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In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Maninder Kalkat, a consultant cardiothoracic surgeon in the Regional Department of Thoracic Surgery at University Hospital Birmingham, about extended resections.   Chapters 00:00 Intro  01:07 Inspiration & Areas of Interest  03:23 Definition & Classification  09:28 History  10:16 Preop Considerations  19:07 Operating Team Plan  22:23 Fitness for Surgery  23:55 Airway Resections  31:33 Chest Wall Resections  36:17 Reconstructive Material  38:43 Vascular Resections  43:53 Postoperative Care  47:59 Future of Extended Resections  50:15 Summary  50:48 Surgery Training Tips They provided an overview of extended resections, including the definition, indications, and examples, as well as the history of extended resections. They also discussed preoperative considerations and examined airway resections, detailing what it is, indications, and the technical principles of the operation. Additionally, they explored chest wall resections, including the definition, indications, and technical principles. Drs. Copperwheat and Kalkat also examined vascular resections, highlighting what they are, indications, and the technical aspects involved. They also reviewed postoperative considerations, complications, and outcomes. Finally, they shared training tips, future directions, and key principles in extended resections.   The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Keep an eye out for next month's episode.   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Puja Khaitan, thoracic consultant at Sheikh Shakhbout Medical City, Abu Dhabi, UAE, and Founder and Congress Chair of the Emirates International Thoracic Surgery Congress, about thoracic surgery in the United Arab Emirates (UAE). Chapters 00:00 Intro 02:35 JANS 1, Therapy & Risk in Idiopathic Pulm Fibrosis 04:18 JANS 2, Sex-Related Treatment Effects 06:03 JANS 3, Endoscopic vs Open RAH in CABG 08:14 JANS 4, Textbook Outcome in MV Surgery 11:16 Career Center 12:08 Video 1, AMDS to FET Conversion 13:13 Video 2, Constrictive Pericarditis & Pericardiectomy 14:42 Video 3, Right Axillary Thoracotomy 16:17 Dr. Khaitan, Thoracic Surgery in the UAE 23:46 Upcoming Events 24:46 Instructional Video Competition They discussed her professional background and training, as well as the differences in cases between the UAE and United States. They also delved into research in the UAE, the state of thoracic hospitals, general surgical residency programs, and the future of fellowships in the country.   Joel also highlights recent JANS articles on a large retrospective propensity-weighted cohort study on antifibrotic therapy and lung cancer risk in patients with idiopathic pulmonary fibrosis, sample size considerations to assess sex-related treatment effects, endoscopic or open radial artery harvest in coronary artery bypass surgery, and results from the Netherlands Heart Registration on mitral valve surgery.  In addition, Joel explores a safe and reproducible redo aortic surgery approach on AMDS to frozen elephant trunk conversion, an approach to constrictive pericarditis and pericardiectomy from diagnosis to definitive surgical, and right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Antifibrotic Therapy and Lung Cancer Risk in Patients With Idiopathic Pulmonary Fibrosis: A Large Retrospective Propensity-Weighted Cohort Study  2.) Sample Size Considerations to Assess Sex-Related Treatment Effects  3.) Endoscopic or Open Radial Artery Harvest in Coronary Artery Bypass Surgery  4.) Textbook Outcome in Mitral Valve Surgery—Results from the Netherlands Heart Registration  CTSNet Content Mentioned  1.) AMDS to Frozen Elephant Trunk Conversion: A Safe and Reproducible Redo Aortic Surgery Approach    2.) From Diagnosis to Definitive Surgical Therapy: An Approach to Constrictive Pericarditis and Pericardiectomy  3.) Right Axillary Thoracotomy: A Minimally Invasive Gateway to Multiple Defects  Other Items Mentioned  1.) Emirates International Thoracic Surgery Congress  2.) Instructional Video Competition   3.) Career Center   4.) CTSNet Events Calendar  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.

