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.

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

1. Complete Dacron Reinforcement of Ross Autograft Does Not Increase Neo-Aortic Valve Regurgitation: A Systematic Review and Meta-Analysis
2. Superficial Parasternal Intercostal Plane Block With Ropivacaine Versus Placebo for Opioid Exposure After Cardiac Surgery (EPOCH CardioLink-10): A Multicentre, Double-Blind, Randomised Trial
3. Outcomes After Conversion From Mechanical to Bioprosthetic Valves for Anticoagulation-Related Complications

CTSNet Content Mentioned

1. Ross Procedure With Internal and External Reduction Annuloplasty Using Autologous Tissue Rings
2. Hemi-Commando Procedure for Bioprosthetic Aortic Valve Endocarditis
3. Left-Sided Uniportal VATS Enucleation of a Large Esophageal Leiomyoma

Other Items Mentioned

1. Centers for Medicare & Medicaid Services Database—TAVR
2. Career Center
3. 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.

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.

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

1. In Vivo Base Editing of PCSK9 With VERVE-102 for Hypercholesterolemia
2. Valve-Sparing Aortic Root Replacement: Defining High-Volume Centres Using Prospective Data
3. Surgical Care for Rheumatic Heart Disease Patients: Insights From the Netherlands Heart Registration
4. Surgical Techniques and Outcome Analysis of Non-Intubated Uniportal VATS Sleeve Lobectomy: A Cohort Study

CTSNet Content Mentioned

1. Minimally Invasive Bentall Procedure via Right Axillary Access: A Step-by-Step Technique
2. Repair of Anomalous Left Coronary Artery From the Pulmonary Artery via Direct Coronary Transfer
3. The Atrium: Multi-Spectrum Robotic Cardiac Surgery

Other Items Mentioned

1. Cardiac Reoperations in Patients With Prior Thoracic Radiation: A Single-Center Analysis of Outcomes and Key Lessons
2. CTSNet Innovation Video Competition
3. Career Center
4. 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.

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

1. ISHLT Consensus Statement on Acute Lung Allograft Dysfunction (ALAD): Definition, Etiology, Diagnostic and Therapeutic Approaches, and Research Priorities
2. Aortic Homografts for Native and Prosthetic Aortic Valve and Root Endocarditis: Results From the EUropean REgistry of Cryopreserved Aortic Homografts EURECAH
3. Outcomes After Lung Re-Transplantation for Restrictive Allograft Syndrome Have Not Improved Over Two Decades
4. Financial Burden of Postoperative Adverse Events Following Lobectomy: Cost Analysis From 10 High-Volume Canadian Hospitals

CTSNet Content Mentioned

1. Surgical Repair of an Anomalous Left Coronary Artery From the Right Pulmonary Artery
2. Minimally Invasive Pulmonary Valve Replacement in Reoperative Settings
3. Surgical Management of Giant Pulmonary Artery Aneurysm Using a T-Shaped Graft-Valve Strategy

Other Items Mentioned

1. CTSNet Innovation Video Competition
2. Career Center
3. 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.

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

1. 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.

Chapters 

00:00 Intro 

02:21 JANS 1, Ethical Leadership in CTS  

07:36 JANS 2, Dual Antiplatelet RCT  

10:27 JANS 3, Robotic MV Program  

12:00 JANS 4, Time of Day Outcomes  

15:34 Video 1, MI AV Replacement via RAM  

17:04 Video 2, LA & Pulm Cuff Dissection  

18:34 Video 3, LVOTE Master Class  

21:09 Dr. Coselli Discussion  

29:35 Upcoming Events  

29:59 CTSNet Profiles Update 

They discussed the increasing use of endovascular techniques and the declining prevalence of open surgery. Additionally, they emphasized the necessity of maintaining open surgery skills for certain cases and provided specific examples where these skills are essential. The conversation also covered the best spinal protection treatment, preconditioning the spinal cord, and hybrid approaches that combine open and endovascular techniques. Furthermore, they highlighted the importance of surgeons being involved in patient follow-up. Dr. Coselli also shared insights on future approaches and recommendations for individuals considering which subspecialty to pursue in cardiothoracic surgery.

Joel also highlights recent JANS articles on ethical leadership in cardiothoracic surgery in an era of consolidation, efficacy of dual antiplatelet therapy for three months vs 12 months after coronary artery bypass grafting, outcomes following the first 100 cases of a new robotic mitral valve program, and time of day of cardiac surgery and postoperative outcomes in the UK.

In addition, Joel explores minimally invasive aortic valve replacement via right anterior minithoracotomy, left atrial and pulmonary cuff dissection after heart and lung en-bloc procurement, and a master class with Drs. Sameh Said and Vince Gaudiani on the Konno procedure and left ventricular outflow tract enlargement.

Before closing, Joel highlights upcoming events in CT surgery.

JANS Items Mentioned

1. Ethical Leadership in Cardiothoracic Surgery in an Era of Consolidation: A Framework for Trust, Transparency, and Workforce Stability
2. Efficacy of Dual Antiplatelet Therapy for Three Months Versus 12 months After Coronary Artery Bypass Grafting: Multicentre, Double Blinded, Randomised Controlled Trial
3. Outcomes Following the First 100 Cases of a New Robotic Mitral Valve Program
4. Time of Day of Cardiac Surgery and Postoperative Outcomes in the UK: A Secondary Analysis of Linked National Datasets

CTSNet Content Mentioned

1. Minimally Invasive Aortic Valve Replacement via Right Anterior Minithoracotomy
2. Left Atrial and Pulmonary Cuff Dissection After Heart and Lung En-Bloc Procurement
3. Master Class: The Konno Procedure and LVOT Enlargement With Sameh Said and Vince Gaudiani

Other Items Mentioned

1. Career Center
2. 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.

Chapters 

00:00 Intro 

01:17 Vasoplegia/Vasodilatory Shock 

06:13 Vasopressors, Cost Considerations 

07:32 Vasoplegia Misconceptions 

08:41 Defining Vasoplegia 

10:54 Blood Pressure Target Variable 

12:54 Inotropes 

17:03 Approach to Atrial Fibrillation 

19:08 Patient Monitoring 

19:27 Surgical/Concomitant Ablation 

23:13 Postop AFib, Preventive Strategies 

28:37 Example Scenario, High Heart Rate 

29:56 Out of AFib Into Sinus Rhythm 

33:01 Anticoagulation 

39:43 Key Points 

Key topics include vasoplegia, vasodilatory shock, and the use of vassopressors, including norepinephrine. They address common misconceptions surrounding vasoplegia shock, the role of epinephrine, and the use of methylene blue. Their conversation further delves into approaches for atrial fibrillation, concomitant surgical ablation, and postoperative atrial fibrillation. They highlight the best preventative strategies for atrial fibrillation and the use of beta blockers for atrial fibrillation. Finally, they discuss current guidelines and the role of anticoagulation in patients with atrial fibrillation.

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.

Chapters 

00:00 Intro 

01:45 ESTS 2026 

02:01 Presidential Address 

02:52 Keynote, Emerging Surgical Technologies 

05:21 Segmentectomy vs Lobectomy 

10:18 Other Key Presentations 

11:34 JANS 1, Propensity Score Analysis 

12:30 JANS 2, FILONEX Hemodiafiltration 

13:21 JANS 3, Transplant Surgery at Night 

14:29 Video 1, Aortic Dissection Presentations 

15:36 Video 2, Endoscopic AV & AA Replacement 

16:45 Video 3, Tetralogy Repair in an Infant 

18:12 Dr. Stamp, Health Media & Policy 

33:46 Career Center 

34:03 Closing 

They begin by discussing Dr. Stamp’s professional background, including her experiences working with the media and the lessons she learned from it. They also explore the positive effects of social media for surgeons, such as networking and learning from peers. Additionally, they identify areas for improvement in aortic surgery and transplants. Dr. Stamp then shares her vision for the future of cardiothoracic surgery, emphasizing the need to reduce fragmentation of care and encourage professionals to focus their efforts on their specific specialties.  

Joel also highlights recent JANS articles on a propensity score matching analysis on the risk of sternal wound infection in bilateral skeletonized internal thoracic artery in coronary artery bypass grafting, a prospective, randomized controlled pilot safety study evaluating the addition of hemodiafiltration to EVLP in marginal donor lungs, mechanical load inhibits cancer growth in mouse and human hearts, and outcomes of lung transplantation surgery performed at night 

In addition, Joel explores totally endoscopic aortic valve and ascending aorta replacement, tetralogy repair in an infant, and a presentation from the 2026 Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting on aortic dissection. 

Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. Risk of Sternal Wound Infection in Bilateral Skeletonized Internal Thoracic Artery in Coronary Artery Bypass Grafting: A Propensity Score Matching Analysis
2. FILONEX—A Prospective, Randomized Controlled Pilot Safety Study Evaluating the Addition of Hemodiafiltration to EVLP in Marginal Donor Lungs
3. Mechanical Load Inhibits Cancer Growth in Mouse and Human Hearts
4. Outcomes of Lung Transplantation Surgery Performed at Night

CTSNet Content Mentioned 

1. SCTS 2026 | Aortic Dissection  
2. Totally Endoscopic Aortic Valve and Ascending Aorta Replacement  
3. Tetralogy Repair in an Infant  

Other Items Mentioned 

1. Career Center 
2. 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.

Chapters 

00:00 Intro 

01:19 Min Inv Approach vs Protocol 

03:06 Potential Emergencies, Bleeding 

06:44 Adjusting Bleeding Parameters 

09:56 Limb Ischemia 

11:10 Cardiac Arrest 

13:35 Pacing vs Sternotomy 

15:07 Arrythmias, Defibrillation 

15:51 Tamponade 

16:49 Tension Pneumothorax 

17:05 Stroke 

17:50 Myocardial Infarction 

18:27 Bleeding in Pleural Space 

19:24 Nurse Response to Bleeding 

21:53 Case of Persistent Bleeding 

22:48 Chest X-Ray Check 

24:22 LV Dysfunction in Post-Op Period 

The discussion covers critical topics such as the cardiac surgical resuscitation algorithm, managing port-side and groin bleeding, and Dr. Guys’ protocols for these situations. They emphasize the importance of monitoring for bleeding in unexpected areas, such as the abdomen, checking pulses, and the significance of practicing with surgical saws before emergencies arise. Additional topics include tamponade, stroke management, the importance of pacing, chest wall bleeding, and protocols for addressing left ventricular dysfunction in the postoperative period.  

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.

Chapters

00:00 Intro 02:37 JANS 1, WhatsApp for Patients 08:27 JANS 2, DCD Heart Transplant 11:07 JANS 3, TIGHT K Trial 13:18 JANS 4, RecoverHeart Calculator 15:57 Video 1, Self Constructed Valve 18:52 Video 2, MVR Sandwich Technique 20:43 Video 3, Distal Coronary Anastomosis Podcast 23:04 Dr. Yang, Annular Enlargement 36:31 Upcoming Events 37:26 Closing

They explored Dr. Yang’s participation in a debate regarding the use of aortic root enlargement for the majority of patients, addressing the opposing views against root enlargement and discussing the percentage of patients who undergo this procedure. The conversation also covered important topics such as the mean gradient dropping and the lifelong management of aortic valve disease. They emphasize the importance of maximizing the initial valve size for optimal outcomes. Additionally, Dr. Yang shared insights on his Y-incision technique, highlighting its advantages and effectiveness. They also examined whether this technique increases the length of the surgical procedure.  

Joel also highlights recent JANS articles on exploring the use of instant messaging groups in the postoperative period for pectus excavatum patients, a multicenter retrospective study comparing DCD heart transplantation in Europe and the United States, six-month outcomes of a trial of potassium supplementation thresholds after cardiac surgery, and determining the individualized probability of myocardial recovery. 

In addition, Joel explores self-constructed tubular heart valve using bovine pericardium for surgical treatment of tricuspid valve endocarditis, mitral valve repair using the sandwich technique for symmetrical bileaflet prolapse, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Elan Burton about distal coronary anastomosis.    Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. Exploring the Use of Instant Messaging Groups in the Postoperative Period for Pectus Excavatum Patients
2. A Comparison of DCD Heart Transplantation in Europe and the United States: A Multi-Centre, Retrospective Study
3. Six-Month Outcomes of a Trial of Potassium Supplementation Thresholds After Cardiac Surgery
4. Determining the Individualized Probability of Myocardial Recovery: The Multicenter RecoverHeart Calculator 

CTSNet Content Mentioned 

1. Self-Constructed Tubular Heart Valve Using Bovine Pericardium for Surgical Treatment of Tricuspid Valve Endocarditis 
2. Mitral Valve Repair Using the Sandwich Technique for Symmetrical Bileaflet Prolapse  
3. The Atrium: Distal Coronary Anastomosis 

Other Items Mentioned 

1. Career Center 
2. 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.

They were joined by Drs. Mateo Marin-Cuartas, associate editor of JACC: Case Reports, CTSNet JANS Editor, and cardiac surgeon at Leipzig Heart Center, Germany, and Tsuyoshi Kaneko, Chair of American College of Cardiology (ACC) Cardiac Surgery Member Section and Chief of Cardiac Surgery at Washington University in St. Louis, MO, USA, to discuss JACC: Case Reports.

Chapters

00:00 Intro 01:45 Instructional Video Competition 05:30 JANS 1, Lung Cancer Metastasis 09:08 JANS 2, Uncorrected Pectus 11:29 JANS 3, Ambulatory VV Life Support 13:38 JANS 4, EuroSCORE II 14:28 Video 1, TAVR Removal Double Patch 16:09 Video 2, ROK Procedure AF 17:46 Video 3, RATS Lobectomy 19:11 JACC Case Reports 35:28 Upcoming Events 36:03 Career Center

They discussed the mission of the journal and the types of submissions it receives. They also covered the types of cases accepted and the various categories within the journal has, such as the "How We Did It" section. Additionally, they talked about the upcoming partnership between JACC: Case Reports and the ACC, as well as past collaborations that JACC has undertaken. Dr. Marin-Cuartas shared insights about his role as an associate editor and highlighted the most interesting case he has encountered in JACC: Case Reports. Furthermore, Dr. Kaneko discussed being the Chair of the ACC Cardiac Surgery Member Section.

Joel also highlights recent JANS articles on the evolutionary characterization of lung cancer metastasis, the impact of severe uncorrected pectus excavatum on outcomes after aortic surgery in Marfan syndrome, determining an optimal central cannulation strategy for ambulatory veno-venous extracorporeal life support, and refitting EuroSCORE II for 120-day mortality after coronary artery bypass grafting using nationwide registry data. In addition, Joel explores complex imaging TAVR removal double patch double valve, RATS extended left upper lobectomy with intrapericardial vascular control and bronchoplasty, and ROK procedure for the treatment of atrial fibrillation. Before closing, Joel highlights upcoming events in CT surgery.  

JANS Items Mentioned

1. Evolutionary Characterization of Lung Cancer Metastasis
2. Impact of Severe Uncorrected Pectus Excavatum on Outcomes After Aortic Surgery in Marfan Syndrome
3. Determining an Optimal Central Cannulation Strategy for Ambulatory Veno-Venous Extracorporeal Life Support
4. Refitting EuroSCORE II for 120-Day Mortality After Coronary Artery Bypass Grafting Using Nationwide Registry Data

CTSNet Content Mentioned

1. Complex Imaging TAVR Removal Double Patch Double Valve
2. RATS Extended Left Upper Lobectomy With Intrapericardial Vascular Control and Bronchoplasty
3. ROK Procedure for the Treatment of Atrial Fibrillation

Other Items Mentioned

1. JACC: Case Reports
2. 2026 Instructional Video Competition Winners
3. Career Center
4. 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.

Chapters 

00:00 Intro 

01:08 Why CT Surgery? 

03:01 Overview & History 

05:02 Geometric Planning & Hemodynamics 

10:40 Sequential & Composite Configurations 

16:23 Y or T Grafts 

21:21 Step-by-Step, Suturing 

30:37 Endarterectomy 

36:37 Intraop Quality Assurance 

40:29 Failed Mechanisms & Pitfalls 

43:18 Future Trends 

45:54 Summary 

47:03 Surgery Training Advice 

They discuss the history of distal coronary anastomosis, geometric planning, and hemodynamics, as well as sequential grafting and composite configurations, including Y and T grafts. The conversation also covers arteriotomy, suturing techniques, and the continuous parachute method. Additionally, they delve into the traction technique, open direct vision, and intraoperative quality assurance, including pulsatility index. Furthermore, they examine failure mechanisms such as graft kinking and explore future trends.

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.

Chapters

00:00 Intro

02:21 JANS 1, NOBLE Trial

07:14 JANS 2, Ischemic Mitral Regurg MVR

08:58 JANS 3, Pregnancy Outcomes AVR

11:19 JANS 4, MCS LVAD Candidates

13:06 Video 1, Thoracoplasty

14:58 Video 2, Nuss Procedure After Ravitch

16:42 Video 3, Traumatic Right Main Bronchus

19:04 REPEAT Trial, Bioprostheses

32:22 Upcoming Events

32:46 Closing

They discussed the trial’s objectives, including what it is, why it is needed, and its overall goals. The setup of the trial was also examined, covering aspects such as funding, composite outcome, and follow-up procedures. Additionally, they addressed the target number of patients required for recruitment and the efforts involved in recruiting patients and centers to participate in the trial. They emphasized the overall significance of the trial, outlining what is necessary for its success and highlighting the importance of collaboration among heart teams.

Joel also highlights recent JANS articles on percutaneous coronary intervention vs coronary artery bypass grafting for unprotected left main stenosis, a two-decade experience on the outcomes of mitral valve repair in ischemic mitral regurgitation, maternal, valvular and fetal outcomes of pregnancy following aortic valve replacement, and temporary mechanical circulatory support in left ventricular assist device candidates with right ventricular dysfunction.

In addition, Joel explores if forgotten techniques of thoracoplasty with latissimus dorsi myoplasty are relevant today, the Nuss procedure after previous Ravitch operation, and uniportal VATS repair of traumatic right main bronchus transection following blunt chest injury.

Before closing, Joel highlights upcoming events in CT surgery.  

