430 Works

Utilization of 3D Printed Heart Model to Tailor Patch During Surgical Ventricular Restoration

Lukas Morkisz, & Marek Deja
A patient with extremely low ejection fraction, pseudoaneurysm of the left ventricle free wall with a volume exceeding volume of the left ventricle, and secondary mitral regurgitation due to postinfarction papillary muscle dislocation was admitted to the hospital. Before the operation, based on CT scans, a 3D model of the left ventricle with an aneurysm was prepared using 3D printing technology. Then the aneurysmal part of the left ventricular wall was removed by cutting the...

Transgastric Laparoscopic-Assisted Endoscopic Excision of a Gastric GIST

Lauren Taylor & Amber Shada
The authors present a case of a transgastric laparoscopic-assisted endoscopic resection in a 64-year-old man with an incidentally found 5.4 cm gastric GIST. The mass was located endoscopically near the gastroesophageal junction. Three transgastric ports were placed and the stomach was insufflated. The mass was excised with ultrasonic shears and removed endoscopically to avoid enlarging the gastrotomy. The mucosotomy was closed with running barbed suture. Final pathology demonstrated negative margins and he was discharged on...

Transgastric Laparoscopic-Assisted Endoscopic Excision of a Gastric GIST

Lauren Taylor & Amber Shada
The authors present a case of a transgastric laparoscopic-assisted endoscopic resection in a 64-year-old man with an incidentally found 5.4 cm gastric GIST. The mass was located endoscopically near the gastroesophageal junction. Three transgastric ports were placed and the stomach was insufflated. The mass was excised with ultrasonic shears and removed endoscopically to avoid enlarging the gastrotomy. The mucosotomy was closed with running barbed suture. Final pathology demonstrated negative margins and he was discharged on...

Clamshell Approach for Growing Teratoma Syndrome

Sara Parini, Fabio Massera, Alina Gallo, Esther Papalia, Guido Baietto, Maria Giovanna Mastromarino & Ottavio Rena
The patient was a 21-year-old man with a history of worsening cough, chest pain, and increasing chest wall asymmetry during the previous six months. Imaging demonstrated a large heterogeneous mass of the left hemithorax, causing compression of the heart, pulmonary artery, left lung, and displacing the mediastinum to the right. Alpha-fetoprotein and beta-HCG were increased. CT scan confirmed the absence of other masses or enlarged lymph nodes and a testicular ultrasound was normal. Fine needle...

Repair of Iatrogenic RVOT Pseudoaneurysm

, Julija Dobrila, Christopher E. Greenleaf & Jorge D. Salazar
The authors present a video case report of an ex-premature, corrected age of 35 weeks who was referred because of a large patent ductus arteriosus, heart failure, and failure to thrive. After multiple unsuccessful attempts at patent ductus arteriosus device closure, it spontaneously closed. At some point during the procedure, the catheter wire was noted to have potentially caused inadvertent injury to the right ventricular outflow tract. The child returned to the intensive care unit...

Subxiphoid Left S3 Segmentectomy

Karel Pfeuty & Bernard Lenot
This video demonstrates a subxiphoid left S3 segmentectomy, as a day surgery radical oncological treatment of an early stage lung cancer in an elderly patient. This is the case of an 82 years-old COPD patient with a 10 mm suspect nodule located in the middle of segment 3. An anatomical 3D reconstruction allowed us to plan this segmentectomy with sufficient margin. The patient was integrated in an ERAS program and a standardized triportal subxiphoid approach...

What Can Adult and Congenital Surgeons Learn From One Another–Parts I and II

Elizabeth Stephens, Joseph A. Dearani, Patrick M. McCarthy, Emre Belli &
CTSNet hosted two thought -provoking roundtable discussions with several several giants in the field of adult and cardiac heart surgery to discuss similarities and differences to share valuable lessons and points and was great to discuss how the two sides have much in common and what differs. Part 1 features Dr. Elizabeth Stephens, a congenital cardiac surgeon at Mayo Clinic, moderating a discussion on mitral valve surgery with panelists Tirone David of Toronto General Hospital,...

Transaortic Extended Left Ventricular Septal Myectomy in an 11 Year Old With HOCM

Sameh M. Said & Gamal Marey
This is an 11-year-old boy with hypertrophic cardiomyopathy (HCM) and MYH-7 gene mutation. He has been on medical therapy with B-blockers but recently it was noticed progression of his symptoms especially during exertion. He experienced recurrent episodes of presyncope and chest pain while riding his bike. Transthoracic echocardiography showed severe septal hypertrophy with a thickness of over 3 cm especially at the basal and midventricular levels. At rest, there was no obvious gradient but with...

Leadership Book Club: Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy by Amy Edmondson

Ara Vaporciyan, Vinod Thourani, Jennifer Romano & Kimberly Holst
The Leadership Book Club, hosted by Ara Vaporciyan, program manager of the Department of Thoracic and Cardiovascular Surgery at the University of Texas MD Anderson, discusses the book Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy by Amy Edmondson. Dr. Vaporicyan is joined by panelists Vinod Thourani, MD, of the Piedmont Heart Institute; Jennifer Romano, MD, of the University of Michigan; and Kimberly Holst, MD, of the Mayo Clinic. The Leadership Book...