In this episode of The Cardiac Recovery Room, moderator Dr. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society; and co-moderator Dr. Kevin Lobdell, Professor and Director of Regional Cardiovascular and Thoracic Quality, Education, and Research at Atrium Health spoke with Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center and Dr. Serdar Gunaydin, Head of Department at the University of Health Sciences in Turkey, about patient blood management.   Chapters  00:00 Intro  01:14 Transfusion as a Risk Factor  07:08 Hemoglobin Drugs  08:24 Pillars of Blood Management  09:56 Anesthesia  12:30 Transfusion Triggers  17:33 O2 Delivery, Hemoglobin Number  22:20 Non-Transfusion Patients  23:22 Anemic Level Bottom Number  25:06 Bleeding Checklist  29:41 Anemia Tolerance  They discussed independent risk factors for blood transfusion, the role of hemoglobin as a predictor for blood transfusion, and considerations related to anemic patients and hemoglobin levels. Additionally, they explored the key pillars of blood management, treating preoperative anemia, and anesthesia. They examined transfusion triggers, oxygen delivery, and the care of non-transfusion patients. Finally, they emphasized the importance of a bleeding checklist and anemia tolerance.   The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Hani Shennib, a Clinical Professor of Vascular and Cardiothoracic Surgery at the University of Arizona College of Medicine, Phoenix, USA, about catheters as a language. Chapters 00:00 Intro 02:48 UK Thoracic Forum 06:11 JANS 1, Detecting AF Using Watch 07:44 JANS 2, End-to-End Anastomotic Stapler 09:24 JANS 3, Improving Patient Selection NSCLC 12:05 JANS 4, 5-Year Women Outcomes TAVR vs SAVR 13:30 Video 1, MVR Tips & Tricks 14:43 Video 2, Ruptured SVA w Hemi-Yacoub Remodeling 16:32 Video 3, Modified Inclusion, Autograft in a Vest 18:04 Dr. Shennib, Catheters as a Language 48:25 Upcoming Events 48:52 Career Center They explore the importance of making catheters a language by learning, speaking, and practicing it daily. They also discuss how cardiac surgeons have lost the role of “gatekeepers,” with cardiologists now controlling more of the decision-making process. Dr. Shennib emphasizes the need for surgeons to be involved in decision-making from diagnosis to treatment and highlights the significance of patient-centered decision-making and the human aspect of these choices. They also compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), examining which procedure is more appropriate in different circumstances. Furthermore, they explore the reasons behind the shrinking cardiac specialty and discuss how to save it. Finally, they discuss the future of cardiac surgery.   Joel also highlights recent JANS articles on a randomized controlled trial on the enhanced detection and prompt diagnosis of atrial fibrillation using an Apple watch, the results of a human cadaver study on a novel aortic end-to-end anastomotic stapler device, improving patient selection for minimally invasive lobectomy or stereotactic ablative radiotherapy based on clinical characteristics, and a systematic review and meta-analysis on the five-year outcomes of transcatheter versus surgical aortic valve replacement in women.  In addition, Joel explores tips and tricks for mitral valve repair from a Brussels experience, treatment of ruptured sinus valsalva aneurysm with hemi-Yacoub remodeling technique, and a Ross procedure with modified inclusion technique. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch: A Randomized Controlled Trial  2.) A Novel Aortic End-to-End Anastomotic Stapler Device—Results of a Human Cadaver Study  3.) Stage I Non-Small Cell Lung Cancer: Improving Patient Selection for Minimally Invasive Lobectomy or Stereotactic Ablative Radiotherapy Based on Clinical Characteristics  4.) Five-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Women: A Systematic Review and Meta-Analysis   CTSNet Content Mentioned  1.) Mitral Valve Repair—Tips and Tricks From Brussels Experience: 2025 London Core Review Cardiothoracic Surgery Course   2.) Treatment of Ruptured Sinus Valsalva Aneurysm With Hemi-Yacoub Remodeling Technique   3.) Ross Procedure With Modified Inclusion Technique: An Autograft in a Vest  Other Items Mentioned  1.) Instructional Video Competition   2.) Career Center   3.