Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.
Episodes
Tuesday Sep 30, 2025
Tuesday Sep 30, 2025
In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. John Puskas, professor of surgery at Emory University, Chief of Cardiothoracic Surgery at Emory University Hospital Midtown, and Wilton Looney Director at the Emory Carlyle Fraser Heart Center in Atlanta, Georgia, USA, about proximal coronary anastomosis.
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
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 Sep 25, 2025
Thursday Sep 25, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Drs. Daniel Brockman, Professor of Small Animal Surgery at The Royal Veterinary College, London, England, and Matteo Rossanese, Senior Lecturer in Small Animal Surgery at The Royal Veterinary College, about performing cardiothoracic surgery in animals.
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
CTSNet Content Mentioned
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
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 Sep 18, 2025
Thursday Sep 18, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Alexis Shafii, professor of surgery and surgical director of heart transplantation at The Texas Heart Institute at Baylor College of Medicine, about the first in-human BiVACOR total artificial heart implantation.
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
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
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 Sep 11, 2025
Thursday Sep 11, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Adanna Akujuo, a cardiothoracic surgeon and the surgical director of the Structural Heart Program at UVA Health University Medical Center, about the Voom Foundation and its trips to Africa.
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
3.) Effect of Duration of Donor Ventilation on Lung Transplant Outcomes
5.) A Soft Robotic Total Artificial Hybrid Heart
CTSNET Content Mentioned
2.) Minimally Invasive Approach for Atrial Septal Defect Closure
3.) Redo Aortic Valve Replacement Via Partial Upper Resternotomy
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 Sep 04, 2025
Thursday Sep 04, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Nicholas Smedira, a cardiac surgeon at the Cleveland Clinic, about mitral valve-induced left ventricular outflow tract (LVOT) obstruction with minimal septal hypertrophy.
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
3.) Endobronchial Valve Therapy Versus Lung Volume Reduction Surgery in the United States
CTSNET Content Mentioned
1.) Repair of Ruptured Right Coronary Artery Aneurysm
Other Items Mentioned
2.) Cardiac Surgical Arrest—An International Conversation 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 Aug 28, 2025
Thursday Aug 28, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Robert Cerfolio, Chief of the Division of Thoracic Surgery at NYU Langone Health, about NYU Langone Health’s rise in hospital rankings.
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
4.) Foundational Endovascular Concepts and Devices for Cardiac Surgeons
CTSNET Content Mentioned
2.) Removal of a Left Atrial Myxoma With a Ministernotomy
Other Items Mentioned
1.) Best Hospitals for Cardiology, Heart & Vascular Surgery
3.) Cardiac Surgical Arrest—An International Conversation Series
4.) Resident 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.
Tuesday Aug 26, 2025
Tuesday Aug 26, 2025
In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Agathe Seguin-Givelet, a thoracic surgeon at Ambroise Pare-Hartmann Hospital in France, about segmentectomy.
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.
Thursday Aug 21, 2025
Thursday Aug 21, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Kenneth Liao, professor of surgery and chief of the Division of Cardiothoracic Transplantation and Circulatory Support at Baylor College of Medicine, about performing the world’s first adult robotic heart surgery in the United States using a subxiphoid approach.
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
3.) Superficial Parasternal Intercostal Plane Block and Full Sternotomy; A Randomized Trial
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
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 Aug 14, 2025
Thursday Aug 14, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Todd Rosengart, professor and chair of the Michael E. DeBakey Department of Surgery at Baylor College of Medicine, about his team performing the world’s first adult robotic heart surgery in the United States.
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
3.) Increased Prevalence of Stroke After Heart Transplant in the New Allocation System Era
CTSNET Content Mentioned
1.) Robotic Left Atrial Appendage Occlusion
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
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 Aug 07, 2025
Thursday Aug 07, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Mara Antonoff, Associate Professor of Thoracic and Cardiovascular Surgery and Program Director for Education at the University of Texas MD Anderson Cancer Center, and President of Women in Thoracic Surgery, about chest tubes.
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
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
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.