JANS Items Mentioned

1. Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Unprotected Left Main Stenosis: 10-Year Final Results From the Randomised, Open-Label, Non-Inferiority NOBLE Trial
2. Outcomes of Mitral Valve Repair in Ischemic Mitral Regurgitation: A Two-Decade Experience
3. Maternal, Valvular and Foetal Outcomes of Pregnancy Following Aortic Valve Replacement 
4. Temporary Mechanical Circulatory Support in Left Ventricular Assist Device Candidates With Right Ventricular Dysfunction: Acuity Without Long-Term Futility

CTSNet Content Mentioned

1. Are the Forgotten Techniques of Thoracoplasty With Latissimus Dorsi Myoplasty Relevant Today? 
2. Nuss Procedure After Previous Ravitch Operation 
3. Uniportal VATS Repair of Traumatic Right Main Bronchus Transection Following Blunt Chest Injury 

Other Items Mentioned

1. The REPEAT Trial
2. Career Center
3. 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.

Chapters 

00:00 Intro 

02:35 Case 1, Diffuse Coagulopathy 

03:26 Bleeding Scale 

08:13 Team-Wide Bleeding Language 

11:07 Alternative Approaches 

14:09 Standardizing Test Results Response 

18:04 No Access to Visoelastic Testing 

19:55 Topical Hemostatic Agents 

23:08 Case 2 

24:14 Coagulopathy vs Surgical Bleeding 

28:08 Passive Hemostatic Agent 

29:10 Visoelastic Testing 

31:29 Closing Points

They discussed two different cases, including patient details and case specifics: one involving diffused coagulopathy and the other concerning focal bleeding. While examining these cases, they talked about hemostasis and the hemostasis checklist. They also discussed the validated intraoperative bleeding (VIBe) scale and its purposes, and the importance of being on the same page as your team. Additionally, they delved into viscoelastic testing and algorithms and addressed scenarios where access to viscoelastic testing may not be available. They also explored the thresholds for guided therapy, including functional fibrinogen levels. Lastly, the experts touched on passive hemostatic and how to teach residents coagulopathy and surgical bleeding.

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.

Chapters

00:00 Intro

02:26 New CTSNet Website

03:31 JANS 1, Thromboendarterectomy Fellowship

05:28 JANS 2, Sodium-Glucose Cotransporter 2 Inhibitor

07:36 JANS 3, Type A Acute Aortic Dissections

09:51 JANS 4, Asymptomatic Aortic Stenosis at 10 Years

11:46 Video 1, Nuss Procedure w Chrondrotomies

13:08 Video 2, Cardiac Redo Surgery

14:52 Video 3, Uniportal Lobectomy Bronchial Reimplantation

16:13 Dr. Leshnower, Ascending Stent Grafts

32:51 Career Center

33:52 Closing

They discussed Dr. Leshnower’s experience with this groundbreaking implantation, including the case details such as the patient’s medical history, the assessment of the patient’s high-risk status, and the criteria for determining their suitability for the procedure. Imaging techniques and the contributions of the other surgeons involved in the case were also highlighted. Furthermore, they delved into the use of the stent in previous ARISE trials and what Dr. Leshnower learned from those early experiences. The conversation also covered topics such as proximal placement, the innominate artery, and the preoperative planning required for the trial. Dr. Leshnower also shared what he learned from this case and discussed the future of the stent graft and this technique.

Joel also highlights recent JANS articles on the safety and efficacy of a dedicated pulmonary thromboendarterectomy fellowship, sodium-glucose cotransporter 2 inhibitor use and outcomes after surgical aortic valve replacement, association between surgical timing and postoperative outcomes in type A acute aortic dissection, and early surgery or conservative care for asymptomatic aortic stenosis at 10 years.

In addition, Joel explores the Nuss procedure with midline chrondrotomies in severe pectus excavatum, redo surgery for failed MVr, iatrogenic ASD, tricuspid valve regurgitation, and aorta replacement, and uniportal VATS left lower sleeve lobectomy with upper lobe bronchial reimplantation for typical carcinoid tumor.

Before closing, Joel highlights upcoming events in CT surgery.  

JANS Items Mentioned

1. Safety and Efficacy of a Dedicated Pulmonary Thromboendarterectomy Fellowship: The UK Experience at a High-Volume Center
2. Sodium-Glucose Cotransporter 2 Inhibitor Use and Outcomes After Surgical Aortic Valve Replacement
3. Association Between Surgical Timing and Postoperative Outcomes in TypeAAcute Aortic Dissection
4. Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis at 10 Years 

CTSNet Content Mentioned

1. The Nuss Procedure With Midline Chrondrotomies in Severe Pectus Excavatum 
2. Redo Surgery for Failed MVr, Iatrogenic ASD, Tricuspid Valve Regurgitation, and Aorta Replacement 
3. Uniportal VATS Left Lower Sleeve Lobectomy With Upper Lobe Bronchial Reimplantation for Typical Carcinoid Tumor 

Other Items Mentioned

1. ARISE III Trial of Gore Ascending Stent Graft Begins Enrollment
2. How to Navigate the New CTSNet Website
3. Career Center
4. 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.

Chapters 

00:00 Intro 

01:26 Case Study 

04:28 Fluid Responsiveness, Dynamic Parameters 

07:37 Variability Within Normal Limits 

09:34 Determining Responsiveness Efficiently 

12:45 No PA-Catheter Patients 

15:35 Reassessing Values 

17:22 First Step 

19:20 No-Fluid Patient 

20:27 Stroke Volume Trends 

21:13 Key Takeaways 

The discussion includes a case study illustrating how functional hemodynamics can guide clinical decisions in this context. They delve into the concepts of fluid management and fluid responsiveness, comparing dynamic parameters and static parameters, and the importance of increasing stroke volume. Key topics also include pulse pressure variation, stroke volume variation, variability, and delta stroke volume. The conversation further covers techniques such as the passive leg raise maneuver and the pulmonary occlusive maneuver.

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.

Chapters

00:00 Intro 

01:43 New CTSNet Website 

02:36 AATS 2026 

09:15 EJCTS News 

10:15 Video 1, Left Ventriculotomy 

10:51 Video 2, 3-Vessel TECAB 

12:24 Video 3, AV Disease in Young Patients 

13:14 Andrea Steely, Aortic Surgery & Follow-Up 

29:14 Upcoming Events 

They discussed the critical importance of educating both patients and surgeons about aortic disease, and the most effective strategies for follow-up care after aortic surgery. The conversation also covered testing genetic factors and stabilizing the aortic arch. They also explored reintervention and the importance of a multidisciplinary follow-up approach. Additionally, they addressed topics such as lung cancer screening, the training of non-MDs to evaluate screening charts, and the development of an aortic pathology sheet for each patient.  

In addition, Joel explores an underutilized approach for closing multiple apical ventricular septal defects, robotic-assisted three-vessel minimally invasive coronary artery bypass, and a presentation from Emile Bacha on the "Surgical Management of Aortic Valve Disease in Young Patients." 

Before closing, Joel highlights upcoming events in CT surgery.   

CTSNet Content Mentioned 

1. Left Ventriculotomy: An Underutilized Approach for Closing Multiple Apical Ventricular Septal Defects 

2. Robotic-Assisted Three-Vessel Minimally Invasive Coronary Artery Bypass 

3. SCTS 2026 | Surgical Management of Aortic Valve Disease in Young Patients 

Other Items Mentioned 

1. How to Navigate the New CTSNet Website 

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.

Chapters

00:00 Intro

02:22 AATS, UAE Conference, King Faisal

05:28 JANS 1, LAA Closure vs Therapy AF

09:53 JANS 2, Thrombus-Free LAA Occlusion

11:49 JANS 3, Immunosuppression & Retransplantation

13:06 JANS 4, Biomarkers & Outcomes Isolated CABG

15:18 Video 1, Rheumatic MV Reconstruction

17:02 Video 2, Morgagni Hernia

18:07 Video 3, Robotic Excision Anterior Mediastinal

19:35 Lin Zhi & Oscar Flores, Chinese Fellowship & Surgery

34:25 Upcoming Events

35:13 Closing

Dr. Flores discusses what the program entails, sharing his experience as a fellow and the opportunities he gained from it. Dr. Lin then outlines the program’s goals and the various procedures that can be learned at Xiamen Cardiovascular Hospital of Xiamen University, which hosts the program. They also cover how to join the program and the application process. Furthermore, they discuss minimally invasive procedures in China and how this approach is growing in popularity.

Joel also highlights recent JANS articles on left atrial appendage closure or medical therapy in atrial fibrillation, long-term thrombus-free left atrial appendage occlusion via magnetofluids, implications of immunosuppression and retransplantation for donor-derived cell-free DNA associated with increased risk of chronic lung allograft dysfunction and mortality, and immunosenescence biomarkers and outcomes in isolated coronary artery bypass grafting. 

In addition, Joel explores rheumatic mitral valve reconstruction, tips for the surgical management of a Morgagni hernia, and right robotic excision of anterior mediastinal mass. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation 

2. Long-Term Thrombus-Free Left Atrial Appendage Occlusion Via Magnetofluids 

3. Donor-Derived Cell-Free DNA Associated With Increased Risk of Chronic Lung Allograft Dysfunction and Mortality: Implications of Immunosuppression and Retransplantation 

4. Immunosenescence Biomarkers and Outcomes in Isolated Coronary Artery Bypass Grafting 

CTSNet Content Mentioned 

1. Rheumatic Mitral Valve Reconstruction 

2. Tips for the Surgical Management of a Morgagni Hernia 

3. Right Robotic Excision of Anterior Mediastinal Mass 

Other Items Mentioned 

1. Endoscopic Cone Repair in an Adult Patient With Ebstein Anomaly   

2. CTSNet Website Redesign: Important Updates and Transition Details  

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.

Chapters

00:00 Intro

01:51 New Website Preparation

02:53 AATS 2026 Overview

11:59 Video 1, Robotic Right-Sided MIDCAB

13:08 Video 2, Extra-Anatomic IAA Repair

14:29 Video 3, Double-Decker Procedure

16:38 Video 4, Aortic Disease Awareness

19:53 Video 5, Robotic Culmen in Situs Inversus

21:30 Frank Tamru, Aortic Valve Technology

35:32 Upcoming Events

36:03 Closing

They explored Tamru’s professional background and involvement with heart surgeons and cardiovascular leaders. The conversation covered various topics, including heart valves and the evolution of open-heart centers. They also discussed the advancements in aortic valve replacement technologies and the critical role of surgeons as decision-makers in the field. Additionally, Frank shared his experience as the founding publisher of the Asian Cardiovascular and Thoracic Annals. 

In addition, Joel explores a robotic-assisted right-sided minimally invasive coronary artery bypass for anomalous origin of the right coronary artery, a transdiaphragmatic aorto-supraceliac extra-anatomic bypass for interrupted aortic arch with collateralizations, double-decker procedure for partial anomalous pulmonary venous connection, robotic-assisted right upper segmentectomy (culmen) in situs inversus totalis, and an interview with Gareth Owens and Dr. Ben Youdelman on Think Aorta and aortic disease awareness. 

Before closing, Joel highlights upcoming events in CT surgery.   

CTSNet Content Mentioned 

1. Robotic-Assisted Right-Sided Minimally Invasive Coronary Artery Bypass for Anomalous Origin of the Right Coronary Artery  

2. A Transdiaphragmatic Aorto-Supraceliac Extra-Anatomic Bypass for Interrupted Aortic Arch With Collateralizations  

3. Double-Decker Procedure for Partial Anomalous Pulmonary Venous Connection  

4. Think Aorta and Aortic Disease Awareness: An Interview With Gareth Owens and Dr. Ben Youdelman  

5. Robotic-Assisted Right Upper Segmentectomy (Culmen) in Situs Inversus Totalis  

Other Items Mentioned 

1. Power: A Memoir 

2. Website Maintenance Alert! 

3. The Lifeline 

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.

Chapters

00:00 Intro 01:42 Upcoming CTSNet Activities 03:01 Website Transition 03:54 JANS 1, Mech vs Bio AVR in 50–70 YO 08:16 JANS 2, Abnormal Bleeding in OR 10:26 JANS 3, Intraop Assessment RV Function 11:54 JANS 4, Laser Anastomosis System CABG 14:49 Video 1, RAMT AVR Hemiarch Replacement 16:23 Video 2, Big Cyst & Small Incisions 17:33 Video 3, Left VATS Pneumonectomy 19:55 Dr. Khalpey, AI in CT Surgery 30:28 Upcoming Events 31:48 Closing

They discuss the importance of ethical AI being and address risk scores. The conversation also covers the application of AI in preoperative, intraoperative, and postoperative settings, as well as predictive algorithms and the benefits of integrating AI within cardiothoracic surgery. Additionally, they emphasize that there will always be a need for surgeons, as AI cannot replace human expertise.  

Joel also highlights recent JANS articles on a systematic review and meta-analysis on mechanical vs biological aortic valve replacement in patients aged 50-70 years, an observational study of inter-rater reliability between anesthetists and surgeons on abnormal bleeding in the cardiac operating room, advancing intraoperative assessment of right ventricular function, and the excimer laser assisted non-occlusive anastomosis (ELANA) anastomotic system surgical technique to construct distal anastomoses using a novel device in coronary artery bypass grafting. 

In addition, Joel explores a right anterior minithoractomy aortic valve replacement, ascending aorta, and hemiarch repair, thoracoscopic resection of a large mediastinal cyst, and left VATS pneumonectomy in pediatric pulmonary mucoepidermoid carcinoma. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1. Mechanical Versus Biological Aortic Valve Replacement in Patients Aged 50-70 Years: A Systematic Review and Meta-Analysis 

2. Abnormal Bleeding in the Cardiac Operating Room: An Observational Study of Inter-Rater Reliability Between Anesthetists and Surgeons 

3. Echocardiographic Correlates of Pressure-Volume-Derived Indices: Advancing Intraoperative Assessment of Right Ventricular Function 

4. The Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) Anastomotic System Surgical Technique to Construct Distal Anastomoses Using a Novel Device in Coronary Artery Bypass Grafting 

CTSNet Content Mentioned 

1. Right Anterior Minithoractomy Aortic Valve Replacement, Ascending Aorta, and Hemiarch Repair  

2. When Size Is Not a Limitation: Thoracoscopic Resection of a Large Mediastinal Cyst  

3. Left VATS Pneumonectomy in Pediatric Pulmonary Mucoepidermoid Carcinoma  

Other Items Mentioned 

1. Website Blackout Notice! 

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.

Chapters

00:00 Intro 

01:04 Patient Philosophy 

02:45 Early Sedation-Delirium Relationship 

05:23 RASS Scale, Sedation 

07:06 Cardiac ICU Patients 

08:35 Lack of Delirium Tracking or Data 

10:56 ROI from Good Care & Data 

14:44 Preventative Approach 

16:16 Convincing Hesitant Adopters 

18:59 Patient Case Study 

21:19 Cultural Paradigm 

24:48 Mobilization 

27:07 Verticalization Beds 

30:03 Gravity on Patient Health 

32:14 Mobility Screening 

33:14 Defining Walking 

34:47 Mobility Responsibility 

36:55 Standardization & Predictability 

38:23 Key Points 

They discussed what an awake and walking intensive care unit (ICU) is, how early mobility and sedation tie in with delirium, and the history of critical care medicine. The conversation also covered the Richmond Agitation-Sedation Scale (RASS) and deep sedation, as well as risk factors for delirium, outdated sedation practices and mobility management, and the importance of having a high reliability environment. Additionally, they explored the ABCDEF bundle and a case study of a patient experiencing delirium. The episode further addressed verticalization beds, walking pads for verticalization, nurse screening tools, and ambulation. 

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.

Chapters 

00:00 Intro 

01:08 Guidelines Background 

02:02 Resuscitation, Monitoring Parameters 

07:37 Approach to Patients in Extremis 

11:39 Quality Assurance, Internal Data 

12:22 End-Tidal 

13:17 Bleeding Management 

15:33 Arrhythmia, Defibrillation 

17:21 Optimizing Tissue Perfusion 

18:09 Key Points 

20:26 Devices & Flow Patterns 

They began by exploring how this paper was developed and how Arora became involved in this project. They discussed the importance of expediting the resuscitation process and examined the recommendations for a tMCS implantation in patients experiencing post-procedural low cardiac output syndrome (LCOS). Key considerations included oxygen saturation levels (SpO2) and point-of-care ultrasound (POCUS), as well as the significance of pulsatility. Additionally, they discussed the interaction between devices and patients and the importance of team training and simulation. They also addressed crucial topics such as coagulation, anticoagulation, and defibrillation. Finally, they examined optimizing tissue perfusion for better patient outcomes.  

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! 

Related Resources 

1. EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery 

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.

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.

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.

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.

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.

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.

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.

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.

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.

Chapters

00:00 Intro

02:04 JANS 1, Adverse Effects Statin Therapy

06:21 JANS 2, Mortality & Reintervention, Robotic MR

09:15 JANS 3, Balloon vs Self Expanding Transcath Valves

11:41 JANS 4, Transcath Aortic Valve in MV Replacement

13:54 Career Center

14:33 Video 1, Endo Cone Repair w Ebstein Anomaly

16:26 Video 2, Retrograde Cardioplegia Cath Placement

17:19 Video 3, Standardized Strategy, Rheumatic MV Disease

20:31 Dr. Ad, Innovations Journal

31:05 Upcoming Events

31:38 New Podcast, The Lifeline

32:15 Closing

They discussed the main topics and procedures covered by Innovations, highlighting its double-blind peer-review process and the special feature section. Additionally, they provided tips for those interested in submitting to the journal.  

Joel also highlights recent JANS articles on a meta-analysis of double-blind randomized controlled trials for the assessment of adverse effects attributed to statin therapy in product labels, mortality and reintervention after robotic mitral repair in the United States, the three-year results of the LYTEN trial on balloon- vs self-expanding transcatheter valves for failed small surgical aortic, and the first-in-human study on transcatheter aortic valve-in-mechanical valve replacement. 

In addition, Joel explores an endoscopic cone repair in an adult patient with Ebstein anomaly, an alternative cannulation site for the placement of a retrograde cardioplegia catheter, and a standardized surgical management strategy for rheumatic mitral valve disease. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Assessment of Adverse Effects Attributed to Statin Therapy in Product Labels: A Meta-Analysis of Double-Blind Randomised Controlled Trials 

2.) Mortality and Reintervention After Robotic Mitral Repair in the United States 

3.) Balloon- Versus Self-Expanding Transcatheter Valves for Failed Small Surgical Aortic Bioprostheses: 3-Year Results of the LYTEN Trial 

4.) Transcatheter Aortic Valve-in-Mechanical Valve Replacement: A First-in-Human Study  

CTSNet Content Mentioned 

1.) Endoscopic Cone Repair in an Adult Patient With Ebstein Anomaly  

2.) Placement of a Retrograde Cardioplegia Catheter: An Alternative Cannulation Site 

3.) Standardized Surgical Management Strategy for Rheumatic Mitral Valve Disease 

Other Items Mentioned 

1.) Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 

2.) The Lifeline 

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.