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Louise Kenny, a consultant pediatric and adult congenital cardiothoracic and transplant surgeon at Freeman Hospital in Newcastle upon Tyne, England, about congenital heart transplants. Chapters 00:00 Intro 02:24 JANS 1, VECTOR Procedure 07:38 JANS 2, Combined Inflation & Cooling 08:26 JANS 3, Caring for VIP Patients 11:43 JANS 4, Country Wealth & Min Inv Correlation 12:57 Career Center 13:37 Video 1, Debranching AAV Step-by-Step 15:14 Video 2, Abramson Technique 16:59 Video 3, Min Inv Cardiac w Dr. Chitwood 18:54 Dr. Kenny, DCD-HOPE Congenital Transplant 31:58 CKD & CSA-AKI Podcast Episode 34:12 Upcoming Events 35:13 Closing They discussed the complexities surrounding congenital heart transplants, donation after brain death (DBD), and donation after circulatory death (DCD). They also explored the benefits of hypothermic oxygenated perfusion (HOPE) for children, particularly in DCD pediatrics patients, and highlighted the first case where this model was used. Additionally, they examined the future of HOPE and its potential for more complex procedures. Moreover, they discussed implanting ventricular assist devices (VAD) in children, along with what other countries are doing regarding congenital heart transplants, including ongoing studies in this field.    Joel also highlights recent JANS articles on the first human VECTOR procedure for percutaneous aorto-coronary bypass graft to prevent coronary obstruction following TAVR, combined inflation and cooling method improves lung function in uncontrolled donation after circulatory death, caring for VIP patients in cardiothoracic surgery, and the national wealth and the global spread of minimally invasive thoracic surgery.  In addition, Joel explores a step-by-step guide for debranching of aortic arch vessels through a cervical approach for aortic arch aneurysm, a master class with Horacio Abramson on the Abramson technique, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Randolph Chitwood about the future of minimally invasive cardiac surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure  2.) Combined Inflation and Cooling Method Improves Lung Function in Uncontrolled Donation After Circulatory Death  3.) Caring for VIP Patients in Cardiothoracic Surgery: Navigating Bias, Pressure, and Protocol  4.) National Wealth and the Global Spread of Minimally Invasive Thoracic Surgery: Insights From the European Society of Thoracic Surgeons Database  CTSNet Content Mentioned  1.) Debranching of Aortic Arch Vessels Through a Cervical Approach for Aortic Arch Aneurysm: A Step-by-Step Guide  2.) Master Class: The Abramson Technique With Horacio Abramson and Joel Dunning  3.) The Atrium: The Future of Minimally Invasive Cardiac Surgery  Other Items Mentioned  1.) HOPE for Children: Successful Pediatric DCD Heart Transplantation Using Hypothermic Oxygenated Perfusion  2.) Instructional Video Competition   3.) Career Center   4.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Drs. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society, and Marlies Ostermann, consultant in critical care and nephrology at Guy's and St. Thomas Foundation Trust and a Director of Research for the Intensive Care Society, about chronic kidney disease (CKD) and cardiac surgery-associated acute kidney injury (CSA-AKI). Chapters 00:00 Intro 02:11 Definition & Background 10:55 Burden of CSA-AKI 12:58 Unmet Medical Need 19:47 Identification & Collaboration 26:07 KDIGO, O2 Delivery 32:15 CKD CSA-AKI Final Remarks 35:10 JANS, Success in African CT Surgery 38:49 Video, Modified Root Inclusion Technique 40:53 Closing They delve into the complexities of CSA-AKI, exploring the percentage of patients affected, defining the condition, and highlighting the overall significance of this issue. They also address creatinine as a late marker for AKI, the long-term scarring that can occur from AKI, and the critical need for thorough preoperative assessments to identify high-risk patients. Additionally, they emphasize the importance of a complete health assessment before surgery. Furthermore, they discuss the dangers of reaching stage 3 AKI, the increased costs of care once that point is reached, and what actions to take if a patient has a positive marker but appears stable. They also highlight the premature use of diuretics contributing to AKI and hyperbilirubinemia. Moreover, they consider how CKD along elevates mortality risk and the importance of developing targeted therapies in the future. Finally, they discuss approaches to reduce ischemia-reperfusion (IR) AKI and the optimization of hemodynamics, as well as potential drugs for treating AKI effectively.   