Tag: 2015

Mini-AVR right anterior thoracotomy

Mattia Glauber of Instituto Clinico Sant’ Amgrogio, Milan argues in favour of the right anterior mini-thoracotomy approach for the performance of minimally invasive aortic valve replacement. He uses a short video to illustrate the technique of sutureless valve insertion.

Posted in Aortic valve Tagged with: , , , , ,

Minimally invasive AVR is more than just cosmetic – the counter argument

John Pepper of the Royal Brompton and Harefield Hospitals, London, United Kingdom, as part of a debate, puts forward the alternate view that there is not yet the evidence for superiority of minimally invasive aortic valve replacement over a full

Posted in Aortic valve Tagged with: , , , ,

Minimally-invasive AVR is more than just cosmetic

Christopher Young of St Thomas’ Hospital, London, UK reviews the evidence for minimally-invasive AVR. He argues that the advantages of this approach over full sternotomy can be seen particularly in the outcomes of high risk patients.

Posted in Aortic valve Tagged with: , , ,

Uniportal VATS endochamelon camera

Eric Lim of the Royal Brompton Hospital, London, UK describes the benefits of using an endochamelon camera in performing VATS lobectomy. He includes an operative video of a sleeve resection.

Posted in Lung Tagged with: , , , , ,

Postoperative mechanical circulatory support

S. Westaby (Oxford, UK) gives an overview of the use of temporary mechanical support for post cardiotomy failure.

Posted in Mechanical support Tagged with: , , ,

Concomitant AF ablation during minimally-invasive mitral valve surgery

Joseph Zacharias of the Lancashire Cardiac Centre, Blackpool, UK gives an overview of the evidence for the use of ablation for atrial fibrillation in minimal access mitral valve surgery. He demonstrates his use of cryoablation and reviews his results.

Posted in Arrhythmias Tagged with: , , , , ,

Temporary mechanical support for critical cardiogenic shock

R. Venkateswaran (Manchester, UK) discusses temporary mechanical circulatory support as a bridge to transplantation in cardiogenic shock, considering the pathophysiology and the strategies which help decision-making.

Posted in Heart failure, Videos Tagged with: , , , ,

Laryngotracheal resections

W. Klepetko (Vienna, Austria) explains in detail the options available for complex airway resections in a variety of conditions.

Posted in Airways, Videos Tagged with: , , , , ,

Endoscopic vein harvest is best

J Zacharias (Blackpool, UK) shows a video demonstration of the technique before reviewing the evidence for and against endoscopic vein harvest.

Posted in Coronary Tagged with: , , , , ,

In favour of open vein harvest

D Souza (Örebro, Sweden) argues that an open vein harvest technique including peri-adventitial fat is best to optimise long-term patency.

Posted in Coronary Tagged with: , , , , ,

Optimising vein graft outcomes

J Pepper (London, UK) considers the causes of vein graft occlusion before looking at possible ways to improve results.

Posted in Coronary Tagged with: , , , , ,

Surgical interventions for veins

G. Angelini (London, UK) describes surgical techniques to improve vein graft patency rates.

Posted in Coronary Tagged with: , , , , ,

Measuring graft flow

G Di Giammarco (Chieti, Italy) describes his experience in graft flow measurement to improve patency outcomes.

Posted in Coronary Tagged with: , , , , , ,

Adequacy of IMA composite grafts

M Ruel (Ottawa, Canada) discusses whether single internal mammary artery grafts can adequately supply the heart.

Posted in Coronary Tagged with: , , , , , , ,

CABG for coronary artery disease

D Taggart (Oxford, UK) argues that CABG remains the best therapy for coronary artery disease in 2015.

Posted in Coronary Tagged with: , , , , ,

Mediastinal surgery robotics

F Melfi (Pisa, Italy) gives an overview of the evidence for the benefits of robotic surgery in the management of mediastinal disease.

Posted in Mediastinum Tagged with: , , , ,

Surgery in borderline lung function

G Rocco (Naples, Italy) considers the difficulties of defining the high risk patient for lung resection. He explains why he thinks that wedge resection remains a valid option is some cases and looks at the increasing importance of minimally-invasive approaches.

