Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.
Episodes
24 hours ago
24 hours ago
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Mario Castillo-Sang, the Surgical Director of Mitral Valve and Heart Failure Therapies at St. Elizabeth Healthcare, Edgewood, Kentucky, USA, about totally endoscopic cardiac surgery.
Chapters
00:00 Intro
01:17 Minimal Access Bedside Cardiac
04:37 Lung Cancer, Histological Subtype
09:29 TAVR vs SAVR, AS & CAD
12:22 Biopros TVR Outcomes
15:48 Mitral Annular Disjunction, MVR
18:47 Ozaki Technique, AV Reconst
20:46 Redo LVOT Reconst for Endocarditis
22:33 Totally Endoscopic ASD Closure TVR
24:08 Dr. Castillo-Sang, MI Bedside Endoscopy
40:51 Closing
They explore key highlights from Dr. Castillo-Sang’s CTSNet series Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach, his journey in performing endoscopic surgeries, and how he learned the techniques. Dr. Castillo-Sang shares the advantages of endoscopic surgery, as well as tips and recommendations for those wanting to learn this approach. He emphasizes the importance of the instruments he has worked with, detailing how these have improved over time. Additionally, they explore Dr. Castillo-Sang’s involvement with the Endoscopic Cardiac Surgeons Club, discussing how he got involved and providing details about the club’s upcoming annual meeting.
Joel also highlights recent JANS articles on the estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time, transcatheter vs surgical aortic valve replacement in Medicare beneficiaries with aortic stenosis and coronary artery disease, long-term outcomes after bioprosthetic tricuspid valve replacement, and outcomes of patients with mitral annular disjunction undergoing mitral valve repair.
In addition, Joel explores aortic valve reconstruction using the Ozaki technique, redo LVOT reconstruction for endocarditis, and totally endoscopic ASD closure with tricuspid valve repair. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
3.) Long-Term Outcomes After Bioprosthetic Tricuspid Valve Replacement: A Multicenter Study
4.) Outcomes of Patients With Mitral Annular Disjunction Undergoing Mitral Valve Repair
CTSNET Content Mentioned
1.) Aortic Valve Reconstruction—The Ozaki Technique
2.) Redo LVOT Reconstruction for Endocarditis
3.) Totally Endoscopic ASD Closure With Tricuspid Valve Repair
Other Items Mentioned
1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach
2.) Endoscopic Cardiac Surgeons Club
4.) Aortic Valve Replacement Series
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.
Thursday Apr 17, 2025
Thursday Apr 17, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning examines the first-ever transcontinental uniportal thoracic surgery.
Chapters
00:00 Intro
01:26 100th Episode, Future
03:01 Transcontinental Uniportal Robotics
09:52 Infective Endo in Octogenerians
12:39 Kidney Replacement Therapy, Cardiac Outcomes
15:50 Stenotic Lesions Simulation
18:59 One-Lung Ventilation, Difficult Airway
21:06 Simplified Approach to Bentall Procedure
24:25 Semi-Skeletonized Harvesting ITA
27:06 AVR and AAR in 85 YO
30:30 Swiss Army Knife Approach Series
32:21 AATS 2025
32:38 Closing
He explores the details of this significant case—location, latency, and the procedure performed—while highlighting the importance of this case, the future of robotics, and the surgeons behind this operation, Dr. Diego Gonzalez Rivas and Dr. Mugurel Bosînceanu. He also discusses Dr. Gonzalez Rivas’s new book, Healing the World, and its impact on the field of medicine.
Joel also highlights recent JANS articles on infective endocarditis in octogenarians, national outcomes of cardiac surgery in patients receiving kidney replacement therapy, computational fluid dynamics to simulate stenotic lesions in coronary end-to-side anastomosis, and the management of the expected difficult airway with planned one-lung ventilation.
