Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.
Episodes
2 hours ago
2 hours ago
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Zain Khalpey, an assistant attending surgeon at NewYork-Presbyterian/Columbia University Irving Medical Center, NY, USA, adjunct assistant professor of surgery at Columbia University Irving Medical Center, NY, USA, and Chief Medical AI Officer, Chair of Applied Clinical AI, and Director of Applied Translational Artificial Research Institute (ATARI), AZ, USA, about utilizing artificial intelligence (AI) in cardiothoracic surgery.
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
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
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.
2 days ago
2 days ago
In this edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Rakesh Arora, Director of Cardiothoracic Critical Care and a professor in the Department of Surgery and Anesthesia at Northwestern Medicine, Chicago, IL, USA. They discuss managing arrest in patients with temporary mechanical circulatory support (tMCS), focusing on a paper Arora authored titled “EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery.”
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
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 02, 2026
Thursday Apr 02, 2026
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Adam Greenbaum, an Associate Professor of Medicine at Emory School of Medicine and Co-director of the Emory Structural Heart and Valve Center, Atlanta, GA, USA, about the groundbreaking percutaneous coronary artery bypass graft procedure he developed called the ventriculo-coronary transcatheter outward navigation and reentry (VECTOR) procedure.
Chapters
00:00 Intro
02:46 FDA Device Recall
03:52 JANS 1, CDC WONDER Aortic Stenosis
06:10 JANS 2, Free vs In-Situ RIMA-CABG
08:04 JANS 3, AF Worsens Outcome of MVR
09:52 JANS 4, EXCEL Trial
12:29 New Website
13:43 Video 1, Ross Procedure Technique
16:16 Video 2, Total Arch Replacement
18:38 Video 3, Pleural Sepsis Podcast
20:51 Dr. Greenbaum, VECTOR Procedure
40:34 Upcoming Events
41:18 Career Center
41:43 Closing
They delved into the development and rationale behind this innovative technique, which aims to provide a solution for patients with no other options, particularly those with narrow sinuses or low-lying coronaries. Additionally, they discussed other leaflet modification methods and the criteria for patient selection for the VECTOR procedure. The conversation also covered the technical steps involved in the procedure, along with specific cases in which it has been utilized, as well as the challenges faced and troubleshooting done by the surgeons. Finally, they explored the future of this procedure.
Joel also highlights recent JANS articles on concerning trends seen in aortic stenosis-related mortality, a meta-analysis on free vs in-situ right internal mammary artery as a conduit in coronary artery bypass surgery, if atrial fibrillation worsens outcome of mitral valve repair for degenerative mitral regurgitation, and the EXCEL trial on spontaneous myocardial infarction after left main revascularization.
In addition, Joel explores the Ross procedure with annular stabilization, interposition graft, and loose-jacket technique, total arch replacement with a novel dual stent device, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Professor Eric Lim about pleural sepsis. Before closing, Joel highlights upcoming events in CT surgery.
JANS Items Mentioned
1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER
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
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 26, 2026
Thursday Mar 26, 2026
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Sameer Hirji, an associate surgeon at Brigham and Women's Hospital in Boston, MA, USA, about a paper he presented on at the 62nd Society of Thoracic Surgeons Annual Meeting titled “Concerning Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER.”
Chapters
00:00 Intro
02:38 JANS 1, Female CT Surgeons NYT Article
04:38 JANS 2, Biopros vs Mech SAVR >65 YO
07:32 JANS 3, Fissure Last Tech, Randomized Trial
09:58 JANS 4, Ozaki Procedure, Perf & Durability
12:46 Video 1, MI Left Atrial Myxoma Resection
14:43 Video 2, Conduction System-Sparing Modified AVR
16:42 Video 3, RCAA w Coronary SF
18:55 Dr. Hirji, CDC WONDER Aortic Stenosis
31:40 Upcoming Events
32:11 Closing
They discussed the study itself, including its overall results, as well as the demographic factors analyzed—such as race, gender, and location—and the results related to these demographics. They also addressed the limitations of the data used and explored possible reasons for the observed results, such as intervention strategies, underdiagnosis, and the prevalence of asymptomatic patients. The conversation further emphasized the importance of patient selection and the heart team.
Joel also highlights recent JANS articles on female cardiothoracic surgeons, unlocking the male fortress, bioprosthetic versus mechanical surgical aortic valve replacement in patients ≥65 years of age, results from a prospective randomized controlled trial on if the fissure last technique really reduces postoperative air leak after lung resection, and mid-term valve performance and durability of the Ozaki procedure in patients on chronic dialysis.
In addition, Joel explores a minimally invasive left atrial myxoma resection, safety and efficacy of a cardiac conduction system-sparing modified aortic valve replacement, and a surgical approach to right coronary artery aneurysm with coronary sinus fistula. Before closing, Joel highlights upcoming events in CT surgery.
JANS Items Mentioned
1. Female Cardiothoracic Surgeons, Unlocking the Male Fortress
2. Bioprosthetic Versus Mechanical Surgical Aortic Valve Replacement in Patients ≥65 Years of Age
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
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 24, 2026
Tuesday Mar 24, 2026
In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Professor Eric Lim, Professor of Thoracic Surgery at Imperial College London and Consultant Thoracic Surgeon at the Royal Brompton Hospital in London, UK, about pleural sepsis.
Chapters
00:00 Intro
00:30 Dr. Lim Background
01:26 Why CT Surgery & Clinical Research?