Posted in Lung, Videos Tagged with: , , , , ,

Robotic lung resection

A Toker (Istanbul, Turkey) explains his views on the use of VATS and robotics for lung resection.

Posted in Lung Tagged with: , , , ,

Chest wall reconstruction

G Rocco (Turin, Italy) describes materials and techniques for chest wall reconstruction after resection.

Posted in Chest wall Tagged with: , , ,

Radial artery as the second conduit

D Taggart (Oxford, UK) reviews the evidence for using the radial artery as the first choice of second conduit in coronary bypass surgery.

Posted in Coronary Tagged with: , , , , , ,

Effect of SYNTAX trial in Europe

P Kolh (Liege, Belgium) considers whether the SYNTAX trial has changed coronary artery disease practice in Europe. He reviews the results, examines the guidelines and emphasises the importance of risk models.

Posted in Coronary Tagged with: , , , , , , ,

Extended pleurectomy decortication

A Nakas (Leicester, UK) gives an overview of the surgical options before concluding that extended pleurectomy decortication should be used in suitable cases.

Posted in Pleura Tagged with: , , , , ,

SABR in borderline lung function

M Snee (Leeds, UK) explains how Stereotactic Ablative Radiotherapy (SABR) works and considers which patients are suitable for this treatment.

Posted in Lung Tagged with: , , , ,

Pushing the boundaries in thoracic surgery – lung transplantation

W Klepetko (Vienna, Austria) gives an overview of aspects of lung transplantation. He looks in detail at surgical techniques, donor organ utilisation, expanding the indications for surgery and the organisation of a service.

Posted in Transplantation Tagged with: , , , ,

First line treatment of mitral valve disease should be by open sternotomy

F Wells (Cambridge, UK) argues against the routine use of a minimal-access approach to mitral valve surgery. He recognises that good results for non-complex disease can be achieved in expert hands but believes that the open appoach is more appropriate

Posted in Mitral valve Tagged with: , , , , ,

Thoracic surgery ECMO

P-E Falcoz (Strasburg, France) gives a detailed overview of the use of extracorporeal membrane oxygenation (ECMO) in thoracic surgery. He describes the different cannulation options and looks at future possibilities.

Posted in Mechanical support Tagged with: , , , ,

Off pump CABG should be abandoned

J Sabik (Cleveland, USA), as part of a debate, argues that off-pump CABG should be abandoned as our default procedure. He reviews results from the major trials as well as metaanalyses to support his view.

Posted in Coronary Tagged with: , , , , , , ,

LVRS as gold standard for emphysema

D Waller (Leicester, UK) argues that lung volume reduction surgery remains the gold standard intervention for emphysema. He reviews the NETT trial and the evidence for valves and coils, before presenting data from his own unit.

Posted in Lung Tagged with: , , , ,

Tracheal substitutes

P Dartevelle (Paris, France) gives a detailed description of tracheal replacement using a forearm free flap.

Posted in Airways, Videos Tagged with: , , , ,

Is bilateral IMA use the gold standard?

J Sabik (Cleveland, USA) considers the evidence for bilateral internal mammary artery usage in coronary bypass surgery. He uses data from the large Cleveland clinic registry to explore the importance of time, coronary vessel anastomosed, conduit used and patient factors

Posted in Coronary Tagged with: , , , , ,

Thoracic robotics fundamentals

F Melfi (Pisa, Italy) describes her experience in the use of robotics in thoracic surgery. She looks at the history of robotic developments before explaining the potential advantages. She gives a detailed review of the literature in this area and

Posted in Lung Tagged with: , , ,

Transoesophageal echocardiography type II mitral regurgitation

A Macnab (Manchester, UK) gives a detailed description of the desirable TOE views in the assessment of the mitral valve.

Posted in Imaging, Videos Tagged with: , , , ,

Transoesophageal echocardiography type I mitral regurgitation

S Ray (Manchester, UK) gives an overview of TOE use in assessing mitral regurgitation with normal leaflet motion.

Posted in Imaging, Videos Tagged with: , , , ,

Transoesophageal echocardiography perioperative guidelines

S Reeves (Charleston, USA) reviews the SCA/ASE 2014 Perioperative Transoesophageal Echocardiography Guidelines.