In addition, Joel explores a simplified approach to the Bentall procedure, semi-skeletonized harvesting of internal thoracic arteries, and aortic valve replacement and ascending aortic replacement in an 85-year-old patient. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
1.) Infective Endocarditis in Octogenarians—A Multicenter Analysis
2.) National Outcomes of Cardiac Surgery in Patients Receiving Kidney Replacement Therapy
3.) Computational Fluid Dynamics to Simulate Stenotic Lesions in Coronary End-to-Side Anastomosis
CTSNET Content Mentioned
1.) A Simplified Approach to the Bentall Procedure
2.) Semi-Skeletonized Harvesting of Internal Thoracic Arteries
3.) Aortic Valve Replacement and Ascending Aortic Replacement in an 85-Year-Old Patient
Other Items Mentioned
1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach
2.) Aortic Valve Replacement Series
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.
Thursday Apr 10, 2025
Thursday Apr 10, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Professor Robert Sneyd, Vice Chair of Aortic Dissection Awareness UK & Ireland, about the charity’s dedication to promoting awareness of aortic dissection.
Chapters
00:00 Intro
03:52 RLAAO Isolated MR Study
09:07 Early Outcomes Reop Aortic Root
11:39 Fallot and Its Variants
16:55 Low-Dose Warfarin, Mech AV
22:02 AVR w LIMA-LAD & AAR
23:40 Pulm Thromboendarterectomy
25:28 Modified Birmingham Technique
27:32 Dr. Sneyd, Aortic Dissection Awareness
31:16 Upcoming Events
32:33 Closing
They discuss Professor Sneyd’s experience with an acute Type A aortic dissection and the lifesaving operation he underwent. Additionally, they explore his involvement with Aortic Dissection Awareness UK & Ireland and the charity’s new programs. They also cover the organization’s outreach efforts and the important patient guide available on their website.
Joel also reviews recent JANS articles on mortality and stroke after routine left atrial appendage occlusion in patients undergoing isolated mitral repair without atrial fibrillation in the United States, if early outcomes of reoperative aortic root surgery is impacted by previous root procedures and indicate reintervention, Fallot and its variants from diagnosis to pulmonary valve replacement, and low-dose warfarin with a novel mechanical aortic valve.
In addition, Joel explores aortic valve replacement with LIMA to LAD artery and an ascending aortic replacement, step-by-step pulmonary thromboendarterectomy for chronic thromboembolic disease, and Norwood-Sano Stage I palliation for hypoplastic left heart syndrome. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
3.) Fallot and Its Variants: From Diagnosis to Pulmonary Valve Replacement
CTSNET Content Mentioned
1.) Aortic Valve Replacement With LIMA to LAD Artery and an Ascending Aortic Replacement
2.) Step-by-Step Pulmonary Thromboendarterectomy for Chronic Thromboembolic Disease
Other Items Mentioned
1.) Aortic Dissection Awareness UK & Ireland Website
2.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration
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.
Thursday Apr 03, 2025
Thursday Apr 03, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Salim Aziz, thoracic and cardiovascular surgeon and clinical professor at George Washington University, about computed tomography (CT) scan-negative type A dissection.
Chapters
00:00 Intro
00:57 Dr. Aziz Preview
02:01 Bringing International Colleagues to Centers
07:01 Ambulation Protocol ECMO
09:12 COPD Severity, Aortic Aneurysm
11:37 Robotic Mitral Repair Learning Curve
15:43 Ross Procedure in Neonates, Analysis
19:21 Tirone David Keynote
21:52 AVR 101
23:08 Robotic Beating-Heart TECAB: LIMA-LAD
25:17 Dr. Aziz, CT Scan-Negative Type A Dissection
43:52 Closing
They discuss Dr. Aziz’s experience with cases that present as CT scan-negative, discussing the details of these cases and the concerning frequency with which aortic dissections are overlooked. They also explore routine transesophageal echocardiogram (TEE) in the operating room, finding tears, and aortic aneurysms.