Joel also highlights a recent JANS article on aligning training, patient profiles, and outcomes to redefine success in cardiac surgery in Africa. In addition, he explores the modified root inclusion technique for a fourth sternotomy with Ross/Konno after previous mechanical aortic valve replacement.   Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Redefining Success in Cardiac Surgery in Africa: Aligning Training, Patient Profiles, and Outcomes  CTSNet Content Mentioned  1.) Fourth Sternotomy With Ross/Konno After Previous Mechanical Aortic Valve Replacement: The Modified Root Inclusion Technique  Other Items Mentioned  1.) Career Center   2.) CTSNet Events Calendar  3.) Instructional Video Competition   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Randolph Chitwood, retired cardiac surgeon and Founding Director of the East Carolina Heart Institute at East Carolina University, about the future of minimally invasive cardiac surgery (MICS). Chapters 00:00 Intro 00:58 Dr. Chitwood Background 04:20 Inspiration for MI 07:12 Reason for Mitral Valve Robotics 07:38 Strong Resistance from Specialty 08:35 Beginning Training 10:24 Origins of MI 13:37 Developmental Research 16:19 Steps in MI Mitral Valve Surgery 17:00 Bypass 17:57 Aortic Valve Surgery 19:10 Root Replacement & Dissection 19:27 Extracurricular Hobbies 20:23 Surgery Training Advice They delve into Dr. Chitwood's professional background and why he chose to study cardiothoracic surgery. They also discuss the evolution of minimally invasive surgery, including incisions and instruments. Additionally, they highlight robotics, minimally invasive techniques for the mitral valve, and coronary artery bypass grafting (CABG). They also cover aortic valve replacement (AVR) and minimally invasive techniques for the aortic valve. Furthermore, Dr. Chitwood provides advice for trainees, including how they can get involved in using minimally invasive techniques.   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 extended resection with Dr. Maninder Kalkat.     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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Drs. Jan Vojacek, a cardiac surgeon in the department of cardiac surgery at University Hospital Hradec Kralove, Czech Republic, and president of the Czech Society for Cardiovascular Surgery, and Maral Ouzounian, cardiac surgeon and head of the division of cardiac surgery at the Peter Munk Cardiac Center, Toronto, Canada, and president of the Canadian Society of Cardiac Surgeons, about the EACTS expert consensus statement on the Ross procedure in adult patients. Chapters 00:00 Intro 02:21 JANS 1, ARISE III Stent Graft Enrollment 04:25 JANS 2, Mech vs Biopros Valves in Hemodialysis 07:37 JANS 3, Surgical Sealants After Pulm Resection 09:54 JANS 4, Constrictive Pericarditis Procedures 12:45 Video 1, VATS CO2 Insufflation Technique 14:03 Third Place, Ascending Aortic Stenting Repair-Bridge 15:05 Second Place, Mustard & En Bloc Rotation of Tracts 16:49 First Place, Supracardiac Anomalous Pulm Ven Return 19:43 Drs. Vojacek & Ouzounian, Ross Procedure 42:02 Upcoming Events 42:21 Instructional Video Competition 42:49 Career Center They discussed the task force and process of getting this statement published, as well as important elements of the guidelines. Additionally, they addressed the significance of shared decision-making with patients, survival rates following the Ross procedure, and overall quality of life. They also compared the Ross procedure to mechanical and biological aortic valve replacements. They explored various surgical techniques related to the Ross procedure, including the native inclusion technique and the prosthetic inclusion technique, emphasizing the importance of technical details, patient selection, and intraoperative management. Furthermore, they discussed the Ross centers of excellence and how to start them.   Joel also highlights recent JANS articles on the ARISE III trial of gore ascending stent graft begins enrollment, mechanical vs bioprosthetic heart valves in hemodialysis patients, an individual patient data meta-analysis of randomized controlled trials on the clinical efficacy of surgical sealants after pulmonary resection, and radical pericardiectomy and use of cardiopulmonary bypass for constrictive pericarditis.  In addition, Joel explores a new approach for thymic pathologies, robotic-assisted repair of supracardiac total anomalous pulmonary venous return, and combined Mustard and en bloc rotation of the outflow tracts. