus Arteriosus in a Neonate

Maxwell F. Kilcoyne, Chi Chi Do-Nguyen & Randy M. Stevens
IntroductionAs transcatheter technology improves, the need for surgical ligation of a patent ductus arteriosus (PDA) decreases. Until recently, no device was approved for infants <5 kg. The Amplatzer Duct Occluder II Additional Size (ADO II AS, Abbott Vascular, Santa Clara, California, USA) was approved by the US Food and Drug Administration for infants >700 grams and at least three days old (1). However, patients <700 grams and those with anatomy unamenable to this transcatheter technology...

Three-Dimensional Printing-Guided Precise Surgery for Complex Pulmonary Arteriovenous Malformation

Harinder Singh Bedi
IntroductionThree-dimensional (3D) printing is a new modality which makes a true-to-life 3D model using sophisticated technology. The authors report its first use in a complex case of a large pulmonary arteriovenous (AV) malformation.Case SummaryA 23-year-old patient presented with severe central cyanosis and clubbing. His echocardiogram was normal. A chest computed tomography (CT) and pulmonary angiogram revealed a large AV malformation. A repeat echocardiogram with injection of agitated saline into a peripheral vein showed appearance of...

Rare Case of Vascular Sling With Left Main Bronchus Compression

& Vijay Raju
This 2-year-old girl was evaluated for a recurrent respiratory tract infection and palpitations. She was further evaluated and diagnosed with a large secundum atrial septal defect (ASD) with dilated right atrium (RA) and right ventricle. However, the left pulmonary artery was not visible on the echocardiogram. A chest computed tomography scan showed that the left pulmonary artery (LPA) arose from the right pulmonary artery (RPA). The LPA traveled between the trachea and esophagus, causing a...

Operative Tips and Tricks to Preserve Tissue for a Good Repair

Patrick Perier
Patrick Perier of the Herz und Gefäß Klinik in Bad Neustadt an der Saale, Germany, discusses the problem of excess tissue in mitral valve repair. He focuses on the posterior leaflet, presenting the strengths and limitations of approaches that preserve tissue and discussing tips for a quality repair.This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This...

Konno-Rastan Aortoventriculoplasty for Aortic Valve Replacement in an Adult With Previous Mediastinal Irradiation

Sameh Said & Gamal Marey
This is a 50-year-old man who presented with exertional dyspnea and fatigue secondary to severe aortic valve stenosis. His past medical/surgical history was significant for previous left lung resection via left thoracotomy followed by a sternotomy for a left pleuropulmonary blastoma that was complicated with a paralyzed left hemidiaphragm. He received adjuvant chemotherapy and mediastinal irradiation as a child. Other significant medical issues include hypertension, hyperlipidemia, obstructive sleep apnea, and obesity with a BMI of...

Thymoma Resection Using Subxiphoid Uniportal Approach

, Samer Al Sawalhi, &
There are different types of anterior mediastinal tumors, such as thymoma, germ cell tumors, ectopic parathyroid tumors, and lymphoid tumors. Completeness of tumor resection has been considered the most important determinant of long-term survival, therefore surgical resection of these tumors should be both safe and radical. Subxiphoid access is a novel approach for anterior mediastinal tumor resection. To perform surgery via this access, specially designed long instruments are required. Subxiphoid access provides excellent visualization of...

Surgical Access Debate: Median Sternotomy is Safer Than Minimally Invasive Techniques

Prakash P. Punjabi
Prakash P. Punjabi of the Imperial College in London, UK, presents the argument for conventional approaches for the treatment of mitral valve disease.This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This content is published with the permission of SCTS. Please click here for more information on SCTS educational programs.

Total Correction of Tetralogy of Fallot in an Infant

, , Shyamal Maiti, & Pradeep Narayan
Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases. The aim of this video is to demonstrate the technical aspects of total correction of TOF in a 5-month-old, 5 kg infant. Median sternotomy was performed. The surgery required standard cardiopulmonary bypass with aortobicaval venous cannulation. The authors’ choice of cardioplegia is del Nido cardioplegia.
The main steps are:
Resection and relief of right ventricular outflow tract (RVOT) obstructionVSD closureReconstruction of RVOT...