05:09 Definition & Overview
07:50 Causes
09:29 Clinical Presentations & Investigations
16:03 Management, RAPID Score
19:49 Medical Management
22:15 Chest Tube Management (ICD)
25:12 IF, Medical Decortication
25:48 Surgical Management
29:30 History
30:34 Debridement & Decortication, Approach
34:30 Patient Positioning
35:18 Thoracotomy
38:43 VATS
39:37 Technical Steps
43:18 Postoperative Management
49:37 Complications
50:58 Summarizing Points
51:50 Surgery Training Advice
They provide an overview of pleural sepsis, highlighting its three stages: the exudative stage, fibrinopurulent stage, and organizing stage. The discussion covers its history and causes, including complications from pneumonia. They also examine symptoms, failure to progress, and imaging techniques such as ultrasound. Additionally, they delve into pleural fluid analysis, the RAPID score, and management strategies, including medical interventions, chest tube drainage, and intrapleural fibrinolytics. Various surgical management strategies are discussed as well, including thoracotomy, video-assisted thoracoscopic surgery (VATS), and robotic approaches. Finally, they address chest tube management, respiratory physiotherapy, acute complications, and long-term complications.
The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Keep an eye out for next month’s episode.
Disclaimer
The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.
Thursday Mar 19, 2026
Thursday Mar 19, 2026
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Shanda Blackmon, a thoracic surgeon and Professor of Surgery, as well as the Director of the Lung Institute at Baylor College of Medicine, Houston, TX, USA, about an article from The New York Times in which she was featured, titled “Female CT Surgeons, Unlocking the Male Fortress.”
Chapters
00:00 Intro
01:35 JANS 1, Fractured Sternal Wires Post-Surgery
05:21 JANS 2, ERAS Protocols in Spain, Consensus Study
07:00 JANS 3, Preserving Native MVs in VSD & MR Patients
09:53 JANS 4, Sternal Closure After Norwood
12:15 Video 1, LIMA Harvest, Robotic Harmonic Scalpel
13:55 Video 2, Butterfly Resection for MV Leaflets
15:26 Video 3, Bidirectional Glenn via Axill Thorac
17:18 Dr. Blackmon, Women in CT Surgery
33:17 Upcoming Events
35:13 Closing
They discussed her experience working with The New York Times and the goal of the article. Key highlights included the pay disparity, with women cardiothoracic surgeons receiving lower pay than their male counterparts, as evidenced by the Society of Thoracic Surgeons (STS) compensation survey. Additionally, they addressed the rewarding aspects of cardiothoracic surgery, the challenges surgeons face, and the initiatives that women cardiothoracic surgeons are starting to tackle, such as the pay equity and leadership opportunities.
Joel also highlights recent JANS articles on a cross-sectional study examining wire configurations, sternal locations, and breakage sites for fractured sternal wires post-coronary surgery, a Delphi consensus study on the standardized recommendations for the implementation of enhanced recovery protocols in thoracic surgery in Spain, surgical strategy for preserving native mitral valves in infants with ventricular septal defects and mitral regurgitation, and routine primary sternal closure after the Norwood procedure.
In addition, Joel explores robotic-assisted left internal mammary harvest with the robotic harmonic scalpel, butterfly resection for prolapsed posterior mitral valve leaflets, and minimally invasive bidirectional Glenn via vertical right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.
JANS Items Mentioned
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
Other Items Mentioned
1.) Female Cardiothoracic Surgeons, Unlocking the Male Fortress
2.) 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.
Wednesday Mar 18, 2026
Wednesday Mar 18, 2026
In this episode of The Cardiac Recovery Room, moderator Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in North Carolina, USA, spoke with Drs. Rakesh Arora, Director of Perioperative and Cardiac Critical Care and Research Director in the Division of Cardiac Surgery at University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio, USA, and Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, about preoperative optimization of cardiac patients.
Chapters
00:00 Intro
01:27 Vulnerable Patients, Identifying Risk
04:24 Assessing Patients, Biological Prep
09:57 Psychological & Cognitive Prep
12:09 Time Between Discharge & Follow-Up
15:40 Anemic Patients, Iron Studies
20:12 Nutrition Screening & Malnutrition
25:30 Future Optimization Topics
They discussed the importance of identifying risks, conducting thorough assessments before the operation, and preoperative education. They also emphasized psychological and cognitive preparation, as well as the time frame between discharge and follow-up. Additionally, they addressed issues related to iron deficiency without anemia, anemic patients, and iron studies. Furthermore, they highlighted the importance of nutrition screening and addressing malnutrition as essential aspects of preoperative care.
The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.
Disclaimer
The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.
Thursday Mar 12, 2026
Thursday Mar 12, 2026
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. John Forrest, a cardiologist and Director of both Interventional Cardiology and the Structural Heart Disease Program at Yale Medicine, New Haven, CT, USA, about a paper he authored titled “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis,” published by the Journal of the American College of Cardiology.
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
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
2.) The Lifeline: End-Tidal Carbon Dioxide Monitoring in Cardiac Surgical Emergencies
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.
Thursday Mar 05, 2026
Thursday Mar 05, 2026
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Drs. Mateo Marin-Cuartas, CTSNet JANS Editor and cardiac surgeon at the University Department of Cardiac Surgery at Leipzig Heart Centre University Hospital in Leipzig, SN, Germany; and Samuel Heuts, a cardiothoracic surgeon in the Department of Cardiothoracic Surgery at Maastricht University Medical Center in Maastricht, LI, about a paper they authored titled “Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk,” published in Heart, a journal produced by the British Medical Journal.
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
2.) Postdilation of Evolut Transcatheter Heart Valves: Insights From Bench Testing
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
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.
Wednesday Mar 04, 2026
Wednesday Mar 04, 2026
In this first edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Barbara McLean, a Critical Care Clinical Nurse Specialist at Grady Memorial Hospital in Atlanta, GA, USA. They discuss end-tidal carbon dioxide (EtCO2) monitoring in cardiac surgical emergencies.
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.