Chapters

00:00 Intro 

01:07 Inspiration & Areas of Interest 

03:23 Definition & Classification 

09:28 History 

10:16 Preop Considerations 

19:07 Operating Team Plan 

22:23 Fitness for Surgery 

23:55 Airway Resections 

31:33 Chest Wall Resections 

36:17 Reconstructive Material 

38:43 Vascular Resections 

43:53 Postoperative Care 

47:59 Future of Extended Resections 

50:15 Summary 

50:48 Surgery Training Tips

They provided an overview of extended resections, including the definition, indications, and examples, as well as the history of extended resections. They also discussed preoperative considerations and examined airway resections, detailing what it is, indications, and the technical principles of the operation. Additionally, they explored chest wall resections, including the definition, indications, and technical principles. Drs. Copperwheat and Kalkat also examined vascular resections, highlighting what they are, indications, and the technical aspects involved. They also reviewed postoperative considerations, complications, and outcomes. Finally, they shared training tips, future directions, and key principles in extended resections.  

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.

Chapters

00:00 Intro

02:35 JANS 1, Therapy & Risk in Idiopathic Pulm Fibrosis

04:18 JANS 2, Sex-Related Treatment Effects

06:03 JANS 3, Endoscopic vs Open RAH in CABG

08:14 JANS 4, Textbook Outcome in MV Surgery

11:16 Career Center

12:08 Video 1, AMDS to FET Conversion

13:13 Video 2, Constrictive Pericarditis & Pericardiectomy

14:42 Video 3, Right Axillary Thoracotomy

16:17 Dr. Khaitan, Thoracic Surgery in the UAE

23:46 Upcoming Events

24:46 Instructional Video Competition

They discussed her professional background and training, as well as the differences in cases between the UAE and United States. They also delved into research in the UAE, the state of thoracic hospitals, general surgical residency programs, and the future of fellowships in the country.  

Joel also highlights recent JANS articles on a large retrospective propensity-weighted cohort study on antifibrotic therapy and lung cancer risk in patients with idiopathic pulmonary fibrosis, sample size considerations to assess sex-related treatment effects, endoscopic or open radial artery harvest in coronary artery bypass surgery, and results from the Netherlands Heart Registration on mitral valve surgery. 

In addition, Joel explores a safe and reproducible redo aortic surgery approach on AMDS to frozen elephant trunk conversion, an approach to constrictive pericarditis and pericardiectomy from diagnosis to definitive surgical, and right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Antifibrotic Therapy and Lung Cancer Risk in Patients With Idiopathic Pulmonary Fibrosis: A Large Retrospective Propensity-Weighted Cohort Study 

2.) Sample Size Considerations to Assess Sex-Related Treatment Effects 

3.) Endoscopic or Open Radial Artery Harvest in Coronary Artery Bypass Surgery 

4.) Textbook Outcome in Mitral Valve Surgery—Results from the Netherlands Heart Registration 

CTSNet Content Mentioned 

1.) AMDS to Frozen Elephant Trunk Conversion: A Safe and Reproducible Redo Aortic Surgery Approach   

2.) From Diagnosis to Definitive Surgical Therapy: An Approach to Constrictive Pericarditis and Pericardiectomy 

3.) Right Axillary Thoracotomy: A Minimally Invasive Gateway to Multiple Defects 

Other Items Mentioned 

1.) Emirates International Thoracic Surgery Congress 

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.

Chapters 

00:00 Intro 

01:14 Transfusion as a Risk Factor 

07:08 Hemoglobin Drugs 

08:24 Pillars of Blood Management 

09:56 Anesthesia 

12:30 Transfusion Triggers 

17:33 O2 Delivery, Hemoglobin Number 

22:20 Non-Transfusion Patients 

23:22 Anemic Level Bottom Number 

25:06 Bleeding Checklist 

29:41 Anemia Tolerance 

They discussed independent risk factors for blood transfusion, the role of hemoglobin as a predictor for blood transfusion, and considerations related to anemic patients and hemoglobin levels. Additionally, they explored the key pillars of blood management, treating preoperative anemia, and anesthesia. They examined transfusion triggers, oxygen delivery, and the care of non-transfusion patients. Finally, they emphasized the importance of a bleeding checklist and anemia tolerance.  

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.

Chapters

00:00 Intro

02:48 UK Thoracic Forum

06:11 JANS 1, Detecting AF Using Watch

07:44 JANS 2, End-to-End Anastomotic Stapler

09:24 JANS 3, Improving Patient Selection NSCLC

12:05 JANS 4, 5-Year Women Outcomes TAVR vs SAVR

13:30 Video 1, MVR Tips & Tricks

14:43 Video 2, Ruptured SVA w Hemi-Yacoub Remodeling

16:32 Video 3, Modified Inclusion, Autograft in a Vest

18:04 Dr. Shennib, Catheters as a Language

48:25 Upcoming Events

48:52 Career Center

They explore the importance of making catheters a language by learning, speaking, and practicing it daily. They also discuss how cardiac surgeons have lost the role of “gatekeepers,” with cardiologists now controlling more of the decision-making process. Dr. Shennib emphasizes the need for surgeons to be involved in decision-making from diagnosis to treatment and highlights the significance of patient-centered decision-making and the human aspect of these choices. They also compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), examining which procedure is more appropriate in different circumstances. Furthermore, they explore the reasons behind the shrinking cardiac specialty and discuss how to save it. Finally, they discuss the future of cardiac surgery.  

Joel also highlights recent JANS articles on a randomized controlled trial on the enhanced detection and prompt diagnosis of atrial fibrillation using an Apple watch, the results of a human cadaver study on a novel aortic end-to-end anastomotic stapler device, improving patient selection for minimally invasive lobectomy or stereotactic ablative radiotherapy based on clinical characteristics, and a systematic review and meta-analysis on the five-year outcomes of transcatheter versus surgical aortic valve replacement in women. 

In addition, Joel explores tips and tricks for mitral valve repair from a Brussels experience, treatment of ruptured sinus valsalva aneurysm with hemi-Yacoub remodeling technique, and a Ross procedure with modified inclusion technique. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch: A Randomized Controlled Trial 

2.) A Novel Aortic End-to-End Anastomotic Stapler Device—Results of a Human Cadaver Study 

3.) Stage I Non-Small Cell Lung Cancer: Improving Patient Selection for Minimally Invasive Lobectomy or Stereotactic Ablative Radiotherapy Based on Clinical Characteristics 

4.) Five-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Women: A Systematic Review and Meta-Analysis  

CTSNet Content Mentioned 

1.) Mitral Valve Repair—Tips and Tricks From Brussels Experience: 2025 London Core Review Cardiothoracic Surgery Course  

2.) Treatment of Ruptured Sinus Valsalva Aneurysm With Hemi-Yacoub Remodeling Technique  

3.) Ross Procedure With Modified Inclusion Technique: An Autograft in a Vest 

Other Items Mentioned 

1.) Instructional Video Competition  

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.

Chapters

00:00 Intro

02:24 JANS 1, VECTOR Procedure

07:38 JANS 2, Combined Inflation & Cooling

08:26 JANS 3, Caring for VIP Patients

11:43 JANS 4, Country Wealth & Min Inv Correlation

12:57 Career Center

13:37 Video 1, Debranching AAV Step-by-Step

15:14 Video 2, Abramson Technique

16:59 Video 3, Min Inv Cardiac w Dr. Chitwood

18:54 Dr. Kenny, DCD-HOPE Congenital Transplant

31:58 CKD & CSA-AKI Podcast Episode

34:12 Upcoming Events

35:13 Closing

They discussed the complexities surrounding congenital heart transplants, donation after brain death (DBD), and donation after circulatory death (DCD). They also explored the benefits of hypothermic oxygenated perfusion (HOPE) for children, particularly in DCD pediatrics patients, and highlighted the first case where this model was used. Additionally, they examined the future of HOPE and its potential for more complex procedures. Moreover, they discussed implanting ventricular assist devices (VAD) in children, along with what other countries are doing regarding congenital heart transplants, including ongoing studies in this field.   

Joel also highlights recent JANS articles on the first human VECTOR procedure for percutaneous aorto-coronary bypass graft to prevent coronary obstruction following TAVR, combined inflation and cooling method improves lung function in uncontrolled donation after circulatory death, caring for VIP patients in cardiothoracic surgery, and the national wealth and the global spread of minimally invasive thoracic surgery. 

In addition, Joel explores a step-by-step guide for debranching of aortic arch vessels through a cervical approach for aortic arch aneurysm, a master class with Horacio Abramson on the Abramson technique, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Randolph Chitwood about the future of minimally invasive cardiac surgery. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure 

2.) Combined Inflation and Cooling Method Improves Lung Function in Uncontrolled Donation After Circulatory Death 

3.) Caring for VIP Patients in Cardiothoracic Surgery: Navigating Bias, Pressure, and Protocol 

4.) National Wealth and the Global Spread of Minimally Invasive Thoracic Surgery: Insights From the European Society of Thoracic Surgeons Database 

CTSNet Content Mentioned 

1.) Debranching of Aortic Arch Vessels Through a Cervical Approach for Aortic Arch Aneurysm: A Step-by-Step Guide 

2.) Master Class: The Abramson Technique With Horacio Abramson and Joel Dunning 

3.) The Atrium: The Future of Minimally Invasive Cardiac Surgery 

Other Items Mentioned 

1.) HOPE for Children: Successful Pediatric DCD Heart Transplantation Using Hypothermic Oxygenated Perfusion 

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.

Chapters

00:00 Intro

02:11 Definition & Background

10:55 Burden of CSA-AKI

12:58 Unmet Medical Need

19:47 Identification & Collaboration

26:07 KDIGO, O2 Delivery

32:15 CKD CSA-AKI Final Remarks

35:10 JANS, Success in African CT Surgery

38:49 Video, Modified Root Inclusion Technique

40:53 Closing

They delve into the complexities of CSA-AKI, exploring the percentage of patients affected, defining the condition, and highlighting the overall significance of this issue. They also address creatinine as a late marker for AKI, the long-term scarring that can occur from AKI, and the critical need for thorough preoperative assessments to identify high-risk patients. Additionally, they emphasize the importance of a complete health assessment before surgery. Furthermore, they discuss the dangers of reaching stage 3 AKI, the increased costs of care once that point is reached, and what actions to take if a patient has a positive marker but appears stable. They also highlight the premature use of diuretics contributing to AKI and hyperbilirubinemia. Moreover, they consider how CKD along elevates mortality risk and the importance of developing targeted therapies in the future. Finally, they discuss approaches to reduce ischemia-reperfusion (IR) AKI and the optimization of hemodynamics, as well as potential drugs for treating AKI effectively.  

Joel also highlights a recent JANS article on aligning training, patient profiles, and outcomes to redefine success in cardiac surgery in Africa. In addition, he explores the modified root inclusion technique for a fourth sternotomy with Ross/Konno after previous mechanical aortic valve replacement.  

Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Redefining Success in Cardiac Surgery in Africa: Aligning Training, Patient Profiles, and Outcomes 

CTSNet Content Mentioned 

1.) Fourth Sternotomy With Ross/Konno After Previous Mechanical Aortic Valve Replacement: The Modified Root Inclusion Technique 

Other Items Mentioned 

1.) Career Center  

2.) CTSNet Events Calendar 

3.) Instructional Video Competition  

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.

Chapters

00:00 Intro

00:58 Dr. Chitwood Background

04:20 Inspiration for MI

07:12 Reason for Mitral Valve Robotics

07:38 Strong Resistance from Specialty

08:35 Beginning Training

10:24 Origins of MI

13:37 Developmental Research

16:19 Steps in MI Mitral Valve Surgery

17:00 Bypass

17:57 Aortic Valve Surgery

19:10 Root Replacement & Dissection

19:27 Extracurricular Hobbies

20:23 Surgery Training Advice

They delve into Dr. Chitwood’s professional background and why he chose to study cardiothoracic surgery. They also discuss the evolution of minimally invasive surgery, including incisions and instruments. Additionally, they highlight robotics, minimally invasive techniques for the mitral valve, and coronary artery bypass grafting (CABG). They also cover aortic valve replacement (AVR) and minimally invasive techniques for the aortic valve. Furthermore, Dr. Chitwood provides advice for trainees, including how they can get involved in using minimally invasive techniques.  

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on extended resection with Dr. Maninder Kalkat.    

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.

Chapters

00:00 Intro

02:21 JANS 1, ARISE III Stent Graft Enrollment

04:25 JANS 2, Mech vs Biopros Valves in Hemodialysis

07:37 JANS 3, Surgical Sealants After Pulm Resection

09:54 JANS 4, Constrictive Pericarditis Procedures

12:45 Video 1, VATS CO2 Insufflation Technique

14:03 Third Place, Ascending Aortic Stenting Repair-Bridge

15:05 Second Place, Mustard & En Bloc Rotation of Tracts

16:49 First Place, Supracardiac Anomalous Pulm Ven Return

19:43 Drs. Vojacek & Ouzounian, Ross Procedure

42:02 Upcoming Events

42:21 Instructional Video Competition

42:49 Career Center

They discussed the task force and process of getting this statement published, as well as important elements of the guidelines. Additionally, they addressed the significance of shared decision-making with patients, survival rates following the Ross procedure, and overall quality of life. They also compared the Ross procedure to mechanical and biological aortic valve replacements. They explored various surgical techniques related to the Ross procedure, including the native inclusion technique and the prosthetic inclusion technique, emphasizing the importance of technical details, patient selection, and intraoperative management. Furthermore, they discussed the Ross centers of excellence and how to start them.  

Joel also highlights recent JANS articles on the ARISE III trial of gore ascending stent graft begins enrollment, mechanical vs bioprosthetic heart valves in hemodialysis patients, an individual patient data meta-analysis of randomized controlled trials on the clinical efficacy of surgical sealants after pulmonary resection, and radical pericardiectomy and use of cardiopulmonary bypass for constrictive pericarditis. 

In addition, Joel explores a new approach for thymic pathologies, robotic-assisted repair of supracardiac total anomalous pulmonary venous return, and combined Mustard and en bloc rotation of the outflow tracts. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) ARISE III Trial of Gore Ascending Stent Graft Begins Enrollment 

2.) Mechanical Versus Bioprosthetic Heart Valves in Hemodialysis Patients 

3.) Clinical Efficacy of Surgical Sealants After Pulmonary Resection: An Individual Patient Data Meta-Analysis of Randomized Controlled Trials 

4.) Radical Pericardiectomy and Use of Cardiopulmonary Bypass for Constrictive Pericarditis 

CTSNet Content Mentioned 

1.) A New Approach for Thymic Pathologies: VATS CO₂ Insufflation Technique 

2.) Robotic-Assisted Repair of Supracardiac Total Anomalous Pulmonary Venous Return  

3.) Combined Mustard and En Bloc Rotation of the Outflow Tracts  

Other Items Mentioned 

1.) EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients  

2.) Winners of the 2025 CTSNet Resident Video Competition 

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.

Chapters

00:00 Intro 

01:19 ICU & Early Extubation 

05:07 Acceptance of ERAS Protocols 

09:38 Lead Staff Advocate for ERAS 

12:59 Sternotomy Perception 

14:43 QoL Data Collection 

17:09 Rehabilitation 

19:04 Discharged Patients & Monitoring 

They discussed the intensive care unit and early extubation, highlighting differences between countries. They also covered the acceptance of the ERAS protocol and the regions that are more hesitant to implement it, as well as its application in cardiac surgery specifically. Additionally, they explored who leads the charge within the team responsible for implementing ERAS and addressed perceptions regarding sternotomy. The conversation also included improving quality of life, reducing complications, and patient-reported outcomes measures, emphasizing the importance of shared decision-making. Furthermore, they discussed rehabilitation, discharging patients, and remote monitoring.  

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.

Chapters

00:00 Intro

01:52 JANS 1, ESTS Guidelines

05:09 JANS 2, Resident-Led Operating

06:57 JANS 3, Fasting Impact on Pulm Aspiration

10:02 JANS 4, What Does a Dr Look Like

12:00 Video 1, Robotic Resection & Reconstruction

13:31 Video 2, Neonatal Off-Pump Shunt DORV

15:11 Video 3, Min Inv Bi-IMA OPCAB

16:12 Dr. Lanuti, JCOG0802 Results

44:58 Upcoming Events

45:38 Instructional Video Competition

45:49 Career Center

They discussed local recurrence rates, pulmonary function, and the subtypes of adenocarcinoma. Additionally, they explored how to apply these results to future patients, central and peripheral lesions, and other randomized trials. They also covered the five-year results of the JCOG0802 trial and future studies and the implications for future studies, focusing on the parameters that should be considered. Furthermore, they addressed pulmonary function tests and wedge resection.  

Joel also highlights recent JANS articles on European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer, a 10-year propensity-matched analysis on the impact of resident-led operating on outcomes in adult cardiac surgery, a systematic review and meta-analysis on no association between preprocedural fasting and witnessed pulmonary aspiration, and asking AI what a doctor looks like. 

In addition, Joel explores robotic anterolateral approach for left secondary carinal tumor resection and reconstruction, neonatal Blalock-Taussig-Thomas shunt for double outlet right ventricle with RVOTO, and minimally invasive Bi-IMA OPCAB via left thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) European Respiratory Society and European Society of Thoracic Surgeons Clinical Practice Guideline on Fitness for Curative Intent Treatment of Lung Cancer 

2.) Impact of Resident-Led Operating on Outcomes in Adult Cardiac Surgery: A 10-Year Propensity-Matched Analysis 

3.) No Association Between Preprocedural Fasting and Witnessed Pulmonary Aspiration: A Systematic Review and Meta-Analysis 

4.) What Does a Doctor Look Like? Asking AI 

CTSNet Content Mentioned 

1.) Robotic Anterolateral Approach for Left Secondary Carinal Tumor Resection and Reconstruction  

2.) Neonatal Off-Pump Blalock-Taussig-Thomas Shunt for Double Outlet Right Ventricle With RVOTO  

3.) Minimally Invasive Bi-IMA OPCAB Via Left Thoracotomy  

Other Items Mentioned 

1.) Instructional Video Competition  

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.

Chapters

00:00 Intro 02:59 JANS 1, Chest Tube Removal Review 05:33 JANS 2, Tricuspid Ann Remodeling 07:53 JANS 3, The Cost of Gender in MV Surgery 09:42 JANS 4, Endo Balloon vs Clamping 11:53 AVR & LIMA to LAD via Bi Minithorac 13:13 Surgical Reimplant ARCAPA 14:14 Editors Picks 2025 20:41 Gavin Wright, Segmentectomy vs Lob 44:33 Upcoming Events 45:56 Instructional Video Competition 46:12 Career Center 46:35 Closing

They discussed the findings of the JCOG0802 trial and compared it to the CALGB 140503 trial. They also covered the use of FEV1 as an assessment tool, the significance of p-values, local recurrence, and Type I errors. Additionally, they reviewed The Lancet paper addressing segmentectomy vs lobectomy. Furthermore, they explored potential future trials, including the debate over wedge resection vs segmentectomy.  