Joel also reviews recent JANS articles on the ambulation protocol for adult patients receiving extracorporeal membrane oxygenation, if the severity of chronic obstructive pulmonary disease is associated with adverse outcomes after open thoracoabdominal aortic aneurysm repair, the learning curve of robotic mitral repair, and long-term outcomes following the Ross procedure in neonates and infants.
In addition, Joel explores a 2024 London Core Review Cardiothoracic Surgery Course on “Surgical Treatments of Aortic Root Aneurysms,” aortic valve replacement 101 through an upper ministernotomy, and robotic beating-heart totally endoscopic coronary bypass. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
CTSNET Content Mentioned
2.) Aortic Valve Replacement 101 Through an Upper Ministernotomy
3.) Robotic Beating-Heart Totally Endoscopic Coronary Bypass (TECAB): LIMA to LAD
Other Items Mentioned
1.) Putative Computed Tomography Scan-Negative Type A Dissection
2.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration
3.) President's Series With Husam Balkhy | ISMICS President
4.) London Core Review Registration
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.
Thursday Mar 27, 2025
Thursday Mar 27, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning recaps two presentations delivered at the Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting 2025.
Chapters
00:00 Intro
02:57 "Teamship," Sir Woodward
09:23 Virtual Surgery Training, Dr. Ahmed
12:55 Upcoming Lung Surgery Trials
14:48 Needle Aspiration & Forceps Biopsy
17:26 Approaches to Clinical Trial Designs
22:10 Noninvasive Ventilation Cardiac Impact
24:59 Lung Volume Reduction, Severe Emphysema
29:22 How To—Upper Ministernotomy
30:45 Valve-Sparing ARR Using Reimplant Tech
32:02 ARCA Management Exploration
33:59 Upcoming Events
34:41 WTS Webinar Series
35:32 Closing
The first presentation was delivered by Sir Clive Woodward, the Rugby World Cup-winning coach, who gave an inspiring talk on "Teamship" and winning behaviors. The second presentation that Joel recaps was delivered by Professor Shafi Ahmed, a multiaward-winning surgeon and an evangelist for augmented and virtual reality, who discussed livestreaming operations, using virtual reality in surgical operations, and virtual medical school.
Joel also reviews recent JANS articles on the diagnostic yield and synergistic impact of needle aspiration and forceps biopsy with electromagnetic navigation bronchoscopy for peripheral pulmonary lesions, the challenges of conventional and novel approaches to clinical trial designs in cardiovascular medicine, the impact of noninvasive ventilation before and after cardiac surgery for preventing cardiac and pulmonary complications, and surgical and bronchoscopic lung volume reduction for severe emphysema.
In addition, Joel explores how to perform an upper ministernotomy, valve-sparing aortic root replacement using the reimplantation technique, and an exploration of anomalous right coronary artery management with Drs. Sameh Said and Vince Gaudiani. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
CTSNET Content Mentioned
1.) How to Perform an Upper Ministernotomy
2.) Valve-Sparing Aortic Root Replacement Using the Reimplantation Technique
3.) Anomalous Right Coronary Artery Management: An Exploration With Sameh Said and Vince Gaudiani
Other Items Mentioned
1.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration
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.
Tuesday Mar 25, 2025
Tuesday Mar 25, 2025
In this month’s episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Thomas D'Amico about VATS lobectomy.
Chapters
00:00 Introduction
01:47 Background
04:11 Indications
04:51 Preoperative Assessment
07:12 Setup
08:21 Patient Positioning
11:26 Basics
13:36 D'Amico's Port Placement
16:46 Uniportal
22:03 Steps
22:44 Anterior-Posterior Order
25:45 Anatomy
26:45 Instruments
30:54 Pleural Dissection
31:33 Inferior Pulmonary Ligament
31:39 Pulmonary Vein
32:01 Artery/Bronchus Dissection
33:38 Nodal Resection
36:25 Tips & Tricks
38:48 Specimen Removal
39:10 Closure
40:02 Postoperative Care
45:01 Outcomes
45:31 CT Surgery Training Advice
They discuss the set-up, patient positioning, port placement, dissection of hilar structures, tips and tricks, and more. They also discuss preoperative assessment, nodal resection, specimen removal, closure, and outcomes.
