CTSNet Podcasts

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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Shanda Blackmon, a thoracic surgeon and Professor of Surgery, as well as the Director of the Lung Institute at Baylor College of Medicine, Houston, TX, USA, about an article from The New York Times in which she was featured, titled “Female CT Surgeons, Unlocking the Male Fortress.”

Chapters

00:00 Intro 

01:35 JANS 1, Fractured Sternal Wires Post-Surgery 

05:21 JANS 2, ERAS Protocols in Spain, Consensus Study 

07:00 JANS 3, Preserving Native MVs in VSD & MR Patients 

09:53 JANS 4, Sternal Closure After Norwood 

12:15 Video 1, LIMA Harvest, Robotic Harmonic Scalpel 

13:55 Video 2, Butterfly Resection for MV Leaflets 

15:26 Video 3, Bidirectional Glenn via Axill Thorac 

17:18 Dr. Blackmon, Women in CT Surgery 

33:17 Upcoming Events 

35:13 Closing 

They discussed her experience working with The New York Times and the goal of the article. Key highlights included the pay disparity, with women cardiothoracic surgeons receiving lower pay than their male counterparts, as evidenced by the Society of Thoracic Surgeons (STS) compensation survey. Additionally, they addressed the rewarding aspects of cardiothoracic surgery, the challenges surgeons face, and the initiatives that women cardiothoracic surgeons are starting to tackle, such as the pay equity and leadership opportunities.  

Joel also highlights recent JANS articles on a cross-sectional study examining wire configurations, sternal locations, and breakage sites for fractured sternal wires post-coronary surgery, a Delphi consensus study on the standardized recommendations for the implementation of enhanced recovery protocols in thoracic surgery in Spain, surgical strategy for preserving native mitral valves in infants with ventricular septal defects and mitral regurgitation, and routine primary sternal closure after the Norwood procedure. 

In addition, Joel explores robotic-assisted left internal mammary harvest with the robotic harmonic scalpel, butterfly resection for prolapsed posterior mitral valve leaflets, and minimally invasive bidirectional Glenn via vertical right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Fractured Sternal Wires Post-Coronary Surgery: A Cross-Sectional Study Examining Wire Configurations, Sternal Locations, and Breakage Sites 

2.) Standardized Recommendations for the Implementation of Enhanced Recovery Protocols in Thoracic Surgery in Spain: A Delphi Consensus Study 

3.) Surgical Strategy for Preserving Native Mitral Valves in Infants With Ventricular Septal Defects and Mitral Regurgitation 

4.) Routine Primary Sternal Closure After the Norwood Procedure 

CTSNet Content Mentioned 

1.) Robotic-Assisted Left Internal Mammary Harvest With the Robotic Harmonic Scalpel​  

2.) Butterfly Resection for Prolapsed Posterior Mitral Valve Leaflets  

3.) Pushing Boundaries in Pediatric Cardiac Surgery: Minimally Invasive Bidirectional Glenn Via Vertical Right Axillary Thoracotomy  

Other Items Mentioned 

1.) Female Cardiothoracic Surgeons, Unlocking the Male Fortress 

2.) Instructional Video Competition    

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.

In this episode of The Cardiac Recovery Room, moderator Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in North Carolina, USA, spoke with Drs. Rakesh Arora, Director of Perioperative and Cardiac Critical Care and Research Director in the Division of Cardiac Surgery at University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio, USA, and Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, about preoperative optimization of cardiac patients.  

Chapters

00:00 Intro

01:27 Vulnerable Patients, Identifying Risk

04:24 Assessing Patients, Biological Prep

09:57 Psychological & Cognitive Prep

12:09 Time Between Discharge & Follow-Up

15:40 Anemic Patients, Iron Studies

20:12 Nutrition Screening & Malnutrition

25:30 Future Optimization Topics

They discussed the importance of identifying risks, conducting thorough assessments before the operation, and preoperative education. They also emphasized psychological and cognitive preparation, as well as the time frame between discharge and follow-up. Additionally, they addressed issues related to iron deficiency without anemia, anemic patients, and iron studies. Furthermore, they highlighted the importance of nutrition screening and addressing malnutrition as essential aspects of preoperative care.   

The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society. 

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. John Forrest, a cardiologist and Director of both Interventional Cardiology and the Structural Heart Disease Program at Yale Medicine, New Haven, CT, USA, about a paper he authored titled “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis,” published by the Journal of the American College of Cardiology.

Chapters

00:00 Intro 

02:38 TAVR vs SAVR Context 

03:54 CDC WONDER Data, TAVR SAVR 

05:37 JANS 1, TAVR vs SAVR 5-Year Outcomes 

07:31 JANS 2, Temporary MCS Devices Landscape 

09:17 JANS 3, Pulm Resection Post-CABG 

10:23 JANS 4, PRE-HIIT Randomized Trial 

12:36 Career Center 

13:10 Video 1, Redo MVR After VIV TAVR 

15:37 Video 2, Repair After Acute Intramural Hematoma 

18:01 Video 3, Acute Severe MR Repair 

19:36 Dr. Forrest, 6-Year TAVR vs SAVR 

44:49 Upcoming Events 

45:33 The Lifeline Podcast 

They explored other randomized trials involving high-risk and intermediate-risk patients with aortic stenosis and examined the specific goals of this low-risk trial. The discussion then delved into the trial’s results, highlighting that there was no significant difference in the composite endpoint of all-cause mortality or disabling stroke. However, a noteworthy finding was that the transcatheter aortic valve replacement (TAVR) arm experienced a higher reintervention rate compared to surgery, primarily due to an increased incidence of aortic regurgitation. They also addressed factors such as valve dilation, stents, and various reasons for surgical valve failure. Additionally, they examined the similarities between this trial and other partner trials and the future for low-risk patients with aortic stenosis.  

Joel also highlights recent JANS articles on the updated five-year outcomes of transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis at low- to intermediate-surgical risk, a United States nationwide analysis on the changing landscape of temporary mechanical circulatory support devices in the new heart allocation system, pulmonary resection post-coronary artery bypass grafting, and a randomized controlled trial on the preoperative exercise to improve fitness in patients undergoing complex surgery for cancer of the lung or esophagus (PRE-HIIT). 

In addition, Joel explores redo mitral valve replacement after previous valve-in-valve mitral TAVR, aortic repair after acute intramural hematoma, and repair of acute severe mitral regurgitation due to iatrogenic papillary muscle rupture. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk 

2.) The Changing Landscape of Temporary Mechanical Circulatory Support Devices in the New Heart Allocation System—A United States Nationwide Analysis 

3.) Pulmonary Resection Post-Coronary Artery Bypass Grafting: Feasible, but Right-Sided Procedures Demand Caution 

4.) Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Esophagus (PRE-HIIT): A Randomized Controlled Trial 

CTSNet Content Mentioned 

1.) Redo Mitral Valve Replacement After Previous Valve-in-Valve Mitral TAVR 

2.) Aortic Repair After Acute Intramural Hematoma  

3.) Repair of Acute Severe Mitral Regurgitation Due to Iatrogenic Papillary Muscle Rupture 

Other Items Mentioned 

1.) Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis 

2.) The Lifeline: End-Tidal Carbon Dioxide Monitoring in Cardiac Surgical Emergencies 

3.) Instructional Video Competition    

4.) Career Center  

5.) 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.