CTSNet Podcasts

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.

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.