CTSNet Podcasts

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Zain Khalpey, an assistant attending surgeon at NewYork-Presbyterian/Columbia University Irving Medical Center, NY, USA, adjunct assistant professor of surgery at Columbia University Irving Medical Center, NY, USA, and Chief Medical AI Officer, Chair of Applied Clinical AI, and Director of Applied Translational Artificial Research Institute (ATARI), AZ, USA, about utilizing artificial intelligence (AI) in cardiothoracic surgery.

Chapters

00:00 Intro
01:42 Upcoming CTSNet Activities
03:01 Website Transition
03:54 JANS 1, Mech vs Bio AVR in 50–70 YO
08:16 JANS 2, Abnormal Bleeding in OR
10:26 JANS 3, Intraop Assessment RV Function
11:54 JANS 4, Laser Anastomosis System CABG
14:49 Video 1, RAMT AVR Hemiarch Replacement
16:23 Video 2, Big Cyst & Small Incisions
17:33 Video 3, Left VATS Pneumonectomy
19:55 Dr. Khalpey, AI in CT Surgery
30:28 Upcoming Events
31:48 Closing

They discuss the importance of ethical AI being and address risk scores. The conversation also covers the application of AI in preoperative, intraoperative, and postoperative settings, as well as predictive algorithms and the benefits of integrating AI within cardiothoracic surgery. Additionally, they emphasize that there will always be a need for surgeons, as AI cannot replace human expertise.  

Joel also highlights recent JANS articles on a systematic review and meta-analysis on mechanical vs biological aortic valve replacement in patients aged 50-70 years, an observational study of inter-rater reliability between anesthetists and surgeons on abnormal bleeding in the cardiac operating room, advancing intraoperative assessment of right ventricular function, and the excimer laser assisted non-occlusive anastomosis (ELANA) anastomotic system surgical technique to construct distal anastomoses using a novel device in coronary artery bypass grafting. 

In addition, Joel explores a right anterior minithoractomy aortic valve replacement, ascending aorta, and hemiarch repair, thoracoscopic resection of a large mediastinal cyst, and left VATS pneumonectomy in pediatric pulmonary mucoepidermoid carcinoma. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. Mechanical Versus Biological Aortic Valve Replacement in Patients Aged 50-70 Years: A Systematic Review and Meta-Analysis 

2. Abnormal Bleeding in the Cardiac Operating Room: An Observational Study of Inter-Rater Reliability Between Anesthetists and Surgeons 

3. Echocardiographic Correlates of Pressure-Volume-Derived Indices: Advancing Intraoperative Assessment of Right Ventricular Function 

4. The Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) Anastomotic System Surgical Technique to Construct Distal Anastomoses Using a Novel Device in Coronary Artery Bypass Grafting 

CTSNet Content Mentioned 

1. Right Anterior Minithoractomy Aortic Valve Replacement, Ascending Aorta, and Hemiarch Repair  

2. When Size Is Not a Limitation: Thoracoscopic Resection of a Large Mediastinal Cyst  

3. Left VATS Pneumonectomy in Pediatric Pulmonary Mucoepidermoid Carcinoma  

Other Items Mentioned 

1. Website Blackout Notice! 

2. Career Center  

3. CTSNet Events Calendar 

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Rakesh Arora, Director of Cardiothoracic Critical Care and a professor in the Department of Surgery and Anesthesia at Northwestern Medicine, Chicago, IL, USA. They discuss managing arrest in patients with temporary mechanical circulatory support (tMCS), focusing on a paper Arora authored titled “EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery.”  

