CTSNet Podcasts

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Chris Malaisrie, a Professor of Surgery in the Division of Cardiac Surgery at Northwestern University and an Attending Cardiac Surgeon at Northwestern Medicine, about valve-sparing aortic root replacement techniques.

Chapters

00:00 Intro
02:25 TAVR Heart Team Coverage
03:52 JANS 1, TAVR vs SAVR Perspective
10:50 JANS 2, Gene-Edited Transplant Model
13:13 JANS 3, Long-Term Outcomes Atrial Fib
14:31 JANS 4, 147-Minute Drowning Circ Arrest
18:01 Video 1, Double Ann Enlargement Prosth Mis
20:48 Video 2, Reop Aortic Root Reconstruction
22:24 Video 3, Normothermic AA Aneurysm
24:22 Dr. Malaisrie, Aortic Root Replacement
41:42 Closing

The conversation covers a wide range of procedures, including the Bentall, Yacoub, and David operations, as well as the Ross procedure and personalized external aortic root support (PEARS). They further explore approaches to mitral and aortic valve repair, the management of diseased leaky valves, and the advantages of the Stanford modification of the David V procedure. Dr. Malaisrie concludes the discussion by offering advice to surgeons on refining their valve repair skills and shares his prediction for the future of valve repair surgery.

Joel also highlights recent JANS articles on age vs lifetime perspective on the transcatheter vs surgical aortic valve implantation, gene-edited pig cardiac xenotransplantation as a bridge to allotransplantation in infants, long-term outcomes of postoperative atrial fibrillation after cardiac surgery, and a case on ice water drowning survival after 147-minute submersion and 7 °C hypothermic circulatory arrest.

In addition, Joel explores double annular enlargement as an effective technique to overcome patient-prosthesis mismatch, reoperation for aortic root reconstruction, and normothermic treatment of an aortic arch aneurysm.

Before closing, Joel highlights upcoming events in CT surgery.

JANS Items Mentioned

Transcatheter vs Surgical Aortic Valve Implantation: Age vs Lifetime Perspective

Gene-Edited Pig Cardiac Xenotransplantation as a Bridge to Allotransplantation in Infants: Progress in a Pig-to-Baboon Model

Long-Term Outcomes of Postoperative Atrial Fibrillation After Cardiac Surgery: Results From 19,000 Patients

Ice Water Drowning Survival After 147-Minute Submersion and 7 °C Hypothermic Circulatory Arrest

CTSNet Content Mentioned

Double Annular Enlargement as an Effective Technique to Overcome Patient-Prosthesis Mismatch

Reoperation for Aortic Root Reconstruction

Normothermic Treatment of an Aortic Arch Aneurysm

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 episode of The Cardiac Recovery Room, moderator Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, USA, spoke with Drs. V. Seenu Reddy, a cardiothoracic surgeon at HCA’s TriStar Cardiovascular Surgery in Nashville, TN, USA, and Kevin Lobdell, Professor and Director of Regional Cardiovascular and Thoracic Quality, Education, and Research at Atrium Health, NC, USA, about postoperative rehabilitation and readmission prevention.

Chapters 

00:00 Intro 

01:51 Readmission Risk Factors 

05:17 Discharging Patients Living Alone 

07:31 Importance of Readmission Reduction 

10:21 Reducing Readmissions 

15:45 Postop Rehabilitation 

19:36 Bringing Rehab to Patients 

23:43 Behavior Modification & Engagement 

25:55 Coordination of Care 

26:36 Personal Engagement 

They explore various factors influencing patient readmission following cardiac surgery, encompassing both medical and social determinants. A significant focus is placed on the challenges faced by patients living alone, the associated risks, and the mitigation strategies that can be implemented to support them, noting how success is higher if patients have a social structure around them. Furthermore, the conversation highlights the importance of reducing readmission rates and using remote monitoring. They also examine the survival benefits of rehabilitation and barriers of postoperative rehabilitation, including transportation.

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 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.