Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.
Episodes
Thursday Jul 31, 2025
Thursday Jul 31, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Joseph Zacharias, a consultant cardiothoracic surgeon at the Lancashire Cardiac Center in Blackpool, England, about lifetime management of heart valve disease.
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
2.) Fit2Perform: European Society of Thoracic Surgery Survey on Member Well-Being
3.) Transcatheter Management of Left-Sided Valvular Heart Disease Following Heart Transplantation
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
Tuesday Jul 29, 2025
Tuesday Jul 29, 2025
In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Professor Pieter Kappetein, Professor of Cardiothoracic Surgery at Erasmus Medical Center and Vice President and Chief Medical Officer of Medtronic, about the future of revascularization.
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.
Thursday Jul 24, 2025
Thursday Jul 24, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with CTSNet Senior Editor Dr. Sameh Said, Chief of the Division of Pediatric and Adult Congenital Cardiac Surgery at Maria Fareri Children's Hospital, Professor of Surgery and Pediatrics at the New York Medical College, and Consultant Cardiac Surgeon at King Faisal Specialist Hospital and Research Center about performing the first successful ex utero intrapartum treatment (EXIT)-to-open atrial septectomy-to-rapid stage I Norwood palliation in a neonate with hypoplastic left heart syndrome and intact interatrial septum.
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?
4.) Inflammatory Diseases and Risk of Lung Cancer Among Individuals Who Have Never Smoked
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
Other Items Mentioned
1.) Guest Editor Series: Coronary Arterial Anomalies—Pediatric and Adult Congenital
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 Jul 17, 2025
Thursday Jul 17, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Daniel Goldstein, professor and vice chairman of Montefiore Health System in New York, USA, about the importance of mentorship.
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
CTSNET Content Mentioned
3.) Mitral Annular Calcification: Assessment, Debridement, and Annular Support for Valve Replacement
Other Items Mentioned
1.) Cardiac Surgical Arrest—An International Conversation, Part 3
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 Jul 10, 2025
Thursday Jul 10, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Jay Pal, Chief of Cardiac Surgery at the University of Washington, about AI-assisted screening for rheumatic heart disease.
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
4.) Cost-Effectiveness of Left Ventricular Assist Device for Transplant-Ineligible Patients
CTSNET Content Mentioned
1.) Excision of a Subvalvular Ring With Preservation of the Aortic Valve
3.) Repair of Rheumatic Mitral Stenosis Using the SCORE Technique
Other Items Mentioned
1.) Cardiac Surgical Arrest—An International Conversation, Part 2
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 Jul 03, 2025
Thursday Jul 03, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Ari Wes, Partner at Peninsula Plastic Surgery and CEO and Cofounder of Orchid Surgical, about clinical surgery video production.
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
CTSNET Content Mentioned
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
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 Jun 26, 2025
Thursday Jun 26, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. David Kalfa, the incoming Chief of Pediatric Cardiac Surgery and Co-Director of the Heart Institute at Nicklaus Children’s Hospital in Miami, about allogeneic mitral valve transplants.
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
4.) Sex Difference in Aortic Root Replacement With a Stentless Bioprosthesis
CTSNET Content Mentioned
3.) Direct Aortic Impella 5.5 in Post-Cardiotomy Shock
Other Items Mentioned
2.) Cardiac Surgical Arrest—An International Conversation, Part 1
3.) Winners of the 2025 CTSNet 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.
Tuesday Jun 24, 2025
Tuesday Jun 24, 2025
In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Faisal Bakaeen, Professor of Surgery at the Cleveland Clinic Lerner College of Medicine and Director of the Coronary Artery Bypass Surgery Center at the Cleveland Clinic, about radial artery harvesting.
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.
Wednesday Jun 18, 2025
Wednesday Jun 18, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with CTSNet Board Member Dr. Keith Naunheim, Vallee L. and Melba Willman Professor and Chief of Cardiothoracic Surgery at Saint Louis University School of Medicine, about artificial intelligence (AI) in cardiothoracic (CT) surgery.
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
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
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 Jun 12, 2025
Thursday Jun 12, 2025
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with CTSNet JANS Editor Dr. Mateo Marin-Cuartas, a cardiac surgeon in the University Department of Cardiac Surgery at the Leipzig Heart Center, Germany, about surgical aortic valve replacement (SAVR) vs transcatheter aortic valve replacement (TAVR).
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
2.) Touching (Proximity) as a Companion Diagnostic Test
CTSNET Content Mentioned
1.) On-Pump Beating Heart Mitral Valve Repair Through Right Anterior Mini Thoracotomy
3.) Head-First Graft Technique in Aortic Arch Replacement
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.