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) ARISE III Trial of Gore Ascending Stent Graft Begins Enrollment  2.) Mechanical Versus Bioprosthetic Heart Valves in Hemodialysis Patients  3.) Clinical Efficacy of Surgical Sealants After Pulmonary Resection: An Individual Patient Data Meta-Analysis of Randomized Controlled Trials  4.) Radical Pericardiectomy and Use of Cardiopulmonary Bypass for Constrictive Pericarditis  CTSNet Content Mentioned  1.) A New Approach for Thymic Pathologies: VATS CO₂ Insufflation Technique  2.) Robotic-Assisted Repair of Supracardiac Total Anomalous Pulmonary Venous Return   3.) Combined Mustard and En Bloc Rotation of the Outflow Tracts   Other Items Mentioned  1.) EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients   2.) Winners of the 2025 CTSNet Resident Video Competition  3.) Instructional Video Competition   4.) Career Center   5.) CTSNet Events Calendar  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.

In this episode of The Cardiac Recovery Room, moderator Dr. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society, spoke with Drs. Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research at Atrium Health; Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center; Marjan Jahangiri, Professor of Cardiac Surgery at St. George's Hospital, University of London; and Serdar Gunaydin, Head of Department at the University of Health Sciences in Turkey, about the attitudes toward and realities of ERAS across the globe.   Chapters 00:00 Intro  01:19 ICU & Early Extubation  05:07 Acceptance of ERAS Protocols  09:38 Lead Staff Advocate for ERAS  12:59 Sternotomy Perception  14:43 QoL Data Collection  17:09 Rehabilitation  19:04 Discharged Patients & Monitoring  They discussed the intensive care unit and early extubation, highlighting differences between countries. They also covered the acceptance of the ERAS protocol and the regions that are more hesitant to implement it, as well as its application in cardiac surgery specifically. Additionally, they explored who leads the charge within the team responsible for implementing ERAS and addressed perceptions regarding sternotomy. The conversation also included improving quality of life, reducing complications, and patient-reported outcomes measures, emphasizing the importance of shared decision-making. Furthermore, they discussed rehabilitation, discharging patients, and remote monitoring.   The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Michael Lanuti, Director of Thoracic Oncology in the Division of Thoracic Surgery at Massachusetts General Hospital and an Associate Professor at Harvard Medical School, and thoracic surgeon and CTSNet Senior Editor Leanne Ashrafian about Dr. Lanuti's thoughts on the JCOG0802 trial and how he believes the wrong parameters were measured. Chapters 00:00 Intro 01:52 JANS 1, ESTS Guidelines 05:09 JANS 2, Resident-Led Operating 06:57 JANS 3, Fasting Impact on Pulm Aspiration 10:02 JANS 4, What Does a Dr Look Like 12:00 Video 1, Robotic Resection & Reconstruction 13:31 Video 2, Neonatal Off-Pump Shunt DORV 15:11 Video 3, Min Inv Bi-IMA OPCAB 16:12 Dr. Lanuti, JCOG0802 Results 44:58 Upcoming Events 45:38 Instructional Video Competition 45:49 Career Center They discussed local recurrence rates, pulmonary function, and the subtypes of adenocarcinoma. Additionally, they explored how to apply these results to future patients, central and peripheral lesions, and other randomized trials. They also covered the five-year results of the JCOG0802 trial and future studies and the implications for future studies, focusing on the parameters that should be considered. Furthermore, they addressed pulmonary function tests and wedge resection.   Joel also highlights recent JANS articles on European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer, a 10-year propensity-matched analysis on the impact of resident-led operating on outcomes in adult cardiac surgery, a systematic review and meta-analysis on no association between preprocedural fasting and witnessed pulmonary aspiration, and asking AI what a doctor looks like.  