Clinical Techniques Headlines

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Thoracic Literature Watch - Third Quarter 2011
11-January-2012

Each quarter Dr. Mark Ferguson, editor of the Cardiac Portal, collects articles pertinent to thoracic topics. The articles are taken from medical and surgical journals other than those found on CTSNet. The 2011 Third Quarter Literature Watch is now available.

Hans Pilegaard, MD
16-December-2011

Hans Pilegaard has performed almost 1,000 procedures using a novel method of Nuss bar insertion that uses a short-bar technique. In this latest interview of the Innovators in cardiothoracic surgery, Pilegaard describes the short-bar technique. Intraoperative video is included of Dr. Pilegaard performing the operation at the Edinburgh Royal Infirmary.

Intrathoracic Migration Of Breast Implant After Thoracoscopic Surgery
09-December-2011

Breast implant complications after thoracic surgery are relatively rare. We present an unusual case of an intact implant migration into the pleural space after thoracoscopic surgery that was initially read as hemothorax on computed tomography of the chest.

Jarvik 2000 LVAD Implantation Through Median Sternotomy With Retroauricular Power Supply
03-December-2011

The authors describe their surgical technique for the problem of gaining access and routing the power cable to the retro-auricular area by using a median sternotomy approach.

New Vignette in the CTSNet Safety Reporting System
09-November-2011

Read the new safety reporting vignette entitled, "Arterial Line Air Embolism Due To Low Venous Reservoir Level," along with a safety analysis. Then, leave a comment about the report or the safety analysis.

Unroofing Procedure for Correction of an Anomalous Right Coronary Artery From the Left Aortic Sinus
09-November-2011

Anomalous right coronary artery arising from the left aortic sinus is a rare malformation, which is known to be associated with an increased risk of sudden death. This video shows the currently favored approach for anatomical repair by an unroofing procedure that results in relocation of the coronary artery into the appropriate aortic sinus.

New Vignette in the CTSNet Safety Reporting System
03-November-2011

A new vignette entitled, “Pressurized Cardiotomy Resulting in Air Embolism,” along with a safety analysis, has been posted on the CTSNet Safety Reporting System. Take a look and leave a comment.

VATS Middle Lobectomy Following a Previous VATS Right Lower Lobectomy
26-October-2011

Prior VATS lobectomy is a relative contraindication to ipsilateral repeat VATS lobectomy due to possible technical difficulties arising from adhesions and scarring, especially at the hilum. This video describes a VATS middle lobectomy in a 63 years old ex-smoker who had a previous VATS right lower lobectomy and pulmonary tuberculosis of the right upper lobe.

Michael Mack, MD
27-September-2011

Dr. Mack describes his techniques and provides tips for coronary artery bypass grafting in his second interview by Dr. Dunning.

Management of a Complex Aortic Dissection with Combined Open and Endovascular Techniques
23-September-2011

Acute Type A aortic dissections can be challenging entities for cardiac surgeons and require close follow-up secondary to their propensity for aneurismal degeneration. A combined open and endovascular technique is described for treating the inital dissection and resultant complications.

Robotic Right Upper Lobectomy
13-September-2011

A minimally invasive approach to resection of early stage lung cancers has been described and many favorable results validated. There is increased interest in pursuing a robotic approach as early experience indicates some potential advantages.

Pascal R. Vouhe, MD
31-August-2011

Interviewed by CTSNet Editor Marko Turina, Dr. Vouhe discusses the switch operation for transposition of the great arteries, with many valuable hints and tips.

First Clinical Experience With A Novel Ultrasonic Bone Scalpel In Surgical Treatment Of Constrictive Pericarditis
25-August-2011

This is a novel usage of an ultrasonic bone scalpel in cardiothoracic surgery used to operate on what is normally one of the most difficult situations that we face, namely the pericardiectomy of a calcified pericardium.

The Thoracic Surgery Residents Association (TSRA) has created the TSRA Review of Cardiothoracic Surgery
24-August-2011

This book was edited by the TSRA and authored by more than 50 cardiothoracic surgery residents from around the country. The material is organized into four different sections: General Thoracic Surgery; Adult Cardiac Surgery; Congenital Cardiac Surgery; and Cardiothoracic Trauma and Critical Care. The book is available at no cost in an electronic format (PDF, EPUB, or Kindle) or for a nominal fee as a print book via Amazon. Details on obtaining the book can be found on the TSRA website.

New Safety Reporting Vignette
22-August-2011

The pregnant patient can often lead to deviations from standard practices. Limiting risks to the fetus should always be considered, but the well-being of the mother needs to be primary in some circumstances.

Minimally Invasive Mitral Valve Repair, with Pre & Post-Op Echo Results
02-August-2011

This video demonstrates a minimally invasive mitral valve repair via right thoracotomy. The patient was a 55 year old male with mitral valve insufficiency and a ruptured chordae on the P2 segment of the posterior leaflet of the mitral valve.

Video-Assisted Harvest of an Intercostal Muscle Flap
29-July-2011

The intercostal muscle is a reliable buttress for the bronchial stump following pneumonectomy and lobectomy in high risk patients. We describe a technique for flap harvest to buttress the bronchial stump after lobectomy using video assisted thoracoscopic surgery.

Thoracic Literature Watch
26-July-2011

The 2011 second quarter Thoracic Literature Watch is now available.

A. Pieter Kappetein, MD
25-July-2011

Dr. David discusses his routine techniques for sternotomy, cannulation, and routine aortic-valve replacement, including choice of valves and when to do a Ross procedure. Then he discusses his signature operation---the aortic valve sparing root replacement, with many valuable hints and tips.

This Giants Interview is sponsored by CryoLife, Inc.

Techniques of Aortic Valve Repair
13-July-2011

This video shows newer techniques of aortic valve repair: commissural annuloplasty; central plication for prolapse; leaflet pericardial augmentation; and ultrasonic calcium debridement. Five cases are shown, over the spectrum of valve pathologies. Greater use of aortic valve repair seems indicated.