ALCAPA Repair via Left Anterior Minithoracotomy

Dmytro Babliak, Anton Marchenko, Volodymyr Demianenko & Oleksandr Babliak
In this video we are presenting the case of minimally invasive repair of the anomalous left coronary artery from the pulmonary artery in adult. 29 year old man has presented with ventricular fibrillation after physical training in the gym and was resuscitated with defibrillation.
Echocardiography showed moderately depressed left ventricular function - 35% and mild mitral insufficiency.
Angiography showed only one right coronary artery arising from the aorta and good collateral flow to the...

Frozen Elephant Trunk Surgery Without Circulatory Arrest in Type A Acute Aortic Dissection

Marco Di Eusanio, Mariano Cefarelli, Paolo Berretta & Emanuele Gatta
In the present video we show, in a step-by-step fashion, how we could perform what to our best knowledge is the first total arch replacement with Frozen Elephant Trunk (FET) without circulatory arrest (CA) in a patient with type A acute dissection.
Our concept, based on the recognition of CA as the last important FET limitation, involves the cannulation of the innominate and femoral arteries to ensure continuous upper and lower body perfusion and...

Ancona Virtual Live Course: Minimally Invasive and Transcatheter Cardiac Surgery From Theory to Practice, Episode II

Marco Di Eusanio
The recording from the Ancona Live Virtual Course – Minimally Invasive and Trans-Catheter Cardiac Surgery – Episode II, presented on June 7 and 8, 2021, is now available!Watch the recording using this link: https://www.minicardiacsurgery-univpm-research.com/2021-course-recordings/
Dear Friends and Colleagues,
With 5332 devices connected from 81 countries, the Ancona Live Virtual Course – Minimally Invasive and Trans-Catheter Cardiac Surgery – Episode II has been a great success. The meeting was an exceptional opportunity to learn from international key opinion...

Minimally Invasive Mitral Valve Repair With Situs Inversus

Bryon Boulton & Aanandi Munshi
This video shows a minimally invasive mitral valve repair on a patient with situs inversus. The patient is a 66 year old male presenting with progressive dyspnea on exertion, paroxysmal nocturnal dyspnea and orthopnea, who had a recent heart failure admission and was diagnosed with severe mitral valve regurgitation. The patient underwent a diagnostic workup. He had a known history of situs inversus and was referred for surgical correction of severe mitral valve regurgitation. Intra-operatively...

Cardiac, Aortic, and Pulmonary Artery Hydatid Cyst

Haseeb Ahmed, Shah Arif, Azam Jan, Bahauddin Khan, Ameerah Khan, Nabeel Awan, Hussain Shah & Ahmad Mehmood
Cardiac, Aortic and Pulmonary Artery Hydatid Cyst

Figure 1: LV wall hydrated cyst not invading into the LV cavity
Introduction:
Hydatid cysts caused by Echinococcus granulosus are usually located in the liver and lungs; cardiac involvement is quite rare. The incidence of cardiac echinococcosis is <2% of the total echinococcosis incidence, even in countries endemic for echinococcosis [1]. The anatomical site of location in the heart most commonly includes the left ventricle; cysts are rarely located in the...

Cardiac, Aortic, and Pulmonary Artery Hydatid Cyst

Haseeb Ahmed, Shah Arif, Azam Jan, Bahauddin Khan, Ameerah Khan, Nabeel Awan, Hussain Shah & Ahmad Mehmood
Cardiac, Aortic and Pulmonary Artery Hydatid Cyst

Figure 1: LV wall hydrated cyst not invading into the LV cavity
Introduction:
Hydatid cysts caused by Echinococcus granulosus are usually located in the liver and lungs; cardiac involvement is quite rare. The incidence of cardiac echinococcosis is <2% of the total echinococcosis incidence, even in countries endemic for echinococcosis [1]. The anatomical site of location in the heart most commonly includes the left ventricle; cysts are rarely located in the...

Robotic Assisted Repair of a Morgagni Diaphragmatic Hernia Utilizing a Thoracic Approach

G. Kimble Jett, Anthony Tran & Lee Hafen
Morgagni hernia is a rare congenital diaphragmatic hernia comprising 2.6% of all diaphragmatic hernias (1). It is a defect between the costal and sternal attachments of the diaphragm muscle anteriorly and is most common on the right but also can be found on the left or on both sides (2). Abdominal contents can herniate into the thoracic cavity.Morgagni hernia can be asymptomatic and discovered as an incidental finding. Most frequent symptoms include pulmonary, chest or...