In addition, Joel explores robotic anterolateral approach for left secondary carinal tumor resection and reconstruction, neonatal Blalock-Taussig-Thomas shunt for double outlet right ventricle with RVOTO, and minimally invasive Bi-IMA OPCAB via left thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) European Respiratory Society and European Society of Thoracic Surgeons Clinical Practice Guideline on Fitness for Curative Intent Treatment of Lung Cancer  2.) Impact of Resident-Led Operating on Outcomes in Adult Cardiac Surgery: A 10-Year Propensity-Matched Analysis  3.) No Association Between Preprocedural Fasting and Witnessed Pulmonary Aspiration: A Systematic Review and Meta-Analysis  4.) What Does a Doctor Look Like? Asking AI  CTSNet Content Mentioned  1.) Robotic Anterolateral Approach for Left Secondary Carinal Tumor Resection and Reconstruction   2.) Neonatal Off-Pump Blalock-Taussig-Thomas Shunt for Double Outlet Right Ventricle With RVOTO   3.) Minimally Invasive Bi-IMA OPCAB Via Left Thoracotomy   Other Items Mentioned  1.) Instructional Video Competition   2.) Career Center   3.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Gavin Wright, thoracic surgeon and Director of Surgical Oncology at St Vincent's Hospital Melbourne, Australia, and thoracic surgeon and CTSNet Senior Editor Leanne Ashrafian about Dr. Wright's thoughts on the JCOG0802 trial and why he prefers segmentectomy over lobectomy. Chapters 00:00 Intro 02:59 JANS 1, Chest Tube Removal Review 05:33 JANS 2, Tricuspid Ann Remodeling 07:53 JANS 3, The Cost of Gender in MV Surgery 09:42 JANS 4, Endo Balloon vs Clamping 11:53 AVR & LIMA to LAD via Bi Minithorac 13:13 Surgical Reimplant ARCAPA 14:14 Editors Picks 2025 20:41 Gavin Wright, Segmentectomy vs Lob 44:33 Upcoming Events 45:56 Instructional Video Competition 46:12 Career Center 46:35 Closing They discussed the findings of the JCOG0802 trial and compared it to the CALGB 140503 trial. They also covered the use of FEV1 as an assessment tool, the significance of p-values, local recurrence, and Type I errors. Additionally, they reviewed The Lancet paper addressing segmentectomy vs lobectomy. Furthermore, they explored potential future trials, including the debate over wedge resection vs segmentectomy.   Joel also highlights recent JANS articles on a systematic review and meta-analysis on chest tube removal after cardiac surgery in first vs. second postoperative day, tricuspid annular remodeling in tachycardia induced cardiomyopathy with functional tricuspid regurgitation, a propensity-score matched analysis on the silent cost of gender in mitral valve surgery, and endo-aortic balloon occlusion versus transthoracic clamping in minimally invasive mitral valve surgery.  In addition, Joel explores endoscopic AVR and LIMA to LAD via bilateral minithoracotomy, surgical reimplantation of the anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA), and the 2025 CTSNet Editors' Picks. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Chest Tube Removal After Cardiac Surgery in First vs. Second Post-Operative Day: A Systematic Review and Meta-Analysis  2.) Tricuspid Annular Remodeling in Tachycardia Induced Cardiomyopathy With Functional Tricuspid Regurgitation  3.) The Silent Cost of Gender in Mitral Valve Surgery: A Propensity-Score Matched Analysis   4.) Endo-Aortic Balloon Occlusion Versus Transthoracic Clamping in Minimally Invasive Mitral Valve Surgery  CTSNet Content Mentioned  1.) Endoscopic AVR and LIMA to LAD Via Bilateral Minithoracotomy   2.) Surgical Reimplantation of the Anomalous Origin of the Right Coronary Artery From the Pulmonary Artery (ARCAPA)   3.) CTSNet Summarized—Editors' Picks 2025  Other Items Mentioned  1.) Instructional Video Competition   2.) 2025 CTSNet Recruitment Guide    3.) Career Center   4.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning reflects on the most popular content of 2025 on CTSNet. Chapters 00:00 Intro 02:15 Top Interview 03:52 Top Webinar 05:23 Top Clinical Video 06:24 Top JANS Article 07:01 Top Video Series 08:02 Top Contributor 08:59 Top Cardiac Procedures 12:14 Top Podcasts 17:02 JANS 1, Doctor Story 21:28 JANS 2, Ex Vivo Heart Perfusion 22:41 JANS 3, PCI vs CABG 24:04 JANS 4, NEOpredict-Lung 25:29 2026 Plans He discusses the top interview, the most popular webinar, and reveals the leading CTSNet contributor of the year. He also highlights the most-read JANS article, the most viewed CTSNet series, the top clinical videos in cardiac surgery, and the leading podcast episodes of 2025 from both The Beat and The Atrium. Additionally, he shares key statistics about CTSNet, including website viewership, YouTube subscribers, and listener demographics.   