CTSNet Podcasts

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the Centers for Medicare & Medicaid Services proposed decision memo regarding the national coverage analysis for transcatheter aortic valve replacement (TAVR).

Chapters

00:00 Intro
01:17 TAVR National Coverage
06:05 JANS 1, EPOCH CardioLink-10 Trial
10:20 JANS 2, Dacron Ross Autograft Analysis
12:23 JANS 3, Mech vs Biopros Valve Outcomes
15:53 Video 1, Ross Procedure I/E Reduction
19:18 Video 2, Hemi-Commando Procedure
22:14 Video 3, Left VATS Enucleation Leiomyoma
24:15 Dr. Meguid, Intraop Molecular Imaging
35:52 Closing

He outlines crucial deadlines, actionable steps for surgeons, the importance of submitting public comments, and the necessity of data collection.

Additionally, he spoke with Dr. Robert Meguid, Professor of Surgery at the University of Colorado Anschutz Medical Campus, Aurora, CO, USA, about intraoperative molecular imaging. They explore how this technology identifies small nodules, the functionality and use cases of the specialized camera, the associated learning curve, and other available systems. The conversation also touches on robotics, lymph node staging, and cost. Furthermore, Dr. Meguid shares insights on his frequency of use of this technique.

Joel also highlights recent JANS articles on a systematic review and meta-analysis on how complete Dacron reinforcement of Ross autograft does not increase neo-aortic valve regurgitation, a randomized trial on superficial parasternal intercostal plane block with ropivacaine vs placebo for opioid exposure after cardiac surgery, and outcomes after conversion from mechanical to bioprosthetic valves for anticoagulation-related complications.

In addition, Joel explores the Ross procedure with internal and external reduction annuloplasty using autologous tissue rings, hemi-commando procedure for bioprosthetic aortic valve endocarditis, and left-sided uniportal VATS enucleation of a large esophageal leiomyoma.

Before closing, Joel highlights upcoming events in CT surgery.

JANS Items Mentioned

Complete Dacron Reinforcement of Ross Autograft Does Not Increase Neo-Aortic Valve Regurgitation: A Systematic Review and Meta-Analysis

Superficial Parasternal Intercostal Plane Block With Ropivacaine Versus Placebo for Opioid Exposure After Cardiac Surgery (EPOCH CardioLink-10): A Multicentre, Double-Blind, Randomised Trial

Outcomes After Conversion From Mechanical to Bioprosthetic Valves for Anticoagulation-Related Complications

CTSNet Content Mentioned

Ross Procedure With Internal and External Reduction Annuloplasty Using Autologous Tissue Rings

Hemi-Commando Procedure for Bioprosthetic Aortic Valve Endocarditis

Left-Sided Uniportal VATS Enucleation of a Large Esophageal Leiomyoma

Other Items Mentioned

Centers for Medicare & Medicaid Services Database—TAVR

Career Center

CTSNet Events

 

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 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 Amy Hackmann, adult cardiac surgeon at Brigham and Women's Hospital, Boston, MA, USA. Together, they explore extracorporeal membrane oxygenation (ECMO) vs emergency resternotomy for cardiac surgical arrest.

Chapters 

00:00 Intro 

01:36 Resuscitation Algorithm 

02:14 Current State of ECMO 

04:25 Speed, Quality Assurance 

08:28 ECMO Concerns 

12:16 Performance Metrics, Decision-Makers 

15:08 Prime Circuits 

15:24 Non-Surgical Arrest Training 

17:42 MCS Devices 

18:41 Instances to Avoid ECMO 

20:16 Time Targets 

21:58 Avoiding Complications, VIS Score 

25:09 Key Points 

The discussion covers quality assurance metrics, patient-specific decisions regarding ECMO vs resternotomy, and chest compressions. The experts also review the importance of advanced preparation, common causes of cardiac arrest following cardiac surgery, and small-incision surgeries, including the use of surgical saws. Furthermore, the discussion emphasizes the importance of mock drills and team training, as well as the use of ECMO on patients who have not experienced cardiac arrest. Finally, they explore scenarios where ECMO would not be used, vasoactive-inotropic score (VIS), and lactate levels.