VATS Lung Middle Lobectomy With Bloc Anatomical Subsegmentectomy S3b

Ilies Bouabdallah
I report a case of VATS middle lobectomy with en bloc sub Segmentectomy S3b. This intervention was performed for a suspicious lesion localized in the horizontal fissure and we plan to perform an anatomical lung sparing resection: middle lobectomy plus upper lobe anterior medial subsegment S3b.
We start by opening the mediastinal pleura using harmonic device taking care of the phrenic nerve. We isolate the middle vein branch and staple it. Then we move...

VATS Lung Middle Lobectomy With Bloc Anatomical Subsegmentectomy S3b

Ilies Bouabdallah
I report a case of VATS middle lobectomy with en bloc sub Segmentectomy S3b. This intervention was performed for a suspicious lesion localized in the horizontal fissure and we plan to perform an anatomical lung sparing resection: middle lobectomy plus upper lobe anterior medial subsegment S3b.
We start by opening the mediastinal pleura using harmonic device taking care of the phrenic nerve. We isolate the middle vein branch and staple it. Then we move...

Utility of Intraoperative Fluorescence Angiography in Congenital Heart Disease

Sameh M. Said & Gamal Marey
INTRODUCTION:
Achieving successful repair in congenital heart disease requires attention to details. Careful evaluation of anastomotic site patency, re-implanted coronary arteries, location of epicardial coronaries and myocardial perfusion may be needed to ensure safe conduct of the operation and excellent results. We have used the technique of IOFA using indocyanine green (ICG) as an integral part of several of our repair techniques.
METHOD:
ICG has a short half-life but long history of safe use....

How I Do It: AVR With Patch Enlargement of the Aortic Root and Ascending Aortoplasty

Hugo Issa, Justin Chan, Varun Bansal, Khalil Jawad & Christopher Feindel
We present our technique of aortic root enlargement and ascending aortoplasty during aortic valve replacement. Benefits of this technique include the ability to implant a larger valve prosthesis, as well as simultaneously reducing the size of a dilated ascending aorta, whilst avoiding reimplantation of the coronary arteries. We present a case of a patient, male, 67 yo, with a sintomatic severe AS. After median sternotomy and cannulation for bypass, an aortotomy is performed incorporating the...

Cox-Maze IV

Ralph J. Damiano & Lauren Barron
The authors present an open Cox-Maze IV (CMPIV) procedure using bipolar radiofrequency (RF) and cryoablation devices(1). This procedure is performed on cardiopulmonary bypass via a median sternotomy due to significant aortic insufficiency. Our ablation technique for a minimally invasive approach differs slightly with respect to the type of ablation utilized for the lesions and has been described(2). The biatrial lesion sets are performed beginning with bilateral pulmonary vein isolation. Isolation is confirmed by documenting exit...

CTSNet Recorded Webinar May 22: Surgical Atrial Fibrillation - What We Must Do and What We Can Do

Marc Gerdisch, Mark La Meir, Patrick McCarthy & Niv Ad
Marc W. Gerdisch, MD, is CTSNet's current Guest Editor for the new series "Surgical Atrial Fibrillation - What We Must Do and What We Can Do." Dr. Gerdisch, chief of cardiothoracic surgery at the Heart Valve Center at Franciscan Health, invited six contributors to bring together cutting-edge videos designed to broaden our perspective on atrial fibrillation. To see more on Dr. Gerdisch's guest editor series click here. In this video, three contributors, Drs Mark La...

Left Thoracoscopic Approach for Convergent AF Ablation: How to do Everything From the Same Side.

Alexander Moiroux-Sahraoui & Konstantinos Zannis
Atrial fibrillation (AF) is associated with increased risk of stroke, heart failure and all-cause mortality [1]. When it comes to treating persistent AF, the Cox-Maze procedure is the gold standard. However, it presents significant morbidity and mortality rates. The classical endocardial ablation approach appears to be safer but has limited efficacy to treat long lasting persistent AF [2]. Thoracoscopic hybrid epicardial-endocardial ablation technique proved to be effective and safe to treat long lasting persistent AF...

Robotic assisted Right Upper Sleeve Lobectomy

Dylan Tan Jun Hao, Jennifer Whiteley, Rocco Bilancia & Alan Kirk
This video describes a step-by-step demonstration of a robotic assisted sleeve lobectomy for the treatment of a typical carcinoid tumour in the right upper lobe. The tumour was visible in the right upper lobe bronchus during endobronchial examination. We used a four-port approach plus utility port for this procedure. Robotic assistance was provided using the Da Vinci X robotic system. Arms 1 and 3 were used as instrument ports, Arm 2 was used as a...

Successful Management of Postoperative Chylothorax in a Neonate after Coarctation Repair

Sameh M. Said & Gamal Marey
This is a 3.8 kg, 6-day old neonate whose initial presentation was a cardiogenic shock secondary to ductal closure. Upon admission, prostaglandins was initiated and the neonate was stabilized. Echocardiography and Computed tomography scan showed critical coarctation with severe arch hypoplasia and a paramembranous ventricular septal defect. One-stage repair via median sternotomy was performed where an extended end-to-end repair of the aortic coarctation was performed with pulmonary homograft patch augmentation of the anastomosis anteriorly, in...

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