Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.
Episodes
Aug 14, 2025
Aug 14, 2025
45 min
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.
Aug 7, 2025
Aug 7, 2025
42 min
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.
Jul 31, 2025
Jul 31, 2025
40 min
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
Jul 29, 2025
Jul 29, 2025
28 min
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.
Jul 24, 2025
Jul 24, 2025
41 min
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.
Jul 17, 2025
Jul 17, 2025
35 min
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.
Jul 10, 2025
Jul 10, 2025
32 min
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.
Jul 3, 2025
Jul 3, 2025
51 min
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.
Jun 26, 2025
Jun 26, 2025
46 min
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.
Jun 24, 2025
Jun 24, 2025
41 min
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.