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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the transcatheter aortic valve replacement (TAVR) heart team potentially losing a member. He explores the current composition of the TAVR heart team, proposed changes, the thoughts of cardiothoracic societies, and future actions regarding this issue.

Chapters 

00:00 Intro 

01:53 TAVR Heart Team 

07:48 JANS 1, Base Editing of PCSK9 

09:47 JANS 2, High Volume Valve Sparing ARR 

12:03 JANS 3, Western Rheumatic Heart Disease 

14:05 JANS 4, Non-Intubated Uniportal VATS SL 

15:38 Video 1, Miami Method-Bentall 

17:02 Video 2, ALCAPA Repair 

18:29 Video 3, Robotic Cardiac Podcast 

22:17 Dr. Sundt, Mantle Radiation Patients 

31:17 Upcoming Events 

Additionally, he spoke with Dr. Thoralf Sundt, Chief of the Division of Cardiac Surgery and Director of the Corrigan Minehan Heart Center at Massachusetts General Hospital, Boston, MA, USA, about patients who have undergone mantle radiation. They discuss the challenges these patients face postoperatively, including the mortality rate associated with reoperations. The conversation also highlights the significance of employing a heart team approach for these patients, emphasizing the importance of preoperative planning and the application of TAVR, which is potentially suitable for these patients. Furthermore, they touch upon topics such as mechanical valves, porcelain aorta, and the importance of conducting careful operations on these patients.

Joel also highlights recent JANS articles on in vivo base editing of PCSK9 with VERVE-102 for hypercholesterolemia, defining high-volume centers using prospective data for valve-sparing aortic root replacement, insights from the Netherlands Heart Registration on surgical care for rheumatic heart disease patients, and a cohort study on surgical techniques and outcome analysis of non-intubated uniportal VATS sleeve lobectomy.

In addition, Joel explores a step-by-step technique for a minimally invasive Bentall procedure via right axillary access, the repair of an anomalous left coronary artery from the pulmonary artery via direct coronary transfer, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Husam Balkhy about multi-spectrum robotic cardiac surgery. Before closing, Joel highlights upcoming events in CT surgery.

JANS Items Mentioned

In Vivo Base Editing of PCSK9 With VERVE-102 for Hypercholesterolemia

Valve-Sparing Aortic Root Replacement: Defining High-Volume Centres Using Prospective Data

Surgical Care for Rheumatic Heart Disease Patients: Insights From the Netherlands Heart Registration

Surgical Techniques and Outcome Analysis of Non-Intubated Uniportal VATS Sleeve Lobectomy: A Cohort Study

CTSNet Content Mentioned

Minimally Invasive Bentall Procedure via Right Axillary Access: A Step-by-Step Technique

Repair of Anomalous Left Coronary Artery From the Pulmonary Artery via Direct Coronary Transfer

The Atrium: Multi-Spectrum Robotic Cardiac Surgery

Other Items Mentioned

Cardiac Reoperations in Patients With Prior Thoracic Radiation: A Single-Center Analysis of Outcomes and Key Lessons

CTSNet Innovation Video Competition

Career Center

CTSNet Events

 

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. Isaac George, CTSNet Board Member and Co-Director of the Structural Heart and Valve Center, Surgical Director of Structural Heart Disease, and Co-Director of the Mitral and Tricuspid Center at Columbia University Medical Center/NewYork-Presbyterian, NY, USA, about the lifetime management of aortic valve disease.