Posted in Imaging, Videos Tagged with: , , , ,

Adult congenital right heart problems

L Winslow (Manchester, UK) explains the mechanisms leading to right heart problems in the adult congenital population.

Posted in Congenital, Videos Tagged with: , , , ,

Ultrasound-based approach to brain and somatic desaturation

A Denault (Montreal, Canada) describes in detail the current modalities available for cerebral monitoring.

Posted in Imaging, Videos Tagged with: , , ,

TOE in Mechanical Assist

J Ender (Leipzig, Germany) discusses the use of transoesophageal echocardiography in the setting of mechanical circulatory support.

Posted in Imaging, Videos Tagged with: , , , ,

Coagulopathy diagnosis

K Görlinger (Essen, Germany) gives an overview on the management of postoperative coagulopathy based on ROTEM results.

Posted in Blood, Videos Tagged with: , , , , , ,

Coagulopathy pathogenesis

J Thachil (Manchester, UK) gives some new insights into the coagulation cascade and the pathogenisis of bleeding after cardiac surgery.

Posted in Blood, Videos Tagged with: , , , , ,

Transoesophageal echocardiography for ITU instability

M Bewsher (Manchester, UK) considers how TOE can help in the management of the postoperative unstable cardiac surgical patient.

Posted in Imaging, Videos Tagged with: , , ,

Transcatheter mitral Edwards Fortis

V Bapat (London, UK) describes the Edwards transcatheter mitral valve replacement system, including a video animation and presentation of his early results.

Posted in Mitral valve, Videos Tagged with: , , , , , , ,

Transcatheter mitral repair overview

A Vahanian (Paris, France) reviews the current status of percutaneous mitral valve repair and considers how this field may develop in the future.

Posted in Mitral valve, Videos Tagged with: , , , , ,

Transoesophageal echocardiography in the catheter lab

A Macnab (Manchester ,UK) shows a variety of cases from the catheter laboratory illustrated with echo imaging.

Posted in Imaging, Videos Tagged with: , , ,

Intravenous iron for anaemia

T Richards (London, UK) details the importance of iron and its transport mechanisms. He then reviews the history of intravenous iron administration and looks at novel options.

Posted in Blood, Videos Tagged with: , , , , ,

Mini-mitral surgery: state of the art in Europe

P Perier (Bad Neustadt/Saale, Germany) reviews the evolution of minimally-invasive mitral valve surgery.

Posted in Mitral valve, Videos Tagged with: , , , ,

TOE type III mitral regurgitation

J Ender (Leipzig, Germany) considers functional restrictive mitral regurgitation, looking at mechanisms, measurements and therapeutic options.

Posted in Mitral valve, Videos Tagged with: , , , , , , , ,

Anaemia pathogenesis

A Klein (Cambridge, UK) reviews the incidence and causes of anaemia.

Posted in Blood, Videos Tagged with: , , ,

Preoperative anaemia management

C von Heymann (Berlin, Germany) reviews the incidence of preoperative anaemia in cardiac surgery and considers its contribution to adverse outcomes.

Posted in Blood, Videos Tagged with: , , , , ,

Adult airway stenosis endoscopy

G Sandhu (London, UK) explains the causes and describes his approach to managing airway stenoses in the adult.

Posted in Airways, Videos Tagged with: , , ,

ECHO in Outpatients

C Royse (Melbourne, Australia) discusses the potential routine use of transthoracic echocardiography, as well as other ultrasound techniques, in preoperative assessment in the outpatient setting. <iframe width=”560″ height=”315″ src=”https://www.youtube-nocookie.com/embed/Wxiu7MbhS9M?rel=0&amp;showinfo=0″ frameborder=”0″ allowfullscreen></iframe>

Posted in Imaging, Videos Tagged with: , , , ,

REPLACE trial of iv fibrinogen

R Gill (Southampton, UK) discusses the role of fibrinogen in coagulation and the REPLACE trial of its use in complex cardiovascular surgery.

Posted in Blood, Videos Tagged with: , , , , , ,

Cerebral blood flow monitoring and autoregulation

H Grocott (Winnipeg, Canada) explains the physiology of cerebral blood flow, looking at options for measurement and interventions to improve flow.