Joel also highlights recent JANS articles on a systematic review and meta-analysis on chest tube removal after cardiac surgery in first vs. second postoperative day, tricuspid annular remodeling in tachycardia induced cardiomyopathy with functional tricuspid regurgitation, a propensity-score matched analysis on the silent cost of gender in mitral valve surgery, and endo-aortic balloon occlusion versus transthoracic clamping in minimally invasive mitral valve surgery. 

In addition, Joel explores endoscopic AVR and LIMA to LAD via bilateral minithoracotomy, surgical reimplantation of the anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA), and the 2025 CTSNet Editors' Picks. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Chest Tube Removal After Cardiac Surgery in First vs. Second Post-Operative Day: A Systematic Review and Meta-Analysis 

2.) Tricuspid Annular Remodeling in Tachycardia Induced Cardiomyopathy With Functional Tricuspid Regurgitation 

3.) The Silent Cost of Gender in Mitral Valve Surgery: A Propensity-Score Matched Analysis  

4.) Endo-Aortic Balloon Occlusion Versus Transthoracic Clamping in Minimally Invasive Mitral Valve Surgery 

CTSNet Content Mentioned 

1.) Endoscopic AVR and LIMA to LAD Via Bilateral Minithoracotomy  

2.) Surgical Reimplantation of the Anomalous Origin of the Right Coronary Artery From the Pulmonary Artery (ARCAPA)  

3.) CTSNet Summarized—Editors’ Picks 2025 

Other Items Mentioned 

1.) Instructional Video Competition  

2.) 2025 CTSNet Recruitment Guide   

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.

Chapters

00:00 Intro

02:15 Top Interview

03:52 Top Webinar

05:23 Top Clinical Video

06:24 Top JANS Article

07:01 Top Video Series

08:02 Top Contributor

08:59 Top Cardiac Procedures

12:14 Top Podcasts

17:02 JANS 1, Doctor Story

21:28 JANS 2, Ex Vivo Heart Perfusion

22:41 JANS 3, PCI vs CABG

24:04 JANS 4, NEOpredict-Lung

25:29 2026 Plans

He discusses the top interview, the most popular webinar, and reveals the leading CTSNet contributor of the year. He also highlights the most-read JANS article, the most viewed CTSNet series, the top clinical videos in cardiac surgery, and the leading podcast episodes of 2025 from both The Beat and The Atrium. Additionally, he shares key statistics about CTSNet, including website viewership, YouTube subscribers, and listener demographics.  

Joel also highlights recent JANS articles on if ex vivo heart perfusion offsets ischemic penalties with six-hour or greater preservation in adult donation after brain death heart transplantation, an impactful article titled “This Man Saved My Life—I Live by His Example,” the long-term outcomes for women with chronic coronary artery disease after percutaneous coronary intervention vs coronary artery bypass grafting, and the long-term outcomes of preoperative nivolumab with or without relatlimab in patients with resectable non-small-cell lung cancer (NEOpredict-Lung).   

In addition, Joel outlines CTSNet’s goals and initiatives to look forward to in 2026. Before closing, he highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.)  Ex Vivo Heart Perfusion Offsets Ischemic Penalties With ≥6-Hour Preservation in Adult Donation-After-Brain-Death Heart Transplantation 

2.) This Man Saved My Life—I Live by His Example 

3.) Women With Chronic Coronary Artery Disease: Long-Term Outcomes After Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting 

4.) Long-Term Outcomes of Preoperative Nivolumab With or Without Relatlimab in Patients With Resectable Non-Small-Cell Lung Cancer (NEOpredict-Lung) 

CTSNet Content Mentioned 

1.) CTSNet Summarized—Most Popular Content of 2025 

2.) CTSNet Summarized—Most Popular Podcast Episodes of 2025 

3.) CTSNet Summarized—Top Cardiac Procedure Videos of 2025  

Other Items Mentioned 

1.) All CTSNet Summarized Content  

2.) 2025 CTSNet Recruitment Guide  

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.

Chapters

00:00 Intro 

02:31 JANS 1, Ethiopian Surgeon 

07:08 JANS 2, RCA to Cor Sinus Fistula 

09:30 JANS 3, Y-Incision Hemodynamics 

12:38 JANS 4, Endograft Infection 

15:06 Instructional Video Competition 

16:01 Career Center 

16:40 Video 1, Complications Podcast 

19:34 Video 2, Totally Endoscopic Case 

21:23 Video 3, Post-Infarction VSD Repair 

23:15 Closing, Upcoming Events 

Joel also highlights recent JANS articles on a heart surgeon who saved another surgeon’s life as a teen and how they now perform surgeries together, right coronary artery to coronary sinus fistula, a surgical aortic valve replacement with Y-incision aortic annular enlargement provided better hemodynamics than transcatheter aortic valve replacement, and management of endograft infection after thoracic endovascular aortic repair. 

In addition, Joel explores totally endoscopic mitral and tricuspid valve repair, ASD with APVR repair, and LAA occlusion, as well as the repair of a post-infarction VSD, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Samer Nashef about complications in cardiothoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.)  A Heart Surgeon Saved His Life as a Teen. Now They Perform Surgeries Together. 

2.) Right Coronary Artery to Coronary Sinus Fistula: A Rare Problem With an Elegant Solution 

3.) Surgical Aortic Valve Replacement With Y-incision Aortic Annular Enlargement Provided Better Hemodynamics Than Transcatheter Aortic Valve Replacement 

4.) Management of Endograft Infection After Thoracic Endovascular Aortic Repair 

CTSNet Content Mentioned 

1.) The Atrium: Complications 

2.) Totally Endoscopic Mitral and Tricuspid Valve Repair, ASD With APVR Repair, and LAA Occlusion 

3.) Repair of a Post-Infarction VSD 

Other Items Mentioned 

1.) Pace4Life  

2.) MICS and Robotic-Assisted Surgery: A Roundtable Discussion With the Endoscopic Cardiac Surgeons Club 

3.) Instructional Video Competition 

4.) 2025 CTSNet Recruitment Guide  

5.) Career Center  

6.) 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.

Chapters

00:00 Intro

02:56 JANS 1, Re-Repair vs Replacement

05:07 JANS 2, Mini Mitral Multicentre RCT

07:01 JANS 3, PERSEVERE Study

08:54 JANS 4, Parietal Pleurectomy vs Pleural Abrasion

11:38 Career Center

12:33 Video 1, Endoscopic Post-Infarction VSD Repair

14:11 Video 2, 3D Dor Procedure & MVR Huge LV Aneurysm

15:19 Video 3, Non-Cardioplegic Myo Protection Robotic

17:16 Nasser Altorki Interview, JCOG

45:16 Upcoming Events

47:20 Closing

They discuss key aspects of the trial, including the noninferiority primary endpoint. Dr. Altorki shares his overall thoughts on the trial, and they also examine topics such as pulmonary function, lobar vs sublobar resection, and segmentectomy vs wedge resection. Additionally, they explore secondary primary lung cancer, the importance of thoracic surgeons presenting data to patients, and best practices for segmentectomy to ensure patient safety. They also examine good wedge resection vs bad wedge resection, planning for segmentectomy, and the future of lobectomy and segmentectomy.  

Joel also highlights recent JANS articles on the outcomes of re-repair vs replacement after failed primary mitral regurgitation repair, minimally invasive thoracoscopically-guided right minithoracotomy vs conventional sternotomy for mitral valve repair, one-year results of novel aortic arch hybrid prosthesis for repair of acute DeBakey Type I dissection with malperfusion, and a meta-analysis of efficacy and safety of parietal pleurectomy vs pleural abrasion in treating spontaneous pneumothorax. 

In addition, Joel explores endoscopic post-infarction VSD repair, 3D video-assisted endoscopic Dor procedure and MVR for post-infarction huge LV aneurysm, and non-cardioplegic myocardial protection for robotic mitral surgery. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Outcomes of Re-Repair Versus Replacement After Failed Primary Mitral Regurgitation Repair: STS Adult Cardiac Surgery Database Analysis 

2.) Minimally Invasive Thoracoscopically-Guided Right Minithoracotomy Versus Conventional Sternotomy for Mitral Valve Repair: The UK Mini Mitral Multicentre RCT 

3.) One-Year Results of Novel Aortic Arch Hybrid Prosthesis for Repair of Acute DeBakey Type I Dissection With Malperfusion: PERSEVERE Study 

4.) A Meta-Analysis of Efficacy and Safety of Parietal Pleurectomy Versus Pleural Abrasion in Treating Spontaneous Pneumothorax 

CTSNet Content Mentioned 

1.) Endoscopic Post-Infarction VSD Repair 

2.) Pushing Surgical Boundaries: 3D Video-Assisted Endoscopic Dor Procedure and MVR for Post-Infarction Huge LV Aneurysm 

3.) Non-Cardioplegic Myocardial Protection for Robotic Mitral Surgery 

Other Items Mentioned 

1.) Instructional Video Competition 

2.) 2025 Endoscopic Cardiac Surgeons Club Video Competition 

3.) 2025 CTSNet Recruitment Guide  

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.

Chapters

00:00 Introduction 

01:38 Overcomplication 

05:29 Simple Barriers 

08:54 Change Obstructionists 

10:52 Status Quo 

12:49 Messing with Protocol 

14:21 Giving Up on Protocol 

16:48 Need for Patient-Reported Outcomes 

19:18 Struggle Into Cardiac Subspecialty 

21:30 Takeaways 

The goal of this discussion was to identify specific challenges and propose potential solutions. They emphasize the importance of having two leaders—a champion and a co-champion—to effectively guide ERAS initiatives. Additionally, they discuss creating standing orders and issues related to microbarriers and resistance to change. They also highlight the need for customization of protocols, acknowledging the differences between surgeons who utilize ERAS and those who do not, as well as the tendency to maintain the status quo. Patient perspectives are another key focus, with a call to implement changes that enhance tracking and monitoring of patient outcomes. Furthermore, they explore the role of technology designed for patients, as well as applying ERAS principles to surgeries that fall “outside of the box.”  

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.

Chapters

00:00 Intro

00:34 Dr. Nashef Background

04:06 Results Monitoring

08:55 Common Complications

14:40 Mentality

19:18 Identifying Room for Improvement

21:25 Pattern of Response

22:47 Long-Term Complications

26:08 Mortality/Morbidity Meetings

28:28 Perfection, Balance

30:33 Coping w Major Complications

35:06 Learning Your Psyche

35:51 Trainee-Consultant Responsibility

37:51 Resilience

39:19 Key Takeaways

41:07 Training Advice

They delve into early complications that trainees experience, approaches to managing acute complications, and nonacute and postoperative complications. They also highlight learning from complications, coping strategies, and the emotional impact involved in cardiothoracic surgery. Additionally, they discuss the concepts of growth, resilience, and strength in cardiothoracic surgery. Furthermore, Dr. Nashef provides advice to trainees currently navigating difficult cases, and general guidance for those in training.  

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Be sure to watch 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.

Chapters

00:00 Intro

02:41 Right to Repair, Robotics Re-Use

04:53 REPEAT Trial

06:30 JANS 1, PCI After CABG Randomized Trial

08:01 JANS 2, No-Touch vs Conventional Saph Veins

11:04 JANS 3, Sir Terence English & Keyvyn Mohagissi

12:09 CTSNet Recruitment Guide

12:54 Video 1, JCOG0802 Bombshell & Webinar

16:33 Video 2, Endoscopic Cardiac Foreign Body Extraction

17:56 Video 3, First Europe Robotic AVR Perceval Valve

18:42 Video 4, Bilateral VATS Sympathectomy

20:10 Laurens Ceulemans Interview

34:15 Upcoming Events

34:48 Closing

They highlighted key takeaways from the procedure and addressed the issue of air leaks. They also discussed bilateral lung volume reduction and emphasized the importance of a team approach. Additionally, they focused on why surgeons should be selecting the healthiest patients for this operation rather than the most critically ill, as well as the future of lung volume reduction.   

Joel also highlights recent JANS articles on a multicenter, randomized trial on the PCI of native coronary artery vs saphenous vein graft after prior bypass surgery, a meta-analysis of randomized trials on the outcomes of no-touch vs conventionally harvested saphenous veins for coronary artery bypass surgery, and the death of transplant pioneer Sir Terence English at 93. 

In addition, Joel explores bombshell 10-year JCOG0802 results showing lobectomy is superior to segmentectomy for lung cancer, endoscopic extraction of a cardiac foreign body, the first robotic aortic valve replacement in Europe using a Perceval valve, and bilateral VATS sympathectomy for ventricular tachycardia electrical storm. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) PCI of Native Coronary Artery vs Saphenous Vein Graft After Prior Bypass Surgery: A Multicenter, Randomized Trial 

2.) Outcomes of No-Touch Vs Conventionally Harvested Saphenous Veins for Coronary Artery Bypass Surgery: A Meta-Analysis of Randomized Trials 

3.) Transplant Pioneer Sir Terence English Dies at 93 

CTSNet Content Mentioned 

1.) Bombshell 10-Year JCOG0802 Results Show Lobectomy Is Superior to Segmentectomy for Lung Cancer 

2.) Military Heart Trauma: Endoscopic Extraction of a Cardiac Foreign Body 

3.) First Robotic Aortic Valve Replacement in Europe Using a Perceval Valve  

4.) Bilateral VATS Sympathectomy for Ventricular Tachycardia Electrical Storm 

Other Items Mentioned 

1.) Restore Robotics  

2.) 2025 Endoscopic Cardiac Surgeons Club Video Competition 

3.) 2025 CTSNet Recruitment Guide  

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.

Chapters

00:00 Intro 

03:10 Sir Terence English 

08:00 JANS 1, Cardiac Xenotransplantation 

09:13 JANS 2, Coffee Consumption on AF 

11:06 JANS 3, Environmental Factors Acute AD 

12:49 JANS 4, PROTHOR Trial 

15:15 Video 1, Combined AV & Coronary via LAM 

17:08 Video 2, ARCA w MV Prolapse 

19:32 Video 3, Redo Elephant Trunk After EAR 

22:06 Chris McGregor Interview 

48:23 Upcoming Events 

50:15 Closing 

They discussed the three approved trials for xenotransplantation in 2025, the preclinical efficacy assessment, and the various challenges of xenotransplantation. Additionally, they explored the history of orthotopic transplants, heart failure, and antibody-mediated rejection. They also examined the future of xenotransplantation and the anatomy of pig hearts vs human hearts.  

Joel also highlights recent JANS articles on the status of cardiac xenotransplantation including preclinical models, the DECAF randomized clinical trial on if caffeinated coffee consumption or abstinence reduces atrial fibrillation; the impact of environmental factors on acute aortic dissection; and a multicenter, international, randomized, controlled, phase 3 trial on the effects of intraoperative higher vs lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR).  

In addition, Joel explores combined aortic valve and coronary surgery via left anterior minithoracotomy, management of anomalous right coronary artery in a patient with mitral valve prolapse, and redo frozen elephant trunk after endovascular arch repair. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) 2025: Status of Cardiac Xenotransplantation Including Preclinical Models 

2.) Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial 

3.) Weathering the Aorta: The Impact of Environmental Factors on Acute Aortic Dissection  

4.) Effects of Intraoperative Higher Versus Lower Positive End-Expiratory Pressure During One-Lung Ventilation for Thoracic Surgery on Postoperative Pulmonary Complications (PROTHOR): A Multicentre, International, Randomised, Controlled, Phase 3 Trial 

CTSNet Content Mentioned 

1.) Combined Aortic Valve and Coronary Surgery via Left Anterior Minithoracotomy: Clinical Experience With Sutureless Bioprosthesis 

2.) Management of Anomalous Right Coronary Artery in a Patient With Mitral Valve Prolapse 

3.) Redo Frozen Elephant Trunk After Endovascular Arch Repair 

Other Items Mentioned 

1.) Resident Video Competition 

2.) 2025 CTSNet Recruitment Guide  

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.

Chapters

00:00 Intro 01:56 Segmentectomy vs Lobectomy News 18:51 JANS 1, CT Residents Emergency Surgery 20:56 JANS 2, Interventional vs Surgical 22:49 JANS 3, Robotic Vascular Surgery 24:32 JANS 4, Surgery vs Surveillance 26:30 Video 1, Branch-First Arch Replacement 28:19 Video 2, Manougian Technique Double Patch 30:14 Video 3, Bentall Surgery via RAM 31:23 Evgenij Potapov Interview 53:55 Upcoming Events

They discussed the key elements of the guidelines, active unloading, and current trends and outcomes in tMCS. Additionally, they addressed protected cardiac surgery for high-risk patients, cardiac arrest, and the impact of recent changes to the donor heart allocation system on tMCS. Dr. Potapov also shared valuable insights on hints and tips for tMCS, anticoagulation management, and the future of tMCS. Furthermore, Joel elaborated on recent discussions regarding lobectomy vs segmentectomy in a detailed analysis. 

Joel also highlights recent JANS articles on a 10-year propensity-matched analysis on if we can safely train cardiothoracic surgical residents to perform emergency surgery, investigating the personality of interventional and surgical cardiovascular specialists, a clinical perspective on robotic-assisted vascular surgery, and a quality-of-life analysis of patients with moderately dilated aortic root or ascending aorta. 

In addition, Joel explores branch-first arch replacement, revisiting the Manougian technique with double-patch, and Bentall surgery via right anterior minithoracotomy. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Can We Safely Train Cardiothoracic Surgical Residents to Perform Emergency Surgery? A 10-Year Propensity-Matched Analysis  

2.) Cut From the Same Cloth? Investigating the Personality of Interventional and Surgical Cardiovascular Specialists 

3.) Robotic-Assisted Vascular Surgery: A Clinical Perspective 

4.) Surgery Versus Surveillance: A Quality-of-Life Analysis of Patients With Moderately Dilated Aortic Root or Ascending Aorta 

CTSNet Content Mentioned 

1.) Branch-First Arch Replacement: How to Do It  

2.) Revisiting the Manougian Technique With Double-Patch  

3.) Bentall Surgery via Right Anterior Minithoracotomy  

Other Items Mentioned 

1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery  

2.) The Cardiac Recovery Room 

3.) Resident Video Competition 

4.) 2025 CTSNet Recruitment Guide    

5.) Career Center  

6.) 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.