Chapters

00:00 Intro

02:11 AATS-CTSN Randomized Trials

04:37 JANS 1, Consensus Statement ALAD

10:28 JANS 2, Lung Re-Transplantation Outcomes

12:19 JANS 3, Aortic Homografts, EURECAH

15:15 JANS 4, Lobectomy Cost Analysis

18:10 Video 1, Anomalous L Coronary Artery

19:38 Video 2, Pulm Valve Replacement Reop

21:38 Video 3, Giant Pulm Artery Aneurysm

23:28 Dr. George Discussion

33:18 Upcoming Events

34:05 Closing

They explored the expansion of transcatheter aortic valve replacement (TAVR), emphasizing the crucial role of the heart valve team in this process. The discussion highlighted the necessity for surgeons to be actively involved in the decision-making process surrounding TAVR, particularly in the early stages. They also addressed the importance of lifetime management of the valve, selecting the appropriate valve, and valve durability. Additionally, they discussed the significance of providing patients with multiple surgical options, the Ross procedure, mechanical valves, and explored which procedures patients are choosing.

Joel also highlights recent JANS articles on the ISHLT consensus statement on acute lung allograft dysfunction, aortic homografts for native and prosthetic aortic valve and root endocarditis, how outcomes after lung re-transplantation for restrictive allograft syndrome have not improved over two decades, and the financial burden of postoperative adverse events following lobectomy.

In addition, Joel explores the surgical repair of an anomalous left coronary artery from the right pulmonary artery, minimally invasive pulmonary valve replacement in reoperative settings, and surgical management of giant pulmonary artery aneurysm using a T-shaped graft-valve strategy.

Before closing, Joel highlights upcoming events in CT surgery.

JANS Items Mentioned

ISHLT Consensus Statement on Acute Lung Allograft Dysfunction (ALAD): Definition, Etiology, Diagnostic and Therapeutic Approaches, and Research Priorities

Aortic Homografts for Native and Prosthetic Aortic Valve and Root Endocarditis: Results From the EUropean REgistry of Cryopreserved Aortic Homografts EURECAH

Outcomes After Lung Re-Transplantation for Restrictive Allograft Syndrome Have Not Improved Over Two Decades

Financial Burden of Postoperative Adverse Events Following Lobectomy: Cost Analysis From 10 High-Volume Canadian Hospitals

CTSNet Content Mentioned

Surgical Repair of an Anomalous Left Coronary Artery From the Right Pulmonary Artery

Minimally Invasive Pulmonary Valve Replacement in Reoperative Settings

Surgical Management of Giant Pulmonary Artery Aneurysm Using a T-Shaped Graft-Valve Strategy

Other Items Mentioned

CTSNet Innovation Video Competition

Career Center

CTSNet Events

 

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 Dr. Husam Balkhy, Professor of Surgery and Director of Robotic and Minimally Invasive Cardiac Surgery at the University of Chicago, IL, USA, about multi-spectrum robotic cardiac surgery.

Chapters 

00:00 Intro 

01:04 Why CT Surgery? 

04:08 History 

08:09 Benefits 

10:00 Challenges 

13:56 Multispectrum Robotic Surgery 

16:15 Patient Selection 

24:33 Work Up, Port Placement 

29:47 Valve Surgery 

31:11 Coronary Surgery 

32:38 Other Surgery 

37:15 Complications 

39:13 Training, Simulations 

45:07 Future of Robotics 

49:00 Key Takeaways 

49:34 Surgery Training Advice 

The discussion focuses on the history of robotics in cardiac surgery, emphasizing the benefits and challenges associated with robotic surgery. It explores the concept of multi-spectrum robotic cardiac surgery and provides an overview of robotic surgery as it currently stands, including the types of valves involved and the various approaches utilized. The conversation also highlights specific techniques in robotic surgery, such as totally endoscopic coronary artery bypass (TECAB). Additionally, it addresses potential complications, including peripheral cannulation injuries and phrenic nerve injury. Furthermore, they discussed training in robotics and the future of robotics.

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. Related Resources

Multi-Spectrum Robotic Cardiac Surgery: Early Outcomes

 

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.