Posted in Imaging, Videos Tagged with: , , ,

Anaesthetic implications of mini-mitral surgery

K Khan (Middlesbrough, UK) discusses his approach to anaesthesia in minimally-invasive mitral valve surgery, describing tips and tricks based on his unit’s experience.

Posted in Mitral valve, Videos Tagged with: , , , , ,

Mitraclip in the UK

M Buch (Manchester, UK) looks at the current indications and outcomes for the Mitraclip, including consideration of the Everest II trial and the 2012 European Valve Guidelines.

Posted in Mitral valve, Videos Tagged with: , , , ,

Mesothelioma oncology

S Popat (London, UK) reviews the evidence for the use of chemotherapy in malignant mesothelioma and explores developing therapeutic options.

Posted in Pleura, Videos Tagged with: , , , , ,

Gaseous micro-emboli and perfusion monitoring

M Bennett (Plymouth, UK) considers how gaseous micro-emboli occur, what there effects might be, and how they might be prevented.

Posted in Videos Tagged with: , , , ,

Difficult airway management

T McLeod (Birmingham, UK) discusses anaesthetic aspects of difficult airway management.

Posted in Airways, Videos Tagged with: , , ,

Digital drains & standards of care

A Brunelli (Leeds, UK) reviews the evidence for electronic digital drainage systems. He explains the mechanism and benefits of regulated suction.

Posted in Pleura, Videos Tagged with: , , , ,

Coagulopathy prevention

D Mazer (Toronto, Canada) discusses the pharmacological prevention of coagulopathy, looking in detail at the evidence for and against the use of tranexamic acid and aprotinin.

Posted in Blood, Videos Tagged with: , , , , , ,

Non red cell treatment and adjuncts

D Mazer (Toronto, Canada) considers the management of postoperative bleeding, looking in particular at the emerging evidence for component therapy.

Posted in Blood, Videos Tagged with: , , , ,

SYNTAX trial influence in the USA

JF Sabik (Cleveland, USA) considers whether the SYNTAX trial has changed practice in the USA and, if not, why not? He reviews the trial design and results before looking at registry data to inform about current patterns of coronary artery

Posted in Coronary Tagged with: , , , , , ,

VATS lobectomy: the new standard of care?

R Petersen (Copenhagen, Denmark) describes some difficult situations in VATS lobectomy before addressing training and the learning curve.

Posted in Lung Tagged with: , , , ,

Thoracoscopy under local anaesthesia

M Munavvar (Preston, UK) describes the use of semi-rigid thoracoscopy under sedation for the diagnosis and management of pleural diseases.

Posted in Pleura Tagged with: , , , ,

Off pump CABG is here to stay

M Lemma (Milan, Italy) puts forward the argument in favour of off-pump coronary bypass surgery.

Posted in Coronary Tagged with: , , , , ,

Recent advances in interventional cardiology

N Curzen (Southampton, UK) explains the importance of physiological ischaemia and FFR in deciding optimal management for coronary disease.

Posted in Coronary Tagged with: , , , , , ,

Ultrasound to reduce CVA in off pump CABG

C Royse (Melbourne, Australia) explains why he believes that the key to reducing risk of stroke is aortic assessment.

Posted in Coronary Tagged with: , , , , , , ,

Digital drains & standards of care

A Brunelli (Leeds, UK) explains the use of digital drains in thoracic surgery and looks at the evidence for their benefits.

Posted in Pleura Tagged with: , , , , ,

Gene therapy in bypass grafts

A Baker (Glasgow, UK) explains the potential use of gene therapy in improving the outcomes of coronary bypass grafts.

Posted in Coronary Tagged with: , , , ,

Extrapleural pneumonectomy indications

P Van Schil (Antwerp, Belgium) stresses the importance of correct terminology before reviewing the results of landmark trials of surgery in the management of mesothelioma.

Posted in Pleura Tagged with: , , , , ,

Lung ultrasound in critical care

F Guarracino (Pisa, Italy) explains how ultrasound can be used in the diagnosis of intra-thoracic diseases.

Posted in Imaging Tagged with: , , , , ,

Venous External Scaffolding Technology (VEST) for veins

E Orion (Tel Aviv, Israel), the co-inventor of the device, looks at the evidence for using an external support to improve vein graft patency.