Chapters

00:00 Intro

02:51 JANS 1, DAMSUN-HF Study

05:41 JANS 2, TAVR vs SAVR Guidelines

07:45 JANS 3, Myocardial Infarction After CABG

10:31 JANS 4, VAD Bridge-to-Transplant

12:27 New Recruitment Guide

13:54 Video 1, Anomalous Right Coronary Artery

15:27 Video 2, Beating Heart Transplant OCS

17:51 Video 3, Aortic Dissection Podcast w Marc Moon

19:26 Randas Batista Interview

37:38 Upcoming Events

They explored what Eisenmenger syndrome is and outlined the most common causes of the condition. They also delved into the history of this syndrome, highlighting the significant contributions of Viktor Eisenmenger and Paul H. Wood. Furthermore, they discussed the impact of this syndrome on lung function and extracting oxygen within the pulmonary artery. Dr. Batista shared valuable technical tips for performing the surgical procedure as well as solutions for managing this syndrome.  

Joel also highlights recent JANS articles on the DAMSUN-HF study on AI-enabled digital auscultation for detecting heart failure with reduced ejection fraction in Sub-Saharan Africa, transcatheter or surgical aortic-valve replacement in low-risk patients at seven years, current clinical practices and future perspectives on periprocedural myocardial infarction after coronary artery bypass grafting, and an analysis of UNOS. 

In addition, Joel explores anomalous right coronary artery, beating heart transplantation using the Organ Care "Heart-in-a-Box" System (OCS), and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Marc Moon about aortic dissection. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) AI-Enabled Digital Auscultation for Detecting Heart Failure With Reduced Ejection Fraction in Sub-Saharan Africa: The DAMSUN-HF Study 

2.) Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years 

3.) Periprocedural Myocardial Infarction After Coronary Artery Bypass Grafting: Current Clinical Practices and Future Perspectives 

4.) Analysis of UNOS: Ventricular Assist Device as Bridge-to-Transplant in Paediatric Patients With Congenital Heart Disease 

CTSNet Content Mentioned 

1.) Anomalous Right Coronary Artery 

2.) Beating Heart Transplantation Using the Organ Care "Heart-in-a-Box" System (OCS) 

3.) The Atrium: Aortic Dissection 

Other Items Mentioned 

1.) The Cardiac Recovery Room 

2.) Resident Video Competition 

3.) 2025 CTSNet Recruitment Guide  

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.

Chapters

00:54 Are There Myths?

02:49 Applying Non-Cardiac Surgery Data

04:52 Reducing NPO, Diabetes Carb-Load

08:17 Postop, Crystalloid Volume

10:31 Bicarb Usage

12:10 Hematocrit & Hemoglobin

14:53 Bronchoscopy for Early Extubation

18:54 Routine X-Rays

22:19 Lactates

24:48 Sleeplessness & Delirium

31:14 Final Thoughts

They discuss important topics such as the rationale for reducing nothing by mouth (NPO) guidelines, NPO after midnight, and the implications of carbohydrate loading for patients with type 1 diabetes. They examine critical issues of volume resuscitation, comparing the use of albumin vs crystalloids, as well as bicarb usage. Additionally, they evaluate hematocrit and hemoglobin levels, questioning whether specific thresholds should be established. The conversation also covers bronchoscopy for early extubation, inline suctioning for a bronchoalveolar lavage (BAL), and the necessity of daily chest x-rays following cardiac surgery. Furthermore, they address topics such as lactates, sleep aids, and delirium. 

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.

Chapters

00:00 Intro

02:28 Vince TAVR Roundtables

03:05 Foreign Body, Case of the Month

03:49 JANS 1, Temporary MCS Guidelines

13:50 JANS 2, Parenting as a CT Surgeon

16:20 JANS 3, Utilization of Long Distance Donors

18:20 JANS 5, Multi-A Grafting in Redo CABG

20:58 Career Center

21:20 Video 1, Pulm & Tricuspid Endocarditis

22:35 Video 2, Valvular Heart Disease Guidelines

27:05 Video 3, Thoraflex Hybrid Graft Insertion

28:16 Zara Shirazi Interview

39:30 Upcoming Events

42:42 Closing

They explored the advantages of working in a hospital in Pakistan compared to Austria, as well as the different techniques and operations, such as extracorporeal membrane oxygenation (ECMO). Dr. Shirazi also shared her experiences as a fellow in Austria and the valuable insights she gained from that experience. Additionally, she discussed her vision for the growth of her unit over the next five years and provided an overview of what a typical surgical week looks like in Pakistan.  

Joel also highlights recent JANS articles on the EACTS/STS/AATS guidelines on temporary mechanical circulatory support in adult cardiac surgery, the unique challenges and positive impacts on children raised by cardiothoracic surgeon mothers, evolving changes in center-level utilization of longer distance donors in heart transplantation, and multiarterial grafting in redo coronary artery bypass grafting. 

In addition, Joel explores pulmonary and tricuspid valve endocarditis, an interview with Drs. Borger and Marin-Cuartas on the guidelines for the management of valvular heart disease, and Thoraflex Hybrid graft insertion in a patient with Marfan syndrome. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery  

2.) Parenting From the OR: The Unique Challenges and Positive Impacts on Children Raised by Cardiothoracic Surgeon Mothers 

3.) Evolving Changes in Centre-Level Utilization of Longer Distance Donors in Heart Transplantation 

4.) Multiarterial Grafting in Redo Coronary Artery Bypass Grafting: Type of Arterial Conduit and Patient Sex Determine Benefit 

CTSNet Content Mentioned 

1.) Pulmonary and Tricuspid Valve Endocarditis: A Late Sequelae of Unrepaired Double Chambered Right Ventricle in an Adult 

2.) Guidelines for the Management of Valvular Heart Disease: An Interview With Drs. Borger and Marin-Cuartas 

3.) Thoraflex Hybrid Graft Insertion in a Patient With Marfan Syndrome 

Other Items Mentioned 

1.) Adapting Global Innovations to Local Realities: Advancing Pediatric Cardiac Surgery in Pakistan—Lessons From Austria 

2.) Roundtable: Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  

3.) Case of the Month: The Case of a Foreign Body 

4.) Resident Video Competition 

5.) The Cardiac Recovery Room 

6.) Career Center  

7.) 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.

Chapters

00:00 Intro

00:33 About Dr. Moon

02:51 Overview

03:33 History

05:27 Pathophysiology & Clinical Presentation

12:14 Diagnosis

15:25 Management

15:36 Step-by-Step, Type A

41:29 Step-by-Step, Type B

44:25 Postop Management

46:51 Complications

51:49 Future of Aortic Dissection

54:38 Key Takeaways

55:16 Training Advice

They begin with an overview of aortic dissection, including its history and pathophysiology. They explored imaging techniques and diagnostic approaches, as well as management options. Additionally, they provided the steps for performing aortic dissection for both Type A and Type B, addressing postoperative management and complications. The episode concludes with a look at the future of aortic dissection, and Dr. Moon provides advice to trainees.  

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on extended resection with Dr. Erinoangelo Rendina.   

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.

Chapters

00:00 Intro

02:26 JANS 1, Ross Procedure Consensus Statement

13:59 JANS 2, Novel Anastomotic Device

16:03 JANS 3, Tracheobronchoplasty Disorders Analysis

18:32 JANS 4, Revasc Strategies Non-Acute Myocardial

20:22 JANS 5, EACTS Core Curriculum for Cardiac Surgeon

21:51 Video 1, Giant Right Coronary Artery Aneurysm

24:01 Video 2, Bentall-de Bono Procedure

25:29 Video 3, Democratizing MI Mitral Repair

27:01 Liam Burns Interview

37:15 Upcoming Events

38:38 Closing

They explored the challenges faced by innovators and emphasized the importance of having a commercial perspective. Additionally, they discussed product design, the fundraising process, and the challenges that commercial leaders face. Burns also shared valuable advice for aspiring innovators.  

Joel also highlights recent JANS articles on the EACTS expert consensus statement on the Ross procedure in adult patients, a human cadaver study on a novel anastomotic device for the sandwich technique in type A aortic dissections, a comparative analysis of distinct airway disorders, revascularization strategies for non-acute myocardial ischemic syndromes, and core curriculum for the cardiac/cardiovascular surgeon. 

In addition, Joel explores the surgical repair of a giant right coronary artery aneurysm with saphenous vein interpositional grafting, the Bentall-de Bono procedure, and democratizing minimally invasive mitral repair. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients  

2.) Novel Anastomotic Device for the Sandwich Technique in Type A Aortic Dissections—A Human Cadaver Study 

3.) Tracheobronchoplasty for Excessive Dynamic Airway Collapse and Tracheobronchomalacia: A Comparative Analysis of Distinct Airway Disorders 

4.) Revascularisation Strategies for Non-Acute Myocardial Ischaemic Syndromes 

5.) The European Association for Cardio-Thoracic Surgery—Core Curriculum for the Cardiac/Cardiovascular Surgeon 

CTSNet Content Mentioned 

1.) Surgical Repair of a Giant Right Coronary Artery Aneurysm With Saphenous Vein Interpositional Grafting  

2.) The Bentall-de Bono Procedure: A Novel, Time-Efficient Mattress-Type Technique for Aortic Root Anastomosis  

3.) Democratizing Minimally Invasive Mitral Repair 

Other Items Mentioned 

1.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 

2.) Case of the Month: The Case of a Foreign Body 

3.) Resident 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.

Chapters

00:00 Intro

01:56 Using AI in Medical Writing

09:07 JANS 1, AI-Writing Article

14:53 JANS 2, Kidney vs Lung Transplant Outcomes

17:04 JANS 3, Harvesting Tech on ITAG

18:56 JANS 4, Phase 2 NeoCOAST-2 Trial

23:01 Career Center

23:41 Video 1, TAVR Explant After CABG w MVR

25:28 Video 2, Updated Y-Incision AA Enlargement

27:05 Video 3, Carotid Artery Cann for CABG

28:16 Upcoming Events

He reviews guidelines set by the International Committee of Journal Editors Committee regarding publication ethics and emphasizes the benefits of utilizing AI in writing processes. Joel also highlights the crucial necessity of including disclosures when employing AI tools. Additionally, he delves into other ways AI can be used, such as data analysis, and discusses taking accountability when using these technologies. Furthermore, he addresses the limitations of AI, noting that it cannot be cited as a source or used as a coauthor.  

Joel also highlights recent JANS articles on assisted artificial intelligence in medical writing, the impact of kidney transplantation on survival outcomes for lung transplantation, if the harvesting technique affects the production of nitric oxide and endothelin in the internal thoracic artery graft, and the platform phase 2 NeoCOAST-2 trial on perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer. 

In addition, Joel explores a TAVR explant after CABG with MVR, tips and tricks for the updated Y-incision aortic annular enlargement, and carotid artery cannulation for cardiopulmonary bypass in minimally invasive cardiac surgery.   

JANS Items Mentioned 

1.) Assisted Artificial Intelligence in Medical Writing: A Primer for Humans  

2.) The Impact of Kidney Transplantation on Survival Outcomes for Lung Transplantation 

3.) The Harvesting Technique Affects the Production of Nitric Oxide and Endothelin in the Internal Thoracic Artery Graft 

4.) Perioperative Durvalumab Plus Chemotherapy Plus New Agents for Resectable Non-Small-Cell Lung Cancer: The Platform Phase 2 NeoCOAST-2 Trial 

CTSNet Content Mentioned 

1.) TAVR Explant After CABG With MVR  

2.) Tips and Tricks for the Updated Y-Incision Aortic Annular Enlargement  

3.) Carotid Artery Cannulation for Cardiopulmonary Bypass in Minimally Invasive Cardiac Surgery  

Other Items Mentioned 

1.) Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals 

2.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 

3.) Resident 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.

Chapters

00:00 Intro 

02:30 JANS 1, CABG After 60 Years 

13:53 JANS 2, Endovascular Arch Repair 

16:45 JANS 3, Impact of Age on ARR 

18:47 JANS 4, Anterior Mediastinal Teratomas 

20:28 Career Center 

21:02 Video 1, RUL Without Dissecting SPV 

22:58 Video 2, Replacement w Double Patch Repair 

23:53 Video 3, TAVR & SAVR Removal w LVOR 

24:47 Dr. Sutherland Interview 

45:26 Closing 

They discuss the history and evolution of these cases, along with the preclinical work that led to this innovative technique. Dr. Sutherland addresses initial challenges such as the uniportal incision, the transcervical retractor system, and enhancing dexterity by incorporating a robotic system. They also detail the first clinical case, including postoperative outcomes and the importance of maintaining safety for the patient. Additionally, they explore the benefits for patients undergoing this procedure and its future potential. Furthermore, Dr. Sutherland provides insights into the procedural steps and key aspects of the procedure.  

Joel also highlights recent JANS articles on coronary artery bypass grafting 60 years after its debut, endograft design options and worldwide results for endovascular arch repair, the impact of age on aortic root replacement, and a multicenter retrospective study on if subxiphoid thoracoscopic surgery is safe and feasible for the treatment of anterior mediastinal teratomas. 

In addition, Joel explores a multiportal approach for robotic right upper lobectomy without dissecting the superior pulmonary vein, aortic and mitral replacement with double patch repair, and TAVR and SAVR removal with left ventricular outflow reconstruction. 

JANS Items Mentioned 

1.) Coronary Artery Bypass Grafting: 60 Years After Its Debut 

2.) Endovascular Arch Repair: Endograft Design Options and Worldwide Results 

3.) The Impact of Age on Aortic Root Replacement 

4.) Subxiphoid Thoracoscopic Surgery Is Safe and Feasible for the Treatment of Anterior Mediastinal Teratomas: A Multicentre Retrospective Study 

CTSNet Content Mentioned 

1.) Robotic Right Upper Lobectomy Without Dissecting the Superior Pulmonary Vein: A Multiportal Approach  

2.) Aortic and Mitral Replacement With Double Patch Repair  

3.) TAVR and SAVR Removal With Left Ventricular Outflow Reconstruction 

Other Items Mentioned 

1.) World's First Transcervical Robotic AVR Procedures Successfully Performed in 4 Cleveland Clinic Patients 

2.) Resident Video Competition 

3.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 

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.

Chapters

00:00 Intro

01:45 EACTS 2025

07:19 JANS 1, HVD Management Guidelines

16:26 JANS 2, Low-Risk AVR Evidence

19:21 JANS 3, Warden Procedure Selection

20:36 JANS 4, Primary Repair of CAT

21:48 JANS 5, NEWTON-CABG Cardiolink-5

23:20 Video 1, Acute Aortic Syndrome

24:54 Video 2, Redo TVR Under Bypass

27:13 Video 3, Giant Tension Bulla

28:47 Dr. Pelletier Interview

34:25 Outro

They delve into the Society of Thoracic Surgeons (STS) guidelines on patient blood management, along with key tips. They also explore preoperative optimization, provide an example, and discuss cell savers and reducing dead space during surgery. Additionally, they touch on postoperative transfusion and the importance of performing meticulous surgery. 

Joel also highlights recent JANS articles on the 2025 ESC/EACTS guidelines for the management of valvular heart disease, low-risk aortic valve replacement at the crossroads of evidence, ideal age and weight for the Warden procedure in patients with partial anomalous pulmonary venous return, a systematic meta-analysis of short- and long-term outcomes of the primary repair of common arterial trunk, and an international, randomized, double-blind, placebo-controlled trial on the effect of Evolocumab on saphenous vein graft patency after coronary artery bypass surgery. 

In addition, Joel explores the surgical treatment of acute aortic syndrome, a redo tricuspid valve replacement technique under right heart bypass for a previously repaired tricuspid valve, and thoracoscopic resection of a giant tension bulla. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease: Developed by the Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)  

2.) Low-Risk Aortic Valve Replacement at the Crossroads of Evidence 

3.) Is There an Ideal Age or Weight for the Warden Procedure in Patients With Partial Anomalous Pulmonary Venous Return? 

4.) Primary Repair of Common Arterial Trunk: A Systematic Meta-Analysis of Short- and Long-Term Outcomes 

5.) Effect of Evolocumab on Saphenous Vein Graft Patency After Coronary Artery Bypass Surgery (NEWTON-CABG CardioLink-5): An International, Randomized, Double-Blind, Placebo-Controlled Trial 

CTSNet Content Mentioned 

1.) Surgical Treatment of Acute Aortic Syndrome  

2.) Redo Tricuspid Valve Replacement Technique Under Right Heart Bypass for a Previously Repaired Tricuspid Valve  

3.) Thoracoscopic Resection of a Giant Tension Bulla  

Other Items Mentioned 

1.) STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management 

2.) Transcatheter vs Surgical Aortic Valve Replacement in Lower-Risk Patients: An Updated Meta-Analysis of Randomized Controlled Trials 

3.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 

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.

Chapters

00:00 Intro 

02:18 Ghana Mission Trip 

04:35 Failures of a Heart Surgeon  

09:27 JANS 1, Accelerometer-Measured Physical Activity  

12:57 JANS 2, Utility of GERAADA Score  

14:41 JANS 3, Aortic Valve Neocuspidization  

17:33 JANS 4, Procedural Planning in Thoracoscopic Segmentectomy 

19:09 JANS 5, The Outlet Orifice Diameter  

22:28 Video 1, Clampless Aortic Valve Replacement  

24:01 Video 2, Multiportal Robot-Assisted Extended LLS S6 

25:13 Video 3, The Atrium 

26:00 EACTS 2025 & Upcoming Events 

27:35 Footage From Ghana 

He discusses the various procedures that he and his team performed during their visit, as well as his overall experience collaborating with the local surgeons. The episode also features surgical footage from his time in Ghana and includes discussion with several surgeons about their work. Additionally, Joel addresses a recent news story from the UK regarding the failures of a heart surgeon that have contributed to multiple patient deaths. He provides an overview of the circumstances surrounding these events and emphasizes the critical importance of teamwork in surgical practice.  

Joel also highlights recent JANS articles on an analysis of the UK mini mitral randomized controlled trial for accelerometer-measured physical activity after mitral valve surgery, the utility of GERAADA score for predicting long-term survival following surgical repair of aortic dissection, early to mid-term results of aortic valve neocuspidization for rheumatic aortic valve disease, a systematic review and meta-analysis for three-dimensional reconstruction and virtual simulation of patient-specific anatomy for procedural planning in thoracoscopic segmentectomy, and the outlet orifice diameter of surgical bioprosthetic aortic stented valves is predominantly much smaller than the inlet orifice diameter. 