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 ECMO.
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.
Thursday Mar 20, 2025
Thursday Mar 20, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning examines future cardiothoracic surgery robotic systems.
Chapters
00:00 Intro
01:05 SCTS 2025
02:50 Intuitive Single-Port System
10:00 Other Robotics in Development
12:49 Medtronic Innovations
15:53 Tumor Air Spaces Spread
18:21 Virtual Reality Effect on Patients
19:58 MR for Isolated Leaflet Lesion
21:48 Post-Surgery Proning Obese ARS Syndrome
23:31 Robotic Bi Ortho Lung Transplant
25:51 Video Competition 2nd and 3rd Place
26:59 Repair of Bileaflet MV Prolapse
27:46 Robotic ASD Closure via LA
28:46 Upcoming Events
29:42 Women in Thoracic Surgery Webinar
30:46 Closing
He discusses the new da Vinci Single-Port surgical system, single-port robotic systems, and the cost difference between single-port and multiport robotic systems. He also examines DV5 technology, the potential of utilizing lasers in robotics, and other practices that are interested in robotic systems.
Joel also reviews recent JANS articles addressing whether tumors spread through air spaces is a determinant for treatment of clinical stage I non-small cell lung cancer, the effect of virtual reality on postoperative anxiety and pain in patients following cardiac surgery, long-term results of edge-to-edge and neochordal mitral repair for isolated anterior leaflet lesions, the prone position in obese patients with acute respiratory distress syndrome after cardiothoracic surgery.
In addition, Joel explores minimally invasive bilateral orthotopic lung transplant with robotic assistance, repair of bileaflet mitral valve prolapse through an upper ministernotomy, and robotic-assisted atrial septal defect closure via the left atrium. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
CTSNET Content Mentioned
1.) Minimally Invasive Bilateral Orthotopic Lung Transplant With Robotic Assistance
2.) Repair of Bileaflet Mitral Valve Prolapse Through an Upper Ministernotomy
3.) Robotic-Assisted Atrial Septal Defect Closure Via the Left Atrium: Dual Case Reports
Other Items Mentioned
1.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration
2.) 2024 CTSNet Resident Video Competition Winners
3.) President's Series With Husam Balkhy | ISMICS President
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.
Thursday Mar 20, 2025
Thursday Mar 20, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning examines how to prevent adverse publicity by patients on social media.
Chapters
00:00 Intro
02:01 Patient-Social Media Interaction
11:56 Lung Cancer Screening Recommendations
15:29 Perc vs Surg Revasc, SWEDEHEART Registry
18:06 Down Syndrome Patient Outcomes
19:20 Nighttime Cardiovascular Staffing Impact
23:42 Samurai Cannulation
28:30 Off-Pump AAD Via Upper Ministernotomy
30:35 Robotic Thoracic Truncal Vagotomy
31:59 Upcoming Events
33:02 Closing
He explores the benefits and drawbacks of patient groups on social media, explains how social media impacted the Shanghai Pulmonary Hospital, and provides examples of online patient groups. He also discusses whether surgeons should encourage patients to post on social media, what roles surgeons should have in online patient groups, and discusses his own experience with online patient groups.
Joel also reviews recent JANS articles on lung cancer screening and USPSTF recommendations, percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease, outcomes in adult congenital heart disease patients with Down syndrome undergoing a cardiac surgical procedure, and the impact of nighttime cardiovascular intensive care unit staffing on failure to rescue and revenue.