Chapters 

00:00 Intro 

01:08 Guidelines Background 

02:02 Resuscitation, Monitoring Parameters 

07:37 Approach to Patients in Extremis 

11:39 Quality Assurance, Internal Data 

12:22 End-Tidal 

13:17 Bleeding Management 

15:33 Arrhythmia, Defibrillation 

17:21 Optimizing Tissue Perfusion 

18:09 Key Points 

20:26 Devices & Flow Patterns 

They began by exploring how this paper was developed and how Arora became involved in this project. They discussed the importance of expediting the resuscitation process and examined the recommendations for a tMCS implantation in patients experiencing post-procedural low cardiac output syndrome (LCOS). Key considerations included oxygen saturation levels (SpO2) and point-of-care ultrasound (POCUS), as well as the significance of pulsatility. Additionally, they discussed the interaction between devices and patients and the importance of team training and simulation. They also addressed crucial topics such as coagulation, anticoagulation, and defibrillation. Finally, they examined optimizing tissue perfusion for better patient outcomes.  

Every month, The Lifeline features intensive care specialists sharing their expert insights into the rapid and effective management of critically ill cardiac surgical patients. Don’t miss next month’s episode! 

Related Resources 

EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery 

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Adam Greenbaum, an Associate Professor of Medicine at Emory School of Medicine and Co-director of the Emory Structural Heart and Valve Center, Atlanta, GA, USA, about the groundbreaking percutaneous coronary artery bypass graft procedure he developed called the ventriculo-coronary transcatheter outward navigation and reentry (VECTOR) procedure.

Chapters

00:00 Intro

02:46 FDA Device Recall

03:52 JANS 1, CDC WONDER Aortic Stenosis

06:10 JANS 2, Free vs In-Situ RIMA-CABG

08:04 JANS 3, AF Worsens Outcome of MVR

09:52 JANS 4, EXCEL Trial

12:29 New Website

13:43 Video 1, Ross Procedure Technique

16:16 Video 2, Total Arch Replacement

18:38 Video 3, Pleural Sepsis Podcast

20:51 Dr. Greenbaum, VECTOR Procedure

40:34 Upcoming Events

41:18 Career Center

41:43 Closing

They delved into the development and rationale behind this innovative technique, which aims to provide a solution for patients with no other options, particularly those with narrow sinuses or low-lying coronaries. Additionally, they discussed other leaflet modification methods and the criteria for patient selection for the VECTOR procedure. The conversation also covered the technical steps involved in the procedure, along with specific cases in which it has been utilized, as well as the challenges faced and troubleshooting done by the surgeons. Finally, they explored the future of this procedure.  

Joel also highlights recent JANS articles on concerning trends seen in aortic stenosis-related mortality, a meta-analysis on free vs in-situ right internal mammary artery as a conduit in coronary artery bypass surgery, if atrial fibrillation worsens outcome of mitral valve repair for degenerative mitral regurgitation, and the EXCEL trial on spontaneous myocardial infarction after left main revascularization. 

In addition, Joel explores the Ross procedure with annular stabilization, interposition graft, and loose-jacket technique, total arch replacement with a novel dual stent device, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Professor Eric Lim about pleural sepsis. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER 

2. Free vs In-Situ Right Internal Mammary Artery as a Conduit in Coronary Artery Bypass Surgery: A Meta-Analysis 

3. Atrial Fibrillation Worsens Outcome of Mitral Valve Repair for Degenerative Mitral Regurgitation: Long-Term Follow-Up of 959 Patients 

4. Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial 

CTSNet Content Mentioned 

1. Ross Procedure With Annular Stabilization, Interposition Graft, and Loose-Jacket Technique  

2. Total Arch Replacement With a Novel Dual Stent Device  

3. The Atrium: Pleural Sepsis  

Other Items Mentioned 

1. Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure 

2. Website Blackout Notice! 

3. Career Center  

4. CTSNet Events Calendar 

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Sameer Hirji, an associate surgeon at Brigham and Women's Hospital in Boston, MA, USA, about a paper he presented on at the 62nd Society of Thoracic Surgeons Annual Meeting titled “Concerning Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER.”