Posted in Coronary Tagged with: , , , , ,

One arterial graft is sufficient

G. Angelini (London, UK) considers the evidence for single versus multiple arterial grafts in coronary bypass surgery, looking to explain why saphenous vein remains the second conduit of choice in the majority of cases worldwide.

Posted in Coronary Tagged with: , , , , , ,

Inflammation and vein graft remodelling

P Quax (Leiden, Netherlands) describes the basic science behind vein graft remodelling, considering what factors trigger the inflammatory response.

Posted in Coronary Tagged with: , , , , ,

Endovascular therapy in acute aortic syndrome

J Brennan (Liverpool, UK) discusses the use of endovascular stenting in the treatment of acute aortic syndromes.

Posted in Aorta Tagged with: , , , , , , , ,

Pulmonary sepsis surgery

A Toker (Istanbul, Turkey) gives an overview of pulmonary infections which may require surgical intervention.

Posted in Lung Tagged with: , , ,

Residual pleural space management

G Massard (Strasbourg, France) discusses the causes of a residual pleural space and considers the options for management.

Posted in Pleura Tagged with: , , , ,

Vein graft external stenting

D Taggart (Oxford, UK) looks at the evidence for external stenting of vein grafts to optimise long-term outcomes.

Posted in Coronary Tagged with: , , , , , ,

Vein graft stem cell therapy

A. Newby (Bristol, UK) discusses the incidence and causes of vein graft failure. He considers options to improve outcomes, in particular the use of periadventitial human stem cells.

Posted in Coronary Tagged with: , , , , , ,

Pleural sepsis surgery

A Toker (Istanbul, Turkey) gives an overview of the surgical options for treating intra-pleural sepsis, emphasising the potential uses of VAC therapy.

Posted in Pleura Tagged with: , , , , ,

Reintervention following acute type A dissection repair

Posted in Aorta Tagged with: , , , , ,

Circulatory support for aortic surgery

J Elefteriades (New Haven, USA) gives ten clearly illustrated technical tips for use in aortic surgery.

Posted in Aorta Tagged with: , , , , ,

Mini Bentall procedure

T Yan (Sydney, Australia), with the aid of video clips, describes the mini-Bentall procedure through a partial upper sternotomy.

Posted in Aorta Tagged with: , , , , ,

Decision making in thoracoabdominal aortic aneurysm repair

Posted in Aorta Tagged with: , , , , ,

Thoracotomy is the gold standard

P Dartevelle (Paris, France) argues in favour of thoracotomy as the best approach for lung resections.

Posted in Lung Tagged with: , , , ,

VATS segmentectomy

Posted in Lung, Videos Tagged with: , , , ,

VATS lobectomy impact on UK resources

Posted in NHS, Videos Tagged with: , , ,

VATS in emergency thoracic practice

Posted in Trauma, Videos Tagged with: , , , ,

Minimally invasive AVR, does size matter?

Posted in Aortic valve, Videos Tagged with: , , , , ,

Robotic surgery in 2015

Posted in Technology, Videos Tagged with: , , ,

Manubrium limited AVR

Posted in Aortic valve, Videos Tagged with: , , , , , ,

Sutureless aortic valve replacement

Posted in Aortic valve, Videos Tagged with: , , , ,

Robotic Surgery

Posted in Technology, Videos Tagged with: , , , ,

Specialised thoracic training

Posted in NHS, Videos Tagged with: , , ,

Bicuspid aortic valve

Posted in Aortic valve, Videos Tagged with: , , , ,

Impact of sub-specialist services

Posted in NHS, Videos Tagged with: , ,

Aortic valve guidelines 2014

Posted in Aortic valve, Videos Tagged with: , , , ,

Recruiting into surgical trials

Posted in Videos Tagged with: , , ,

Building a MIS solution

Posted in Mitral valve, Videos Tagged with: , , , ,

Total antegrade perfusion in minimally invasive surgery

Posted in Mitral valve, Videos Tagged with: , , ,

Mitral valve infective endocarditis

Posted in Mitral valve, Videos Tagged with: , , , ,

Outcome measures

Posted in Data & statistics, Videos Tagged with: , ,

Early intervention in mitral valve surgery

Posted in Mitral valve, Videos Tagged with: , , ,