Joel also highlights recent JANS articles on if ex vivo heart perfusion offsets ischemic penalties with six-hour or greater preservation in adult donation after brain death heart transplantation, an impactful article titled “This Man Saved My Life—I Live by His Example,” the long-term outcomes for women with chronic coronary artery disease after percutaneous coronary intervention vs coronary artery bypass grafting, and the long-term outcomes of preoperative nivolumab with or without relatlimab in patients with resectable non-small-cell lung cancer (NEOpredict-Lung).    In addition, Joel outlines CTSNet's goals and initiatives to look forward to in 2026. Before closing, he highlights upcoming events in CT surgery.    JANS Items Mentioned  1.)  Ex Vivo Heart Perfusion Offsets Ischemic Penalties With ≥6-Hour Preservation in Adult Donation-After-Brain-Death Heart Transplantation  2.) This Man Saved My Life—I Live by His Example  3.) Women With Chronic Coronary Artery Disease: Long-Term Outcomes After Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting  4.) Long-Term Outcomes of Preoperative Nivolumab With or Without Relatlimab in Patients With Resectable Non-Small-Cell Lung Cancer (NEOpredict-Lung)  CTSNet Content Mentioned  1.) CTSNet Summarized—Most Popular Content of 2025  2.) CTSNet Summarized—Most Popular Podcast Episodes of 2025  3.) CTSNet Summarized—Top Cardiac Procedure Videos of 2025   Other Items Mentioned  1.) All CTSNet Summarized Content   2.) 2025 CTSNet Recruitment Guide   3.) Career Center   4.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses how to get involved with Pace4Life, a charity he supports that provides reconditioned pacemakers to Ghana. He also previews upcoming podcast episodes and guests, including discussions on the Ross procedure guidelines and more interviews related to the JCOG0802 trial.  Chapters 00:00 Intro  02:31 JANS 1, Ethiopian Surgeon  07:08 JANS 2, RCA to Cor Sinus Fistula  09:30 JANS 3, Y-Incision Hemodynamics  12:38 JANS 4, Endograft Infection  15:06 Instructional Video Competition  16:01 Career Center  16:40 Video 1, Complications Podcast  19:34 Video 2, Totally Endoscopic Case  21:23 Video 3, Post-Infarction VSD Repair  23:15 Closing, Upcoming Events  Joel also highlights recent JANS articles on a heart surgeon who saved another surgeon's life as a teen and how they now perform surgeries together, right coronary artery to coronary sinus fistula, a surgical aortic valve replacement with Y-incision aortic annular enlargement provided better hemodynamics than transcatheter aortic valve replacement, and management of endograft infection after thoracic endovascular aortic repair.  In addition, Joel explores totally endoscopic mitral and tricuspid valve repair, ASD with APVR repair, and LAA occlusion, as well as the repair of a post-infarction VSD, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Samer Nashef about complications in cardiothoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.)  A Heart Surgeon Saved His Life as a Teen. Now They Perform Surgeries Together.  2.) Right Coronary Artery to Coronary Sinus Fistula: A Rare Problem With an Elegant Solution  3.) Surgical Aortic Valve Replacement With Y-incision Aortic Annular Enlargement Provided Better Hemodynamics Than Transcatheter Aortic Valve Replacement  4.) Management of Endograft Infection After Thoracic Endovascular Aortic Repair  CTSNet Content Mentioned  1.) The Atrium: Complications  2.) Totally Endoscopic Mitral and Tricuspid Valve Repair, ASD With APVR Repair, and LAA Occlusion  3.) Repair of a Post-Infarction VSD  Other Items Mentioned  1.) Pace4Life   2.) MICS and Robotic-Assisted Surgery: A Roundtable Discussion With the Endoscopic Cardiac Surgeons Club  3.) Instructional Video Competition  4.) 2025 CTSNet Recruitment Guide   5.) Career Center   6.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Nasser Altorki, thoracic surgeon at Weill Cornell Medicine in New York, and thoracic surgeon and CTSNet Senior Editor Leanne Ashrafian about the 10-year results from the JCOG0802 trial. Chapters 00:00 Intro 02:56 JANS 1, Re-Repair vs Replacement 05:07 JANS 2, Mini Mitral Multicentre RCT 07:01 JANS 3, PERSEVERE Study 08:54 JANS 4, Parietal Pleurectomy vs Pleural Abrasion 11:38 Career Center 12:33 Video 1, Endoscopic Post-Infarction VSD Repair 14:11 Video 2, 3D Dor Procedure & MVR Huge LV Aneurysm 15:19 Video 3, Non-Cardioplegic Myo Protection Robotic 17:16 Nasser Altorki Interview, JCOG 45:16 Upcoming Events 47:20 Closing They discuss key aspects of the trial, including the noninferiority primary endpoint. Dr. Altorki shares his overall thoughts on the trial, and they also examine topics such as pulmonary function, lobar vs sublobar resection, and segmentectomy vs wedge resection. Additionally, they explore secondary primary lung cancer, the importance of thoracic surgeons presenting data to patients, and best practices for segmentectomy to ensure patient safety. They also examine good wedge resection vs bad wedge resection, planning for segmentectomy, and the future of lobectomy and segmentectomy.   