AV Valve Repair in a 3 kg Infant With Tricuspid Atresia

Vinod Sebastian & Charlie Steele
The authors present a case of AV valve repair in a 3 kg infant with tricuspid atresia.
The patient was diagnosed prenatally with tricuspid atresia. The patient was born full term with a birth weight of 2.8 kg. Diagnosis was confirmed as tricuspid atresia with transposition of the great arteries. Atrial septal defect and bulboventricular foramen were unrestrictive and the BVF was larger in dimension than the aortic valve. The patient underwent PA banding as...

Extra-Anatomical Bypass for Repair of Adult Distal Arch Restenosis

, Ahmad Khaled Darwazah, Issa Khdour &
Surgical correction of redo complex aortic pathology through the same thoractomy incision can be associated with significant risks, including re-entry into a possibly frozen hemithorax. This could lead to injury to nerves and, more importantly, bleeding from hugely dilated collateral intercostal arteries, precluding optimal surgical repair (1). A single-stage approach via median sternotomy provides several distinct advantages (2).The authors present a case of a 20-year-old man with a history of hypoplastic arch operated on at...

Non-Intubated Subxiphoid Multiport VATS Thymectomy

Jian Hu, , Azmat Rustam, Shilpa Gandhi, Katarzyna Zanowska & Wahid Gohrain
This is a video of a non-intubated subxiphoid multiport VATS thymectomy. The patient was a 40-year-old man who was an asymptomatic chronic smoker. On incidental evaluation, HRCT thorax was suggestive of anterior mediastinal lesions, which on further MRI thorax was confirmed to be cystic and 1.8 x 0.8c m. Awake ventilation anesthesia without muscle relaxant was given under LMA. Tubeless principles were adopted. The patient was placed in a supine position, keeping legs wide apart...

CTSNet Step-by-Step Series: Tricuspid Annuloplasty

, Omar Jarral, Shruti Jayakumar, Jason Varzaly, Leanne Harling & James Edwards
In the case shown in this video, a midline sternotomy was used, which is ideal for multiple procedures. However, a right thoracotomy can be done as a minimally invasive approach if tricuspid repair is being done in isolation. This procedure requires cannulation of both the superior (SVC) and inferior vena cavae (IVC) as well as the aorta. In this video, bicaval cannulation can be seen. This involves placing purse-string sutures in to the right atrium,...

Robotic Right Lower Lobe Anteromedial Basilar (S7 + S8) Segmentectomy: A Case Report and Discussion

Ankit Dhamija, , Alper Toker & Ghulam Abbas
Pulmonary segmentectomy can be an adequate oncological lung resection for early stage lung cancer and deeper metastatic lesions. In select patients, the outcomes are comparable to lobectomy. Historically, this operation has been associated with higher air leak and prolonged length of stay (1). Both video-assisted (VATS) and robotic assisted segmentectomy have similar outcomes (2). The authors believe the robotic approach allows for a more precise dissection secondary to its 3D visibility, dexterity, and wrist mobility....

Minimally Invasive Techniques are Safer Than Median Sternotomy

Torsten Doenst
Torsten Doenst of the University Hospital Jena in Germany presents the argument for minimally invasive techniques over median sternotomy in the treatment of mitral valve disease.
This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This content is published with the permission of SCTS. Please click here for more information on SCTS educational programs..

Single Stage Retrograde Replacement of Thoracic Aorta With Aortic Valve Replacement

Mohammed Ibrahim, , Mohammed Idhrees, &
A 63-year-old old man was diagnosed with an aortic aneurysm by routine chest X-ray. His 2D echo showed moderate aortic regurgitation with normal LV function. A CT aortogram revealed an aortic aneurysm involving the ascending aorta, arch, and descending thoracic aorta. Coronary angiogram showed a tight ostioproximal lesion in the ramus intermedius. He was taken up for surgery.A median sternotomy was done. A 7 mm dacron graft was attached to the right axillary artery and...