In addition, Joel explores a clampless aortic valve replacement in a partial porcelain aorta with aortic root enlargement and CABG with two grafts, multiportal robot-assisted extended lower left segmentectomy, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. John D. Puskas about proximal coronary anastomosis. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Accelerometer-Measured Physical Activity After Mitral Valve Surgery: An Analysis of the UK Mini Mitral Randomized Controlled Trial 

2.) Utility of GERAADA Score for Predicting Long-Term Survival Following Surgical Repair of Aortic Dissection 

3.) Early to Mid-Term Results of Aortic Valve Neocuspidization for Rheumatic Aortic Valve Disease 

4.) Three-Dimensional Reconstruction and Virtual Simulation of Patient-Specific Anatomy for Procedural Planning in Thoracoscopic Segmentectomy: A Systematic Review and Meta-Analysis 

5.) The Outlet Orifice Diameter of Surgical Bioprosthetic Aortic Stented Valves Is Predominantly Much Smaller Than the Inlet Orifice Diameter  

CTSNet Content Mentioned 

1.) Clampless Aortic Valve Replacement in a Partial Porcelain Aorta With Aortic Root Enlargement and CABG With Two Grafts 

2.) Multiportal Robot-Assisted Extended Lower Left Segmentectomy: Superior Segment S6 With Lateral S9 Resection 

3.) The Atrium: Proximal Coronary Anastomosis  

Other Items Mentioned 

1.) Joel Dunning YouTube Channel | The Arrhythmia Alliance Hearts of Ghana Mission 2025  

2.) Heart Surgeon’s Failures Contributed to Multiple Deaths  

3.) The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts 

4.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 

5.) Career Center  

6.) 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.

Chapters

00:00 Intro 

01:54 Ghana Mission Trip 

06:23 JANS 1, Pig-to-Human Transplant 

08:08 JANS 2, CABG Acute Type A AD 

10:06 JANS 3, Chylothorax Lymph Node Management 

11:22 JANS 4, ICU Resternotomy Adoption 

13:38 JANS 5, Octogenarians Repair vs MV Surgery 

15:10 Career Center 

15:31 Video 1, MVR Patent Bilateral IMammary Grafts 

16:36 Video 2, Repeat RA Thoracotomy 

17:39 Video 3, Vascular Injuries in Robotics 

19:12 Dr. Jeppsson Interview 

33:30 EACTS 2025 & Upcoming Events 

They began by providing an overview of the study, including the reason for conducting it, the expansion of the study to other Nordic countries, and its results. They also discuss the funding for the research and the recruitment process. Additionally, they cover dual antiplatelet therapy and compare this study with similar research. Finally, they explore registry-based studies and future research on ticagrelor and aspirin, or aspirin alone, following coronary surgery for acute coronary syndrome. 

Joel also highlights recent JANS articles exploring whether protective coronary artery bypass grafting improves surgical outcomes in acute type A aortic dissection with coronary ostial involvement, the association of chylothorax with aggressiveness of lymph node management during pulmonary resection, if intensive care unit resternotomy should be practiced in all facilities that perform cardiac surgery, transcatheter edge-to-edge repair vs mitral valve surgery in octogenarians, and research using pig-to-human lung xenotransplantation into a brain-dead recipient. 

In addition, Joel explores robotic mitral valve replacement in a patient with patent bilateral internal mammary grafts, repeat right axillary thoracotomy as a safe and feasible approach for repair of recurrent LAVVR after previous AVSD repair, and handling vascular injuries in robotic thoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Protective Coronary Artery Bypass Grafting Improves Surgical Outcomes in Acute Type A Aortic Dissection With Coronary Ostial Involvement 

2.) The Association of Chylothorax With Aggressiveness of Lymph Node Management During Pulmonary Resection 

3.) Expert Opinion: Intensive Care Unit Resternotomy Should Be Practiced in All Facilities That Perform Cardiac Surgery 

4.) Transcatheter Edge-to-Edge Repair Versus Mitral Valve Surgery in Octogenarians: Comparative Analysis of Safety, Durability, and Survival 

5.) Pig-to-Human Lung Xenotransplantation Into a Brain-Dead Recipient 

CTSNet Content Mentioned 

1.) Robotic Mitral Valve Replacement in a Patient With Patent Bilateral Internal Mammary Grafts: A Case Video 

2.) Repeat Right Axillary Thoracotomy Is a Safe and Feasible Approach for Repair of Recurrent LAVVR After Previous AVSD Repair  

3.) Handling Vascular Injuries in Robotic Thoracic Surgery: Real-Life Cases Using a Fibrin-Based Hemostatic Technique 

Other Items Mentioned 

1.) Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome  

2.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani 

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.

Chapters

00:00 Intro

00:44 About Dr. Puskas

03:35 Background & History

06:56 10 Commandments for PA

10:34 When to Do It?

13:57 Aorta Site Selection

19:32 Step-by-Step

29:21 Sewing Onto Aorta

33:15 Variations & Alternatives

44:50 Key Messages

46:08 Advice to Trainees

They discuss the 10 principles for proximal anastomosis during coronary artery bypass grafting, saphenous vein grafts vs free arterial grafts, as well as the optimal site selection on the aorta. They also explored key aspects of preparation and arteriotomy, and highlighted various variations and alternatives, such as clampless techniques and sequential grafting. Additionally, they examined the pitfalls and complications associated with proximal coronary anastomosis and the future of proximal coronary anastomosis.   

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on aortic dissection with Dr. Marc Moon. 

Related Resources  

1. The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts  

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.

Chapters

00:00 Intro

01:44 Innovation Competition Results

07:18 JANS 1, Modified Bio-Bentall

08:45 JANS 2, External Aortic Root

11:53 JANS 3, Re-Redo Pulm Valve

13:19 JANS 4, Tracheal Regeneration Model

16:15 Career Center

16:56 Video 1, EXIT-to-Open Atrial Septectomy

17:16 Video 2, Incision Repair of Tetra Fallot

19:40 Video 3, Isolated Pulm Leaflet Autograft

22:33 Dr. Brockman and Rossanese Interview

51:11 Upcoming Events

53:30 Closing

They explore the evolution of cardiothoracic surgery in veterinary medicine, discussing a variety of cases and the techniques employed, including mitral valve repair. Additionally, they highlight the anatomical differences between animals and humans, explaining how surgical techniques must be adapted accordingly. They also cover methods for testing valves, measuring the quality of repairs, and monitoring postoperative outcomes and follow-ups. Furthermore, they touch upon various conditions, such as tetralogy of Fallot, heart valve defects, etc.  

Joel also highlights recent JANS articles on modified Bio-Bentall operation with a rapid deployment valve, personalized external aortic root support, clinical success of re-redo pulmonary valve and pulmonary trunk homograft replacement during the second trimester of pregnancy, and lessons learned from various 3D-printed tracheal grafts in an extensive porcine model for de novo tracheal regeneration. 

In addition, Joel explores an EXIT-to-open atrial septectomy for hypoplastic left heart syndrome with intact atrial septum, incision of the moderator band during repair of tetralogy of Fallot, and a new solution for aortic valve repair, isolated pulmonary leaflet autograft. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Modified Bio-Bentall Operation With A Rapid Deployment Valve 

2.) Personalized External Aortic Root Support: The Dutch Experience 

3.) Clinical Success of Re-Redo Pulmonary Valve and Pulmonary Trunk Homograft Replacement During the Second Trimester of Pregnancy 

4.) Lessons Learned From Various 3D-Printed Tracheal Grafts in an Extensive Porcine Model for De Novo Tracheal Regeneration 

CTSNet Content Mentioned 

1.) EXIT-to-Open Atrial Septectomy for Hypoplastic Left Heart Syndrome With Intact Atrial Septum: Gone in 90 Seconds! 

2.) Incision of the Moderator Band During Repair of Tetralogy of Fallot  

3.) Isolated Pulmonary Leaflet Autograft: A New Solution for Aortic Valve Repair 

Other Items Mentioned 

1.) Career Center  

2.) 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.

Chapters

00:00 Intro 01:54 JANS 1, Validation of SYNTAX 04:58 JANS 2, Long-Distance ECMO Bridge 09:05 JANS 3, Segmentectomies Made Easy 10:49 JANS 4, MI Total Arterial BG 12:56 Career Center 13:46 Video 1, MI ASD Closure 15:43 Video 2, Basics of MV Surgery 17:03 Video 3, Construct Autologous P MV 20:19 Dr. Shafii Interview 33:37 Upcoming Events 34:56 Closing

They discuss the preclinical work and the history behind the development of this innovative device. Dr. Shafii also showcases the device and explains its functionality in detail. They also highlight the first patient who received the BiVACOR total artificial heart implantation and provide insights into learning the nuances of this operation.  Additionally, they explore the critical aspects of explanting the device and the importance of understanding how to explant the heart. Furthermore, they discuss the next steps for gaining approval of the BiVACOR total artificial heart, including the feasibility trial, and speculate on where we might be in five years regarding total artificial heart implantation.  

Joel also highlights recent JANS articles on the external validation of SYNTAX score II in a real-world cohort undergoing coronary artery bypass grafting, successful extracorporeal membrane oxygenation bridge to lung transplant with a patient transported from Hawaii to Nashville, Tennessee, USA, robotic-assisted left S3 segmentectomy, and minimally invasive total arterial bypass grafting via left minithoracotomy in obese patients. 

In addition, Joel explores direct cannulation for minimally invasive ASD closure, an instructional video for residents on the basics of mitral valve surgery, and how to construct an autologous pericardial mitral valve for infants and small children. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) External Validation of SYNTAX Score II in a Real-World Cohort Undergoing Coronary Artery Bypass Grafting 

2.) Successful Extracorporeal Membrane Oxygenation Bridge to Lung Transplant With a Patient Transported From Hawaii to Nashville, Tennessee 

3.) Segmentectomies Made Easy Series: Robotic-Assisted Left S3 Segmentectomy 

4.) Minimally Invasive Total Arterial Bypass Grafting via Left Minithoracotomy in Obese Patients 

CTSNet Content Mentioned 

1.) Minimally Invasive ASD Closure: Direct Cannulation  

2.) Basics of Mitral Valve Surgery: An Instructional Video for Residents  

3.) How to Construct an Autologous Pericardial Mitral Valve for Infants and Small Children  

Other Items Mentioned 

1.) Career Center  

2.) 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.

Chapters

00:00 Intro

01:39 Dr. Akujuo, Medical Missions

21:57 JANS 1, Ticagrelor and Aspirin Coronary

25:20 JANS 2, Long-Term MVR Durability Model

27:37 JANS 3, Duration of Donor Ventilation

29:18 JANS 4, Min Inv Concomitant Tri VR

31:40 JANS 5, Soft Robotic Artificial Hybrid Heart

33:32 Career Center

34:20 Video 1, RVOT Injury During Dissection

37:05 Video 2, Min Inv ASD Closure

38:31 Video 3, Redo AVR via Partial U Resternotomy

40:08 Upcoming Events

40:54 Closing

They explore the foundation’s goals, including training and educating local medical staff and providing essential care. Additionally, Dr. Akujo offers insights into the upcoming trip, discussing what a typical day entails, transportation logistics, accommodation, and the expenses that surgeons participating in the trip will need to cover, as well as what costs are taken care of by the foundation. The conversation also covers security measures in place, the average number of staff members on these trips, the daily surgical volume, and the most common cases.  

Joel also highlights recent JANS articles on which is best, ticagrelor and aspirin or aspirin alone after coronary surgery for acute coronary syndrome; an artificial intelligence and machine learning model for personalized prediction of long-term mitral valve repair durability; effect of duration of donor ventilation on lung transplant outcomes; surgical decision-making for concomitant tricuspid valve repair in minimally invasive mitral valve surgery; and a soft robotic total artificial hybrid heart. 

In addition, Joel explores right ventricular outflow tract injury during deep dissection in valve-sparing aortic root replacement, a minimally invasive approach for atrial septal defect closure, and redo aortic valve replacement via partial upper resternotomy. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome 

2.) An Artificial Intelligence and Machine Learning Model for Personalized Prediction of Long-Term Mitral Valve Repair Durability 

3.) Effect of Duration of Donor Ventilation on Lung Transplant Outcomes 

4.) Surgical Decision-Making for Concomitant Tricuspid Valve Repair in Minimally Invasive Mitral Valve Surgery 

5.) A Soft Robotic Total Artificial Hybrid Heart 

CTSNET Content Mentioned 

1.) Right Ventricular Outflow Tract Injury During Deep Dissection in Valve-Sparing Aortic Root Replacement  

2.) Minimally Invasive Approach for Atrial Septal Defect Closure 

3.) Redo Aortic Valve Replacement Via Partial Upper Resternotomy 

Other Items Mentioned 

1.) Voom Foundation  

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.

Chapters 

00:00 Intro

02:25 JANS 1, Transcervical Robotic AVR

07:49 JANS 2, Post Cor-Knot vs Manual Tying

10:18 JANS 3, Valve Therapy vs Volume Reduction

12:55 JANS 4, Cardiac Early Extraction vs Management

15:17 Career Center

16:18 Video 1, Repair of Ruptured RCAA

17:57 Video 2, Right Atrial Myxoma from IVC Junction

20:05 Video 3, Modified Re-Do Commando

22:43 Dr. Smedira Interview

45:44 Upcoming Events

46:58 Closing

They discuss the importance of understanding the anatomy and physiology of the papillary muscles, as well as flow vortices. They also cover various techniques for mitral valve repair and replacement, emphasizing the importance of making the leaflet coaptation zone as posterior as possible. Additionally, they explore how learning techniques for mitral valve-induced LVOT obstruction with minimal septal hypertrophy have evolved through exposure and experience.  

Joel also highlights recent JANS articles on the world's first transcervical robotic AVR procedures successfully performed in four Cleveland Clinic patients, a comparison of outcomes post Cor-Knot vs manual tying in valve surgery, endobronchial valve therapy vs lung volume reduction surgery in the United States, and early extraction vs conservative management in patients with noninfected cardiac implantable electronic devices undergoing cardiac surgery for left-sided infective endocarditis.  

In addition, Joel explores the repair of a ruptured right coronary artery aneurysm, removal of a right atrial myxoma from the IVC junction with patch repair using the left atrial appendage, and a modified redo Commando procedure in a patient with septic shock due to aortic and mitral valve endocarditis. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) World's First Transcervical Robotic AVR Procedures Successfully Performed in 4 Cleveland Clinic Patients 

2.) Comparison of Outcomes Post Cor-Knot Versus Manual Tying in Valve Surgery: Our 8-year Analysis of Over 1000 Patients 

3.) Endobronchial Valve Therapy Versus Lung Volume Reduction Surgery in the United States 

4.) Early Extraction Versus Conservative Management in Patients With Noninfected Cardiac Implantable Electronic Devices Undergoing Cardiac Surgery for Left-Sided Infective Endocarditis 

CTSNET Content Mentioned 

1.) Repair of Ruptured Right Coronary Artery Aneurysm 

2.) Removal of a Right Atrial Myxoma From the IVC Junction With Patch Repair Using the Left Atrial Appendage 

3.) Modified Re-Do Commando Procedure in a Patient With Septic Shock Due to Aortic and Mitral Valve Endocarditis  

Other Items Mentioned 

1.) A Surgeon’s Toolkit for Mitral Valve-Induced Left Ventricular Outflow Tract Obstruction With Minimal Septal Hypertrophy 

2.) Cardiac Surgical Arrest—An International Conversation Series   

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.

Chapters

00:00 Intro

02:19 Best Hospitals Report

08:52 JANS 1, Physician Compensation

13:54 JANS 2, International Challenges

18:36 Career Center

19:40 JANS 3, Rib Fracture Guidelines

23:16 JANS 4, Endovasc Concepts & Devices

26:05 Video 1, Redo Aortic Root David

26:43 Video 2, Removal of LAM

28:16 Video 3, Posterior MAD Correction

30:23 Dr. Cerfolio Interview

51:29 Upcoming Events

53:18 Resident Video Competition

54:10 Closing

They discuss the process that contributed to this improvement, including the efficiency quality index and the benefits of discharging patients on postoperative day one while maintaining constant communication with them as opposed to keeping them hospitalized for extended stays. Additionally, they emphasize the importance of patients going home to a safe environment, postoperative protocols, and the future of NYU Langone Health. 

Joel also highlights recent JANS articles on the 2025 Doximity Physician Compensation Report, the current landscape and challenges facing international medical graduates in cardiothoracic surgery training, Chest Wall Injury Society guidelines for surgical stabilization of rib fractures, and foundational endovascular concepts and devices for cardiac surgeons.  

In addition, Joel explores the David procedure in a patient with a previous Type A dissection surgery, removal of a left atrial myxoma with a ministernotomy, and surgical correction of the posterior mitral annular disjunction associated with structural abnormalities of the mitral valve. Before closing, Joel highlights upcoming events in CT surgery.  

JANS Items Mentioned 

1.) Physician Compensation Report 2025 

2.) The Current Landscape and Challenges Facing International Medical Graduates in Cardiothoracic Surgery Training 

3.) Chest Wall Injury Society Guidelines for Surgical Stabilization of Rib Fractures: Indications, Contraindications, and Timing 

4.) Foundational Endovascular Concepts and Devices for Cardiac Surgeons 

CTSNET Content Mentioned 

1.) Redo Aortic Root Surgery: The David Procedure in a Patient With a Previous Type A Dissection Surgery 

2.) Removal of a Left Atrial Myxoma With a Ministernotomy 

3.) Surgical Correction of the Posterior Mitral Annular Disjunction Associated With Structural Abnormalities of the Mitral Valve 

Other Items Mentioned 

1.) Best Hospitals for Cardiology, Heart & Vascular Surgery 

2.) NYU Langone Health Leads the Nation with Four No. 1–Ranked Specialties by U.S. News & World Report 

3.) Cardiac Surgical Arrest—An International Conversation Series   

4.) Resident Video Competition 

5.) Career Center  

6.) 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.

Chapters

00:00 Intro

01:09 Choosing CT Surgery

02:52 Background

05:23 Indications

10:20 Evidence & Key Trials

16:52 Preop Planning

20:42 Surgical Anatomy

23:14 Approaches

24:39 Step-by-Step

38:40 Pearls & Pitfalls

41:25 Postop Care & Complications

42:55 Key Points

44:03 Training Tips

They explain what segmentectomy is, the differences between segmentectomy and lobectomy, preoperative planning, and the surgical anatomy of the segments. They also explore various approaches, provide a step-by-step guide on how to perform segmentectomy, discuss potential pitfalls, and share training tips.  

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on proximal anastomosis with Dr. John Puskas.  

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.