In addition, Joel explores Samurai (the Direct True Lumen Technique) cannulation in acute type I aortic dissection, off-pump aortic arch debranching via upper ministernotomy, and robotic thoracic truncal vagotomy. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
1.) Lung Cancer Screening and USPSTF Recommendations
3.) Outcomes in Adult Congenital Heart Disease Patients With Down Syndrome Undergoing a Cardiac Surgical Procedure
4.) Impact of Nighttime Cardiovascular Intensive Care Unit Staffing on Failure to Rescue and Revenue
CTSNET Content Mentioned
1.) Samurai (the Direct True Lumen Technique) Cannulation in Acute Type I Aortic Dissection
2.) Off-Pump Aortic Arch Debranching Via Upper Ministernotomy
3.) Robotic Thoracic Truncal Vagotomy
Other Items Mentioned
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.
Thursday Mar 06, 2025
Thursday Mar 06, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning examines surgical staplers. He explores the history of surgical staplers, the evolution of surgical staplers, and discusses the company that created the first automated minimally invasive surgical stapler—United States Surgical Corporation (USSC). He also discusses details about the AutoSuture Premium Poly stapler and why it is still being created. Joel also shares details about when he visited a production line that is responsible for creating surgical staplers. He discusses his experience and his highlights from this event, which includes meeting Dr. Rene Petersen and Dr. Laurens Ceulemans.
Joel also reviews recent JANS articles on heart transplantation and donation after circulatory death in children, priorities for medical device regulatory approval, transplantation of a genetically modified porcine heart into a live human, and mechanisms of repair failure after mitral valve repair using chordal replacement.
In addition, Joel explores treating intractable hiccups by clipping the phrenic nerve using VATS, robotic totally endoscopic CryoMaze ablation under ventricular fibrillatory arrest, and a new podcast episode from Dr. Alice Copperwheat, “The Atrium: Internal Mammary Artery Harvesting,” with expert guest Dr. David Taggart. Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
3.) Transplantation of a Genetically Modified Porcine Heart Into a Live Human
4.) Mechanisms of Repair Failure After Mitral Valve Repair Using Chordal Replacement
CTSNET Content Mentioned
1.) Treating Intractable Hiccups by Clipping the Phrenic Nerve Using VATS
2.) The Atrium: Internal Mammary Artery Harvesting
3.) Robotic Totally Endoscopic Cryo-Maze Ablation Under Ventricular Fibrillatory Arrest
Other Items Mentioned
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.
Friday Feb 28, 2025
Friday Feb 28, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Mujtaba Mubashir, CTSNet JANS editor and surgical resident at Beth Israel Deaconess Medical Center, about being a JANS editor. They discuss what JANS is, their favorite part about JANS, and their favorite articles. They also explore highlights from the 61st Society of Thoracic Surgeons Annual Meeting, including how to manage chest tubes after surgery and their favorite part of the meeting. Joel also shares details about his recent trip to Accra, Ghana, for the first Pan-African Society for Cardiothoracic Surgery (PASCaTS) and Global Heart Forum summit. He discusses different organizations, including Emergency NGO Sudan and Every Heartbeat Matters, examines various mission models, and discusses patients and surgeons he met at the summit.
Joel also reviews recent JANS articles on moving toward standardization in robotic lung transplants, how single lung transplantation is safe when the other lung is declined, perioperative outcomes and survival of modified subxiphoid video-assisted thoracoscopic surgery thymectomy for T2-3 thymic malignancies, and robotic thoracic surgery using the single-port robotic system.
In addition, Joel explores how to replace a severely calcified mitral valve, preoperative management of patients at high risk for recurrent laryngeal nerve injury during esophagectomy, and a presentation from the 10th Annual International Coronary Congress, “Maintaining CABG as a Gold Standard in 2024.” Before closing, he highlights upcoming events in CT surgery.
JANS Items Mentioned
2.) Single Lung Transplantation Is Safe When the Other Lung Is Declined
CTSNET Content Mentioned
1.) How to Replace a Severely Calcified Mitral Valve
2.) ICC 2024 | Maintaining CABG as a Gold Standard In 2024
Other Items Mentioned
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.