Video-Assisted Thoracoscopic Surgery Resection of a Large Esophageal Diverticulum With Esophageal Myotomy

Edward D. Percy, Azra Panjwani & Ahmad S. Ashrafi
IntroductionEsophageal diverticulum is a rare condition characterized by protrusion of the esophageal mucosa through an area of weakness in the surrounding muscular layers. Generally, esophageal diverticula can be categorized as pulsion or traction. The former constitutes a false diverticulum, as the mucosa is the only protruding layer (1). Traction diverticula, on the other hand, include all muscular layers of the esophagus and tend to occur as a result of mediastinal inflammation (1, 2). Midesophageal, also...

COVID-19 and Cardiac Surgery: An Overview From a Lower Middle Income Country

, Shahid A Sami &
This study is an overview of the impact of COVID-19 on the provision of cardiac surgery in a Lower Middle Income Country, Pakistan, the fifth most populous country in the world with 24% of Pakistan's population living below the national poverty line (3) before the COVID-19 outbreak.

Left Internal Mammary Artery Harvesting: The Skeletonization Technique

Anh Vo, Tuong Nguyen & Dinh Nguyen
This video shows the basic technique of skeletonized left internal mammary artery (LIMA) harvesting. Skeletonization is an advanced technique of graft harvesting for coronary artery bypass grafting (CABG), and while it requires meticulous attention, it has many advantages. For example, skeletonization of the IMA can minimize sternal ischemia and lower the risk of mediastinitis, and the graft is longer and larger than a pedicled IMA.
A conventional median sternotomy is performed in the usual manner. A...

From Thoracic Surgery Triage to Service Reactivation: How to Protect Yourself

Hussein Elkhayat
There is currently not enough evidence to decide upon the best practice for thoracic surgery during the pandemic since the situation continues to be highly dynamic on a day-to-day basis. The author presents this short video recorded from a Medtronic thoracic surgery appearing in a webinar during this pandemic to emphasize the points that need to be addressed for service reactivation and how can surgeons can protect themselves during this time.ReferencesThoracic Surgery Outcomes Research Network,...

Double Valve Repair for Marfan Aortic Root Aneurysm and Bileaflet (Barlow’s) Mitral Valve

George T. Stavridis, George Kantidakis, Vaios V. Kaminiotis, &
ObjectivesRepair of simultaneous complex aortic and mitral valve defects in patients with Marfan syndrome can be difficult. This video illustrates a double valve repair using two remodeling annuloplasty rings, as a technical simplification for simultaneous reconstruction. Video SummaryRisk-adjusted outcomes of multiple valve procedures may be better with repair than with prosthetic valve replacement (1, 2). The patient in this video was a 38-year-old woman with Marfan syndrome, along with aortic root aneurysm and severe aortic...

Recent Advances in Radiation Oncology in the Management of Lung Cancer

Kevin Franks
Kevin Franks of the Leeds Cancer Centre in the UK discusses recent advances in radiotherapy technology for the treatment of lung cancer.This presentation was originally given during the SCTS Ionescu University program at the 2018 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This content is published with the permission of SCTS. Please click here for more information on SCTS educational programs.

Concepts in CABG: An Interview With David Taggart

& David Taggart
Dr Om P. Yadava of the National Heart Institute in New Delhi, India, and Editor-in-Chief of the Indian Journal of Thoracic and Cardiovascular Surgery discusses contemporary issues in coronary artery bypass grafting (CABG) with Professor David Taggart of the University of Oxford in the UK at the 2018 Annual Conference of the Indian Association of Cardiovascular and Thoracic Surgeons.
Dr Yadava begins by suggesting that more ink has been spilt than blood over total arterial...

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