CTSNet Podcasts

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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Drs. Mateo Marin-Cuartas, CTSNet JANS Editor and cardiac surgeon at the University Department of Cardiac Surgery at Leipzig Heart Centre University Hospital in Leipzig, SN, Germany; and Samuel Heuts, a cardiothoracic surgeon in the Department of Cardiothoracic Surgery at Maastricht University Medical Center in Maastricht, LI, about a paper they authored titled “Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk,” published in Heart, a journal produced by the British Medical Journal.

Chapters

00:00 Intro
01:51 JANS 1, 6-Year Outcomes TAVR vs SAVR
06:45 JANS 2, Evolut THV Postdilation
09:22 Video 2, TAVI in SAVR Explantation
11:10 JANS 3, High Risk Increasing Adoption of DCD
13:17 JANS 4, Lobar Quantitation for Assessment
15:16 Video 1, Narayana Robotic AVR
17:23 Video 3, Extended Resections Podcast
18:30 Dr. Marin-Cuartas & Heuts, TAVR vs SAVR
36:42 Upcoming Events
37:32 Instructional Video Competition
38:55 Career Center

They discussed the motivations behind the creation of this paper and provided insights into its Bayesian hierarchical design. Key findings included the five-year all-cause mortality rates and the risk of stroke associated with the procedures. They also referenced other studies with similar findings, such as a recently published paper from the Journal of the American College of Cardiology on the “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis.” Finally, they explored the future of transcatheter aortic valve implantation and surgical aortic valve replacement.  

Joel also highlights recent JANS articles on the six-year outcomes after transcatheter vs surgical aortic valve replacement in low-risk patients with aortic stenosis, postdilation of Evolut transcatheter heart valves, insights into current practices in the United States regarding increasing adoption of donation after circulatory death in high-risk heart transplant recipients, and the value of V/Q SPECT/CT lobar quantitation for pre-treatment assessment of lung malignancy. 

In addition, Joel explores robotic-assisted aortic valve replacement, TAVI in SAVR explantation, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Maninder Kalkat about extended resections. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

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

2.) Postdilation of Evolut Transcatheter Heart Valves: Insights From Bench Testing 

3.) Increasing Adoption of Donation After Circulatory Death in High Risk Heart Transplant Recipients: Insights Into Current Practices in the United States 

4.) The Value of V/Q SPECT/CT Lobar Quantitation for Pre-Treatment Assessment of Lung Malignancy 

CTSNet Content Mentioned 

1.) Robotic-Assisted Aortic Valve Replacement  

2.) TAVI in SAVR Explantation: A Two-Step Technique for Successful Removal  

3.) The Atrium: Extended Resections  

Other 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 Lifeline 

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.

In this first 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 Barbara McLean, a Critical Care Clinical Nurse Specialist at Grady Memorial Hospital in Atlanta, GA, USA. They discuss end-tidal carbon dioxide (EtCO2) monitoring in cardiac surgical emergencies. 

Chapters

00:00 Intro

01:30 End-Tidal CO2 Monitoring Overview

09:16 Case 1

13:52 Case 2

19:57 Outlier Cases

21:01 Global Application

Mclean began by providing an overview of EtCO2, including bedside interpretation, values for rapid non-invasive cardiopulmonary evaluation during acute decompensation, critical values that warrant intervention, and how to differentiate ventilation and perfusion abnormalities, metabolic acidosis, hypoventilation, hyperventilation, and arterial CO2. They then discuss various case studies outlining postoperative outcomes and the symptoms patients were experiencing emphasizing this important monitoring modality to aid in accurate and timely clinical assessment during complex emergencies. 

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! 

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.