Chapters

00:00 Intro

02:31 JANS 1, Endocarditis Guidelines

13:02 JANS 2, Hybrid vs Catheter

16:16 JANS 3, Full Sternotomy Trial

18:07 JANS 4, Buttressing the BA

19:05 JANS 5, Intraspinal Vasc Perf

20:15 Career Center

20:37 Video 1, Root Replace & Ann Reconstr

21:56 Video 2, Bi-Atrial Cann for BVAD

24:17 Video 3, Pediatric Device Implant

26:23 Dr. Liao Interview

49:07 Upcoming Events

49:39 Closing

They discuss the details of the procedure, including its background, ischemic time, technique, and postoperative outcomes. Additionally, they explore the application of the subxiphoid approach for robotic heart transplants and robotic mitral valve repair vs traditional open-chest (sternotomy) repair. Dr. Liao shares insights into the training and practice required for this operation and discusses the advantages of using robotics in heart transplants. He also reflects on what he would do differently in future procedures.  

Joel also highlights recent JANS articles on the surgical implications of the 2023 ESC endocarditis guidelines endorsed by EACTS, the two-year results from the randomized CEASE-AF trial on the durable effectiveness and safety of hybrid ablation vs catheter ablation, a randomized trial on superficial parasternal intercostal plane block and full sternotomy, a comparison of the short- and long-term outcomes in patients undergoing sleeve lobectomy with or without buttressing the bronchial anastomosis, and intraspinal vascular perfusion territories of the descending thoracic aorta. 

In addition, Joel explores free-style root replacement and annular reconstruction for destructive aortic root endocarditis, bi-atrial cannulation for biventricular assist device in children, and a device implantation in a 26 kg child. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Surgical Implications of the 2023 ESC Endocarditis Guidelines Endorsed by EACTS: Bridging Guidelines and Practice  

2.) Durable Effectiveness and Safety of Hybrid Ablation Versus Catheter Ablation: 2-year Results From the Randomized CEASE-AF Trial 

3.) Superficial Parasternal Intercostal Plane Block and Full Sternotomy; A Randomized Trial 

4.) Comparison of Short- and Long-Term Outcomes in Patients Undergoing Sleeve Lobectomy With or Without Buttressing the Bronchial Anastomosis 

5.) Intraspinal Vascular Perfusion Territories of the Descending Thoracic Aorta 

CTSNET Content Mentioned 

1.) Free-Style Root Replacement and Annular Reconstruction for Destructive Aortic Root Endocarditis 

2.) Bi-Atrial Cannulation for Biventricular Assist Device in Children 

3.) Device Implantation in a 26 kg Child 

Other Items Mentioned 

1.) Guest Editor Series Webinar: Insights Into Pediatric Mechanical Circulatory Support 

2.) Cardiac Surgical Arrest—An International Conversation Series   

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.

Chapters

00:00 Intro

02:27 JANS 1, On-Table Extubation

14:13 JANS 2, Intraop Broncho Biopsies

18:26 JANS 3, Stroke After Transplant

20:51 JANS 4, Pulm Carcinoid Tumors

22:56 Career Center

24:05 Video 1, Robotic LAAO

25:36 Video 2, Bedside VV ECMO

26:44 Video 3, Inverted Y AE

28:01 Dr. Rosengart Interview, Novel Approaches

40:57 Upcoming Events

42:58 Closing

They discuss postoperative outcomes and the 100-day follow-up appointment, the benefits of the robotic technique in transplants, and the surgeons who participated in this procedure. Additionally, Dr. Rosengart shares advice for individuals performing robotic transplants, his experience leading this unit, and its notable accomplishments, including other world-first procedures.  

Joel also highlights recent JANS articles on the 10 best practices of on-table extubation after cardiac surgery, if we can rely on intraoperative bronchoscopic biopsies for surgical decision making, increased prevalence of stroke after heart transplant in the new allocation system era, and the surgical management of both stage III and stage IV pulmonary carcinoid tumors confers survival benefit. 

In addition, Joel explores robotic left atrial appendage occlusion, bedside veno-venous extracorporeal membrane oxygenation cannulation technique in an awake patient, and a stepwise surgical approach for inverted Y annular enlargement in the bicuspid aortic valve. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) The 10 Commandments of On-Table Extubation After Cardiac Surgery: Why and How to Increase Adoption 

2.) Can We Rely on Intraoperative Bronchoscopic Biopsies for Surgical Decision Making? 78 Single Anesthetic Robotic Bronchoscopy to Anatomic Resections 

3.) Increased Prevalence of Stroke After Heart Transplant in the New Allocation System Era 

4.) Surgical Management of Both Stage III and Stage IV Pulmonary Carcinoid Tumors Confers Survival Benefit 

CTSNET Content Mentioned 

1.) Robotic Left Atrial Appendage Occlusion  

2.) Bedside Veno-Venous Extracorporeal Membrane Oxygenation Cannulation Technique in an Awake Patient 

3.) Inverted Y Annular Enlargement in Bicuspid Aortic Valve: A Stepwise Surgical Approach 

Other Items Mentioned 

1.) Guest Editor Series: Insights Into Pediatric Mechanical Circulatory Support 

2.) Cardiac Surgical Arrest—An International Conversation Series   

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.

Chapters

00:00 Intro

02:21 JANS 1, Ross Long-Term Outcomes

04:12 JANS 2, Valve Replacement Pregnancy

07:09 JANS 3, Bronchopleural Fistula

09:36 JANS 4, AUTHEARTVISIT Study

11:51 Career Center

13:56 Video 1, Bicuspid AVR & AAR

16:15 Video 2, Cold Head-Warm Body Perfusion

19:00 Video 3, Dr. Kappetein Podcast

20:23 Dr. Antonoff Interview, Chest Tube Management

38:45 Closing

They discuss single chest tube vs double chest tube, the benefits of single chest tubes, and various chest tube sizes. They also explore reducing chest drain pain, stitching the chest tube, and chest tube output thresholds for removal. Additionally, they cover drain removal, air leaks, and clamping.  

Joel also highlights recent JANS articles on whether the Ross procedure in young adults delivers favorable long-term clinical and QOL outcomes, a literature review including new data from the registry of pregnancy and cardiac disease III regarding valve replacement during pregnancy, a multi-institutional analysis of the treatment outcomes and prognostic factors in the ESSG-01 study, and the choice of surgical aortic valve replacement type and midterm outcomes in 50 to 65-year-olds.  

In addition, Joel explores bicuspid aortic valve repair and ascending aorta replacement, a guide to isolated cerebral perfusion using two bypass circuits, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Professor Pieter Kappetein about the future of revascularization. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Ross Procedure in Young Adults Delivers Favorable Long-Term Clinical and QOL Outcomes 

2.) Valve Replacement During Pregnancy: Literature Review Including New Data From the Registry of Pregnancy and Cardiac Disease III 

3.) Bronchopleural Fistula: A Multi-Institutional Analysis of the Treatment Outcomes and Prognostic Factors in the ESSG-01 Study  

4.) The Choice of Surgical Aortic Valve Replacement Type and Mid-Term Outcomes in 50 to 65-Year-Olds: Results of the AUTHEARTVISIT Study  

CTSNET Content Mentioned 

1.) Bicuspid Aortic Valve Repair and Ascending Aorta Replacement  

2.) Cold Head-Warm Body Perfusion: A Guide to Isolated Cerebral Perfusion Using Two Bypass Circuits 

3.) The Atrium: The Future of Revascularization  

Other Items Mentioned 

1.) Guest Editor Series: Insights Into Pediatric Mechanical Circulatory Support 

2.) Cardiac Surgical Arrest—An International Conversation Series   

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.

Chapters

00:00 Intro

02:13 Early Intervention, Disease Management

04:40 JANS 1, Sept on Placental Support

07:04 JANS 2, Surgeon Well-Being

09:41 JANS 3, Cardiac

10:58 JANS 4, PPM in SAVR

12:57 JANS 5, Cardiac Registry

14:22 Video 1, Close U Ministernotomy

15:19 Video 2, Endo AVR & MVR

16:03 Video 3, VATS

17:20 Dr. Zacharias Interview, HVD

38:04 Upcoming Events

38:51 Closing

They delve into Dr. Zacharias’s recent paper titled “Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time,” and discuss how the idea for the paper originated highlighting key takeaways. They also address perceived risks vs actual risks and why less than 25 percent of patients are referred for necessary interventions. Additionally, they examine the future of cardiac surgery, endoscopic cardiac surgery, and endoscopic vein harvesting.  

Joel also highlights recent JANS articles on a novel and logistic approach for hypoplastic left heart syndrome with intact atrial septum, a European Society of Thoracic Surgery survey on member well-being, transcatheter management of left-sided valvular heart disease following heart transplantation, a multi-institutional study on the prevalence and clinical impact of patient-prosthesis mismatch in surgical aortic valve replacement, and a systematic review and meta-analysis of the German registry of acute aortic dissection type A score for 30-day mortality prediction in type A acute aortic dissection surgery.  

In addition, Joel explores how to close an upper ministernotomy, endoscopic aortic valve replacement and mitral valve replacement, and uniportal VATS decortication for late-stage TB empyema. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Open Atrial Septectomy on Placental Support: A Novel and Logistic Approach for Hypoplastic Left Heart Syndrome With Intact Atrial Septum 

2.) Fit2Perform: European Society of Thoracic Surgery Survey on Member Well-Being 

3.) Transcatheter Management of Left-Sided Valvular Heart Disease Following Heart Transplantation 

4.) A Multi-Institutional Study on the Prevalence and Clinical Impact of Patient-Prosthesis Mismatch in Surgical Aortic Valve Replacement 

5.) The German Registry of Acute Aortic Dissection Type A Score for 30-Day Mortality Prediction in Type A Acute Aortic Dissection Surgery: A Systematic Review and Meta-Analysis 

CTSNet Content Mentioned 

1.) How to Close an Upper Ministernotomy  

2.) Endoscopic Aortic Valve Replacement and Mitral Valve Replacement  

3.) Uniportal VATS Decortication for Late-Stage TB Empyema  

Other Items Mentioned 

1.) Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time 

2.) Guest Editor Series Webinar: Coronary Arterial Anomalies—Pediatric and Adult Congenital

3.) Cardiac Surgical Arrest—An International Conversation, Part 4

4.) Career Center  

5.) CTSNet Events Calendar 

Chapters

00:00 Introduction

00:47 Dr. Kappetein Background

04:19 Getting Into Research

05:36 Work Balance

06:35 Industry Role in Career

09:30 Status of Revascularization

12:20 SYNTAX Trial

13:40 EXCEL Trial

15:54 AHA Guidelines & Heart Teams

18:59 Heart Teams

21:15 Future of Revascularization

24:10 Hybrid Approaches

25:55 Advice for Surgery Training

They discuss the history of revascularization, the SYNTAX trial, the EXCEL trial, and the new American Heart Association (AHA) guidelines. They also explore the Heart Team approach and what’s on the horizon in this important surgery specialty.   

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on segmentectomy with thoracic surgeon Dr. Agathe Seguin-Givelet.

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.

Chapters

00:00 Intro

03:13 JANS 1, Cardiac Transplant

09:04 JANS 2, Lung Transplant

10:19 JANS 3, Cardiac Transplant

11:08 JANS 4, Lung Cancer

13:01 JANS 5, Thoracic

15:44 Video 1, Congenital Cardiac

17:53 Video 2, Cardiac

19:49 Video 3, Cardiac

21:50 Dr. Said Interview, EXIT Procedure

37:28 Upcoming Events

39:32 Closing

They discuss the surgical steps involved in this groundbreaking procedure, including specific details about the surgery, the preparation undertaken prior to the operation, and the key factors that contributed to its success. Additionally, they covered the challenges encountered during this first successful EXIT procedure case, as well as the standard management practices for these cases at medical centers, such as fetal balloon atrial septostomy, along with postnatal transcatheter, surgical, or hybrid interventions and their associated surgical risks. Furthermore, they address the broader challenges faced when operating on patients with hypoplastic left heart syndrome, including the differences between restrictive atrial septum and intact atrial septum.  

Joel also highlights recent JANS articles on the current state and future directions of cardiac xenotransplantation, if age is a contraindication for lung transplantation in the elderly, a summary of the International Society for Heart and Lung Transplantation consensus conference on emerging understanding of antibodies and antibody-mediated rejection in heart transplantation, inflammatory diseases and risk of lung cancer among individuals who have never smoked, and active chest tube clearance added to an Enhanced Recovery After Cardiac Surgery (ERAS) program improves outcomes and reduces resource utilization. 

In addition, Joel explores a single incision mitral valve repair and LIMA-to-LAD bypass via a left anterior minithoracotomy, repair of post-infarction ventricular septal defect using a double patch sandwich technique, and reconstruction of the left trigone during the Commando procedure for invasive prosthetic aortic valve endocarditis. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Cardiac Xenotransplantation: Current State and Future Directions 

2.) Lung Transplantation in the Elderly: Is Age a Contraindication? 

3.) Summary of the International Society for Heart and Lung Transplantation Consensus Conference on Emerging Understanding of Antibodies and Antibody-Mediated Rejection in Heart Transplantation 

4.) Inflammatory Diseases and Risk of Lung Cancer Among Individuals Who Have Never Smoked 

5.) Active Chest Tube Clearance Added to an Enhanced Recovery After Cardiac Surgery (ERAS) Program Improves Outcomes and Reduces Resource Utilization 

CTSNET Content Mentioned 

1.) Single Incision Mitral Valve Repair and LIMA-to-LAD Bypass via a Left Anterior Minithoracotomy 

2.) Repair of Post-Infarction Ventricular Septal Defect Using a Double Patch Sandwich Technique 

3.) Reconstruction of the Left Trigone During the Commando Procedure for Invasive Prosthetic Aortic Valve Endocarditis 

Other Items Mentioned 

1.) Guest Editor Series: Coronary Arterial Anomalies—Pediatric and Adult Congenital  

2.) Cardiac Surgical Arrest—An International Conversation Series  

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.

Chapters

00:00 Intro

03:24 JANS 1, Cardiac

05:42 JANS 2, General

08:40 JANS 3, Cardiac

12:17 JANS 4, General

13:45 JANS 5, Cardiac

14:53 Video 1, Cardiac

16:48 Video 2, Thoracic

18:53 Video 3, Cardiac

20:29 Dr. Goldstein Interview

33:06 Closing

They explore how to be an effective mentor, outlining essential steps in mentoring and the process of developing great surgeons. They also discuss the significance of volunteering and contributing to advance within the field. Additionally, they cover the incentives of being a good mentor, provide advice for trainees currently seeing to join a program, and delve into how and why Dr. Goldstein was selected by the ISHLT Foundation to receive the 2025 Francis D. Pagani, MD, Endowed Mentorship Award. In a separate segment, Joel addresses minimally invasive surgery in Europe.  

Joel also highlights recent JANS articles on lifetime management of heart valve disease, social media use among cardiothoracic surgeons, a surgeon’s tool kit for mitral valve-induced left ventricular outflow tract obstruction with minimal septal hypertrophy, transatlantic analysis of gender representation in general thoracic surgery, and extent of coronary artery disease and clinical outcomes with ticagrelor monotherapy vs aspirin after coronary artery bypass grafting. 

In addition, Joel explores an infarct exclusion technique for posterior ischemic ventricular septal defect in a patient with Impella 5.5 support, mastering robotic lung resection using the French lobectomy technique for standardized surgical education, and assessment, debridement, and annular support for valve replacement in a case of mitral annular calcification. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time 

2.) Social Media Use Among Cardiothoracic Surgeons: The Online Landscape and Comparisons Between Subgroups 

3.) A Surgeon’s Toolkit for Mitral Valve-Induced Left Ventricular Outflow Tract Obstruction With Minimal Septal Hypertrophy 

4.) Trans-Atlantic Analysis of Gender Representation in General Thoracic Surgery: Challenges Permeate the Academic Community 

5.) Extent of Coronary Artery Disease and Clinical Outcomes With Ticagrelor Monotherapy Versus Aspirin After Coronary Artery Bypass Grafting: Insights From the TiCAB Trial 

CTSNET Content Mentioned 

1.) Infarct Exclusion Technique for Posterior Ischemic Ventricular Septal Defect in a Patient With Impella 5.5 Support 

2.) Mastering Robotic Lung Resection: The French Lobectomy Technique for Standardized Surgical Education 

3.) Mitral Annular Calcification: Assessment, Debridement, and Annular Support for Valve Replacement 

Other Items Mentioned 

1.) Cardiac Surgical Arrest—An International Conversation, Part 3 

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.

Chapters

00:00 Intro

02:17 JANS 1, Cardiac

05:15 JANS 2, Thoracic

07:01 JANS 3, Thoracic

09:41 JANS 4, Cardiac

12:14 JANS 5, Thoracic

13:37 Subvalvular Ring Excision, AVR

15:30 SCORE Technique, Rheu M Stenosis

18:43 VATS Intraperi L Pneumonectomy

20:00 Dr. Pal Interview

30:52 Closing

They discuss how the AI-assisted stethoscope functions and its ability to identify rheumatic heart disease, highlighting the advantages of this technology in low-resource settings and the future potential of the device. Additionally, they explore the device’s capability to diagnose heart failure and the benefits of using this advanced tool over a traditional analog stethoscope. 

Joel also highlights recent JANS articles on blood pressure and heart rate management in patients after repair of type A aortic dissection, long-term outcomes and prognostic factors after chest wall resection and reconstruction, a comparison between robot- and video-assisted thoracoscopic surgeries for anterior mediastinal lesions, and the cost-effectiveness of left ventricular assist device for transplant-ineligible patients. 

In addition, Joel explores an excision of a subvalvular ring with preservation of the aortic valve, a step-by-step VATS approach for intrapericardial left pneumonectomy for a centrally located lung tumor, and a repair of rheumatic mitral stenosis using the SCORE technique. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Blood Pressure and Heart Rate Management in Patients After Repair of Type A Aortic Dissection 

2.) Long-Term Outcome and Prognostic Factors After Chest Wall Resection and Reconstruction 

3.) Comparison Between Robot- and Video-Assisted Thoracoscopic Surgeries for Anterior Mediastinal Lesions 

4.) Cost-Effectiveness of Left Ventricular Assist Device for Transplant-Ineligible Patients 

5.) Three-Dimensional Tracheo-Bronchial Reconstruction to Plan Endoscopic Stent Insertion for Malignant Upper Airway Stenosis

CTSNET Content Mentioned 

1.) Excision of a Subvalvular Ring With Preservation of the Aortic Valve 

2.) VATS Intrapericardial Left Pneumonectomy for Centrally Located Lung Tumor: Step-by-Step Approach With Technical Pearls 

3.) Repair of Rheumatic Mitral Stenosis Using the SCORE Technique 

Other Items Mentioned 

1.) Cardiac Surgical Arrest—An International Conversation, Part 2  

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.