Chapters

00:00 Intro 

02:38 JANS 1, Female CT Surgeons NYT Article 

04:38 JANS 2, Biopros vs Mech SAVR >65 YO 

07:32 JANS 3, Fissure Last Tech, Randomized Trial 

09:58 JANS 4, Ozaki Procedure, Perf & Durability 

12:46 Video 1, MI Left Atrial Myxoma Resection 

14:43 Video 2, Conduction System-Sparing Modified AVR 

16:42 Video 3, RCAA w Coronary SF 

18:55 Dr. Hirji, CDC WONDER Aortic Stenosis 

31:40 Upcoming Events 

32:11 Closing

They discussed the study itself, including its overall results, as well as the demographic factors analyzed—such as race, gender, and location—and the results related to these demographics. They also addressed the limitations of the data used and explored possible reasons for the observed results, such as intervention strategies, underdiagnosis, and the prevalence of asymptomatic patients. The conversation further emphasized the importance of patient selection and the heart team. 

Joel also highlights recent JANS articles on female cardiothoracic surgeons, unlocking the male fortress, bioprosthetic versus mechanical surgical aortic valve replacement in patients ≥65 years of age, results from a prospective randomized controlled trial on if the fissure last technique really reduces postoperative air leak after lung resection, and mid-term valve performance and durability of the Ozaki procedure in patients on chronic dialysis. 

In addition, Joel explores a minimally invasive left atrial myxoma resection, safety and efficacy of a cardiac conduction system-sparing modified aortic valve replacement, and a surgical approach to right coronary artery aneurysm with coronary sinus fistula. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. Female Cardiothoracic Surgeons, Unlocking the Male Fortress 

2. Bioprosthetic Versus Mechanical Surgical Aortic Valve Replacement in Patients ≥65 Years of Age 

3. Does the Fissure Last Technique Really Reduce Postoperative Airleak After Lung Resection? Results From a Prospective Randomized Controlled Trial  

4. Mid-Term Valve Performance and Durability of the Ozaki Procedure in Patients on Chronic Dialysis 

CTSNet Content Mentioned 

1. Minimally Invasive Left Atrial Myxoma Resection  

2. Safety and Efficacy of a Cardiac Conduction System-Sparing Modified Aortic Valve Replacement  

3. Surgical Approach to Right Coronary Artery Aneurysm With Coronary Sinus Fistula  

Other Items Mentioned 

1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER  

2. Career Center  

3. CTSNet Events Calendar 
 

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Professor Eric Lim, Professor of Thoracic Surgery at Imperial College London and Consultant Thoracic Surgeon at the Royal Brompton Hospital in London, UK, about pleural sepsis.  

Chapters 

00:00 Intro 

00:30 Dr. Lim Background 

01:26 Why CT Surgery & Clinical Research? 

05:09 Definition & Overview 

07:50 Causes 

09:29 Clinical Presentations & Investigations 

16:03 Management, RAPID Score 

19:49 Medical Management 

22:15 Chest Tube Management (ICD) 

25:12 IF, Medical Decortication 

25:48 Surgical Management 

29:30 History 

30:34 Debridement & Decortication, Approach 

34:30 Patient Positioning 

35:18 Thoracotomy 

38:43 VATS 

39:37 Technical Steps 

43:18 Postoperative Management 

49:37 Complications 

50:58 Summarizing Points 

51:50 Surgery Training Advice 

They provide an overview of pleural sepsis, highlighting its three stages: the exudative stage, fibrinopurulent stage, and organizing stage. The discussion covers its history and causes, including complications from pneumonia. They also examine symptoms, failure to progress, and imaging techniques such as ultrasound. Additionally, they delve into pleural fluid analysis, the RAPID score, and management strategies, including medical interventions, chest tube drainage, and intrapleural fibrinolytics. Various surgical management strategies are discussed as well, including thoracotomy, video-assisted thoracoscopic surgery (VATS), and robotic approaches. Finally, they address chest tube management, respiratory physiotherapy, acute complications, and long-term complications.   

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Keep an eye out for next month’s episode.  

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.