Chapters

00:00 Intro

01:46 Interview Preview

02:16 No Chest-Open Heart Transplant

05:07 NSCLC Time to Surgery

07:55 Impact of Preop Invasive Nodal Staging

11:04 Air Space Spread Impacts Adenocarcinoma

14:26 Intrapericard Pneum w Broncho & Flap

16:42 Ross Procedure Unveiled

21:16 Radial Artery Harvesting Podcast

23:32 Dr. Wes Interview, Video Production

46:06 Cardiac Surgical Arrest Series

46:52 Closing

They discuss the value of starting with the right camera, the impact of field of view, head-mounted cameras vs. stationary cameras, and the importance of capturing the surgeon’s perspective. Additionally, they explore the educational benefits of recording surgeries, the criteria for selecting an ideal storage solution for recordings, and the future of clinical surgery videos.  

Joel also highlights recent JANS articles on first fully robotic heart transplant in the US performed without opening the patient's chest, defining the optimal diagnosis-to-resection interval to reduce mortality in early-stage non-small cell lung cancer, concurrent spread through air spaces in dominant tumors impacts prognosis in synchronous multiple primary lung adenocarcinoma, and the impact of preoperative invasive nodal staging on unexpected mediastinal upstaging in early-stage non-small cell lung cancer. 

In addition, Joel explores a robot-assisted intrapericardial pneumonectomy with bronchoplasty and thymic flap post neoadjuvant chemo/IO, insights into various techniques and modifications for the Ross procedure, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Faisal Bakaeen from the Cleveland Clinic on radial artery harvesting. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) First Fully Robotic Heart Transplant in the US Performed Without Opening Patient's Chest 

2.) Time to Surgery in Early-Stage Non-Small Cell Lung Cancer: Defining the Optimal Diagnosis-to-Resection Interval to Reduce Mortality 

3.) Concurrent Spread Through Air Spaces in Dominant Tumors Impacts Prognosis in Synchronous Multiple Primary Lung Adenocarcinoma  

4.) The Impact of Preoperative Invasive Nodal Staging on Unexpected Mediastinal Upstaging in Early-Stage Non-small Cell Lung Cancer  

CTSNET Content Mentioned 

1.) Robot-Assisted Intrapericardial Pneumonectomy With Bronchoplasty and Thymic Flap Post Neoadjuvant Chemo/IO 

2.) The Ross Procedure Unveiled: Insights into Various Techniques and Modifications  

3.) The Atrium: Radial Artery Harvesting  

Other Items Mentioned 

1.) Cardiac Surgical Arrest—An International Conversation, Part 2 

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.

Chapters

00:00 Intro

01:46 Interview Preview

02:54 MV Surgery After Failed Intervention

07:46 Tears Predict Outcomes After Hemi-Arch

10:32 Pain Catastrophizing Scale

14:27 ARR w Stentless Biopros, Sex Difference

16:38 Open Implant TAV via Redo Sternotomy

19:05 Repeat Sternotomy w Completion Unifocaliz

21:07 Direct Aortic Impella 5.5 in PC Shock

25:16 Dr. Kalfa Interview, AMV Transplant

39:58 Upcoming Events

41:26 Closing

They discuss methods for obtaining a mitral valve for transplantation, and topics such as immunosuppression, aortic coagulation, and the progress that has been made in this field. They also explore how to perform a living allogeneic heart valve transplant and the future of this technique.  

Joel also highlights recent JANS articles on mitral valve surgery after failed transcatheter intervention for mitral regurgitation, whether distal anastomotic new entry tears predict long-term outcomes after hemiarch repair for DeBakey I aortic dissection, using a pain catastrophizing scale as a predictor for acute postoperative pain following video-assisted thoracoscopic surgery lobectomy, and sex difference in aortic root replacement with a stentless bioprosthesis. 

In addition, Joel explores an open implantation of a transcatheter aortic valve via redo sternotomy, mitral valve replacement, and tricuspid valve repair in a high-risk patient, repeat sternotomy with completion unifocalization and extensive pulmonary arterial reconstruction in ToF/PA/MAPCAs, and direct aortic Impella 5.5 in post-cardiotomy shock. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Mitral Valve Surgery After Failed Transcatheter Intervention for Mitral Regurgitation: Techniques, Challenges, and Outcomes 

2.) Distal Anastomotic New Entry Tears Predict Long-Term Outcomes After Hemi-Arch Repair for DeBakey I Aortic Dissection 

3.) Pain Catastrophizing Scale as a Predictor for Acute Postoperative Pain Following Video-Assisted Thoracoscopic Surgery Lobectomy 

4.) Sex Difference in Aortic Root Replacement With a Stentless Bioprosthesis 

CTSNET Content Mentioned 

1.) Open Implantation of a Transcatheter Aortic Valve via Redo Sternotomy, Mitral Valve Replacement, and Tricuspid Valve Repair in a High-Risk-Patient 

2.) Challenging Pulmonary Arterial Reconstruction: Repeat Sternotomy With Completion Unifocalization and Extensive Pulmonary Arterial Reconstruction in ToF/PA/MAPCAs  

3.) Direct Aortic Impella 5.5 in Post-Cardiotomy Shock 

Other Items Mentioned 

1.) Allogeneic Mitral Valve Transplant: Historical Precedent, Current Considerations, and Future Implementation 

2.) Cardiac Surgical Arrest—An International Conversation, Part 1 

3.) Winners of the 2025 CTSNet 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.

Chapters

00:00 Introduction

01:45 Dr. Bakaeen Background

05:26 Historical Timeline

06:40 Radial Artery Advantages

08:58 Anatomy

14:31 Patient Preparation & Selection

16:44 Harvest Technique (Open)

24:21 Closure

26:47 Graft Prep & Vasodilation

29:08 Graft Patency

29:34 Graft Use

31:22 Post-Op Management

32:10 Complications

35:22 Future of RAH

38:43 Key Takeaways

39:25 Surgery Training Advice

They discuss the benefits of utilizing radial artery harvesting, preparation, the open harvesting technique, and endoscopic harvesting. They also explore graft preparation and vasodilation, postoperative management, and complications.  

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on segmentectomy and an upcoming discussion of the future of revascularization with Professor Pieter Kappetein.  

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.

Chapters

00:00 Intro

01:31 Guest Preview, Dr. Naunheim

02:34 Clinic Notes via AI

04:41 Congenital Challenging Anatomy

06:47 Exposing Intramyocardial LAD Artery

09:28 Multiple Stent Grafts, Aorta Aneurysm

11:33 AVR w M & TVR, R-Anterior Thoracotomy

13:50 Dr. Naunheim, AI in CT Surgery

34:33 Upcoming Events

35:16 Cardiac Surgical Arrest Series

36:37 Robert Lowery Obituary

38:38 Closing

They discuss how AI will affect and impact CT surgery, where AI is already incorporated in the CT surgery world, and the importance of field-testing AI. They also explore the pros and cons of AI and being proactive about using AI. 

Joel also highlights a recent JANS article on left axillary thoracotomy for closure of ventricular septal defect in an infant with situs solitus and extreme levoposition of the heart.  

In addition, Joel explores a surgical technique of exposing the intramyocardial left anterior descending artery, open surgical repair of a giant abdominal aorta aneurysm filled with multiple stent grafts, and aortic valve replacement with mitral and tricuspid valve repair via a right anterior thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Creating Opportunities From Challenging Anatomy: Left Axillary Thoracotomy for Closure of Ventricular Septal Defect in an Infant With Situs Solitus and Extreme Levoposition of the Heart 

CTSNET Content Mentioned 

1.) Surgical Technique of Exposing Intramyocardial Left Anterior Descending Artery 

2.) Open Surgical Repair of a Giant Abdominal Aorta Aneurysm Filled With Multiple Stent Grafts 

3.) Aortic Valve Replacement With Mitral and Tricuspid Valve Repair Via a Right Anterior Thoracotomy 

Other Items Mentioned 

1.) Cardiac Surgical Arrest—An International Conversation, Part 1 

2.) Obituary for Dr. Robert Lowery 

3.) Winners of the 2025 CTSNet 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.

Chapters

00:00 Intro

00:57 Dr. Marin-Cuartas Feature

02:28 SHURUI Robot Feasability

05:09 Touching as Diagnostic Test

09:06 Removal of Rib Stab Hardware

13:00 Resectable EGFR-Positive NSCLC

16:12 On-Pump Beating Heart MVR

17:56 Post-Infarction Myocardial Rupture

19:52 Head-First Graft Technique

22:18 SAVR vs TAVR, Dr. Marin-Cuartas

46:44 Upcoming Events

47:52 Closing

They discuss SAVR and TAVR guidelines, the suitability of SAVR vs TAVR for patients aged 65-75, and mechanical heart valves. They also explore surgery after TAVR, TAVR after TAVR, and the future of addressing aortic valve stenosis.  

Joel also highlights recent JANS articles on the safety and feasibility of novel single-port robotic-assisted lobectomy/segmentectomy for lung cancer, touching (proximity) as a companion diagnostic test, long-term outcomes after removal of rib stabilization hardware in patients with blunt chest trauma, and advancing the needle on the management of resectable EGFR-positive NSCLC.   

In addition, Joel explores an on-pump beating heart mitral valve repair through right anterior minithoracotomy, post-infarction myocardial rupture treated with surgical repair and graded mechanical support, and a head-first graft technique in aortic arch replacement. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Safety and Feasibility of Novel Single-Port Robotic-Assisted Lobectomy/Segmentectomy for Lung Cancer 

2.) Touching (Proximity) as a Companion Diagnostic Test  

3.)  Long-Term Outcomes After Removal of Rib Stabilization Hardware in Patients With Blunt Chest Trauma 

4.) Advancing the Needle on the Management of Resectable EGFR-Positive NSCLC: Is Neoadjuvant Osimertinib the Answer? 

CTSNET Content Mentioned 

1.) On-Pump Beating Heart Mitral Valve Repair Through Right Anterior Mini Thoracotomy 

2.) Drain, Patch, Unload: Post-Infarction Myocardial Rupture Treated With Surgical Repair and Graded Mechanical Support 

3.) Head-First Graft Technique in Aortic Arch Replacement 

Other Items Mentioned 

1.) Career Center  

2.) 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.

Chapters

00:00 Intro

01:30 ESTS 2025 Conference

09:11 SHURUI Robot Study

10:04 Willard A. Fry

12:44 Transplant Recipient Pregnancy Outcomes

15:25 Low-Flow, Low-Gradient Aortic Stenosis

17:12 Warm Ischemic Intervals Effect

19:16 Extracorp Circulation vs Conventional

23:23 Femoral Cannulation for CPB Min Invasive

24:25 Valve Sparing Aortic Root Replacement

25:27 Valve Surgery Podcast w Michael Mack

27:21 Upcoming Events

27:54 Closing

He discusses the key themes and takeaways from the event, the SHURUI single-port robotic system, the hands-on experience with the da Vinci Single-Port system led by Dr. Tom Routledge, and the extraordinary guest lecture from Ernő Rubik, the inventor of the Rubik’s cube. Joel also highlights various presentations from the meeting, including “Does the Fissureless Technique Really Reduce Air Leak? Results of the Prospective Randomized Study Fissureless Versus Fissurefirst (3F Trial)” by Tom Routledge, “Tour D’Horizon About Potential Newcomings in the 10th Edition” by Valerie Rusch, and much more. Additionally, he pays tribute to Willard A. Fry and his significant accomplishments.  

Joel also highlights recent JANS articles on pregnancy outcomes in 53 female lung transplant recipients, outcomes of surgical versus transcatheter aortic valve replacement in patients with low-flow, low-gradient aortic stenosis, the effect of warm ischemic intervals on primary graft dysfunction in normothermic regional perfusion for donation after circulatory death heart transplant, and minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery. 

In addition, Joel explores femoral cannulation for CPB during minimally invasive cardiac surgery, a presentation from the Society for Cardiothoracic Surgery in Great Britain and Ireland annual meeting on “Valve Sparing Aortic Root Replacement—Tips and Tricks,” and the one-year anniversary episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with cardiothoracic surgery pioneer Dr. Michael Mack on the future of valve surgery. Before closing, Joel highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Pregnancy Outcomes in 53 Female Lung Transplant Recipients 

2.) Outcomes of Surgical Versus Transcatheter Aortic Valve Replacement in Patients With Low-Flow, Low-Gradient Aortic Stenosis 

3.) The Effect of Warm Ischemic Intervals on Primary Graft Dysfunction in Normothermic Regional Perfusion for Donation After Circulatory Death Heart Transplant 

4.) Minimal Invasive Extracorporeal Circulation Versus Conventional Cardiopulmonary Bypass in Cardiac Surgery: A Contemporary Systematic Review and Meta-Analysis 

CTSNET Content Mentioned 

1.) Femoral Cannulation for CPB During Minimally Invasive Cardiac Surgery 

2.) SCTS 2025 | Valve Sparing Aortic Root Replacement—Tips and Tricks 

3.) The Atrium: The Future of Valve Surgery 

Other Items Mentioned 

1.) Safety and Feasibility of Novel Single-Port Robotic-Assisted Lobectomy/Segmentectomy for Lung Cancer 

2.) A Eulogy for Willard A. Fry 

3.) 2025 SCTS Annual Meeting Videos  

4.) The Atrium—All Episodes  

5.) Career Center  

6.) 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.

Chapters

00:00 Intro

01:33 Surgical Instrument Donations

02:43 Adverse Outcomes in Surgery

10:05 Lymph Node NSCLC Study

12:45 Pleural Invasion by AI Analysis

15:54 Robotic vs Conventional MVR

18:55 Postop Atrioventricular Block

22:36 Extra-Anatomical Bypass & AVR

24:25 Redo MV w Different Strategies

27:57 Manage Aorto-Mitral Abscess Endocarditis

30:41 GOMED Interview

43:04 Closing

They discuss the reasons behind its creation, its mission, the current status of the organization, and how individuals and companies can get involved. Additionally, they explored some of the equipment GOMED has and what it needs, and the various locations it serves. Joel also shares insights about a recent patient of his with Marfan Syndrome and pectus excavatum, emphasizing the ongoing importance of the N=1 trial in clinical research. 

Joel also highlights recent JANS articles on lymph node sampling and survival in non-small cell lung cancer, pleural invasion of peripheral cT1 lung cancer by deep learning analysis of thoracoscopic images, clinical outcomes and costs of robotic-assisted vs conventional mitral valve repair, and postoperative atrioventricular block after surgery for congenital heart disease.  

In addition, Joel explores extra-anatomical aortic bypass and aortic valve replacement in a patient with aortic coarctation and severe aortic insufficiency, totally endoscopic redo mitral valve surgery with different myocardial protection strategies, and managing aorto-mitral abscess endocarditis after previous AVR with an LVOT enlargement procedure. Before closing, he highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Lymph Node Sampling and Survival in Non-Small Cell Lung Cancer: A 10-Year Danish Cohort Study 

2.) Pleural Invasion of Peripheral cT1 Lung Cancer by Deep Learning Analysis of Thoracoscopic Images: A Retrospective Pilot Study 

3.) Clinical Outcomes and Costs of Robotic-Assisted vs Conventional Mitral Valve Repair: A National Analysis 

4.) Postoperative Atrioventricular Block After Surgery for Congenital Heart Disease: Incidence, Recovery and Risks 

CTSNET Content Mentioned 

1.) Extra-Anatomical Aortic Bypass and Aortic Valve Replacement in a Patient With Aortic Coarctation and Severe Aortic Insufficiency 

2.) Totally Endoscopic Redo Mitral Valve Surgery With Different Myocardial Protection Strategies 

3.) Managing Aorto-Mitral Abscess Endocarditis After Previous AVR With an LVOT Enlargement Procedure 

Other Items Mentioned 

1.) Global Outreach for Medical Equity and Development 

2.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach 

3.) Aortic Valve Replacement Series  

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.

Chapters

00:00 Introductions

01:18 Dr. Mack Background

03:41 Becoming a CT Surgeon

07:53 Path to Academic Surgery

10:19 Unconventional Thinking

11:30 TAVR vs SAVR

21:54 Surgical Replacement Future

25:59 Minimally Invasive Preference

27:27 Long-Term Data Impact

30:58 Aortic Valve Research Status

35:35 Mitral Clip vs Repair, Tricuspid

41:40 Mitral Robotic

44:38 Artificial Intelligence

48:43 Specializing Your Career

52:53 Three Career Tips

They discuss transcatheter aortic valve replacement (TAVR), surgical aortic valve replacement (SAVR), MitraClips, the mitral valve, and the tricuspid valve. They also explore future research, the role of artificial intelligence (AI) and Dr. Mack provides advice for trainees.  

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on radial artery harvesting with Dr. Faisal Bakaeen of the Cleveland Clinic.

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.

Chapters

00:00 Intro

01:29 Integrative Medicine

09:13 Bar Dislocation, Pectus

10:53 Effective Circulating Volume Fraction

13:14 Repair vs Replacement, Edge-to-Edge

16:14 Relaxed TAVI Age Threshold?

18:14 Supravalvar Aortic Stenosis Transaxillary

20:09 How-To, AAE Tricuspid Repair

21:49 Modified Robotic Tracheobronchoplasty

23:34 Dr. Fuller-Shavel, Integrative Oncology

56:21 Upcoming Events

58:28 Closing

They discuss what integrative oncology entails, mistletoe therapy, oncothermia, and the innovative integrative oncology app called Oncio. They also explore guidelines relating to this topic, nutrition, and immune checkpoint inhibitors. Dr. Fuller-Shavel also provides recommendations for supporting patients’ mindfulness during cancer treatment.  

Joel also highlights recent JANS articles on bar dislocation after pectus excavatum repair, effective circulating volume fraction in Type A aortic dissection, surgical mitral valve repair vs replacement after failed mitral transcatheter edge-to-edge repair, and if the age threshold for TAVI can be relaxed to below 65 years.  

In addition, Joel explores minimally invasive transaxillary repair of supravalvar aortic stenosis, how to perform an aortic annulus enlargement with tricuspid repair, and modified robotic-assisted tracheobronchoplasty in a patient with severe calcific mediastinal lymphadenopathy. Before closing, he highlights upcoming events in CT surgery.   

JANS Items Mentioned 

1.) Bar Dislocation After Pectus Excavatum Repair: A Systematic Review of Risk Factors, Stabilization Techniques, and Management Strategies 

2.) The Effective Circulating Volume Fraction in Type A Aortic Dissection: A New Risk Factor?  

3.) Surgical Mitral Valve Repair vs Replacement After Failed Mitral Transcatheter Edge-to-Edge Repair: The CUTTING-EDGE Registry 

4.) Could the Age Threshold for TAVI be Relaxed to Below 65 Years? Pros and Cons