Joel also highlights recent JANS articles on the outcomes of re-repair vs replacement after failed primary mitral regurgitation repair, minimally invasive thoracoscopically-guided right minithoracotomy vs conventional sternotomy for mitral valve repair, one-year results of novel aortic arch hybrid prosthesis for repair of acute DeBakey Type I dissection with malperfusion, and a meta-analysis of efficacy and safety of parietal pleurectomy vs pleural abrasion in treating spontaneous pneumothorax.  In addition, Joel explores endoscopic post-infarction VSD repair, 3D video-assisted endoscopic Dor procedure and MVR for post-infarction huge LV aneurysm, and non-cardioplegic myocardial protection for robotic mitral surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Outcomes of Re-Repair Versus Replacement After Failed Primary Mitral Regurgitation Repair: STS Adult Cardiac Surgery Database Analysis  2.) Minimally Invasive Thoracoscopically-Guided Right Minithoracotomy Versus Conventional Sternotomy for Mitral Valve Repair: The UK Mini Mitral Multicentre RCT  3.) One-Year Results of Novel Aortic Arch Hybrid Prosthesis for Repair of Acute DeBakey Type I Dissection With Malperfusion: PERSEVERE Study  4.) A Meta-Analysis of Efficacy and Safety of Parietal Pleurectomy Versus Pleural Abrasion in Treating Spontaneous Pneumothorax  CTSNet Content Mentioned  1.) Endoscopic Post-Infarction VSD Repair  2.) Pushing Surgical Boundaries: 3D Video-Assisted Endoscopic Dor Procedure and MVR for Post-Infarction Huge LV Aneurysm  3.) Non-Cardioplegic Myocardial Protection for Robotic Mitral Surgery  Other Items Mentioned  1.) Instructional Video Competition  2.) 2025 Endoscopic Cardiac Surgeons Club Video Competition  3.) 2025 CTSNet Recruitment Guide   4.) Career Center   5.) CTSNet Events Calendar  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.

In this episode of The Cardiac Recovery Room, moderator Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in North Carolina, USA, spoke with Alexander Gregory, a cardiovascular anesthesiologist and assistant professor in the Department of Anesthesiology, Perioperative and Pain Medicine, and the Libin Cardiovascular Institute at the Cumming School of Medicine, University of Calgary, Canada, and Dr. V. Seenu Reddy, a cardiothoracic surgeon at HCA's TriStar Cardiovascular Surgery in Nashville, Tennesee, USA, about the 10 things they hate about Enhanced Recovery After Surgery (ERAS).   Chapters 00:00 Introduction  01:38 Overcomplication  05:29 Simple Barriers  08:54 Change Obstructionists  10:52 Status Quo  12:49 Messing with Protocol  14:21 Giving Up on Protocol  16:48 Need for Patient-Reported Outcomes  19:18 Struggle Into Cardiac Subspecialty  21:30 Takeaways  The goal of this discussion was to identify specific challenges and propose potential solutions. They emphasize the importance of having two leaders—a champion and a co-champion—to effectively guide ERAS initiatives. Additionally, they discuss creating standing orders and issues related to microbarriers and resistance to change. They also highlight the need for customization of protocols, acknowledging the differences between surgeons who utilize ERAS and those who do not, as well as the tendency to maintain the status quo. Patient perspectives are another key focus, with a call to implement changes that enhance tracking and monitoring of patient outcomes. Furthermore, they explore the role of technology designed for patients, as well as applying ERAS principles to surgeries that fall “outside of the box.”   The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Samer Nashef, a consultant cardiac surgeon at Papworth Hospital in Cambridge, about complications in cardiothoracic surgery. Chapters 00:00 Intro 00:34 Dr. Nashef Background 04:06 Results Monitoring 08:55 Common Complications 14:40 Mentality 19:18 Identifying Room for Improvement 21:25 Pattern of Response 22:47 Long-Term Complications 26:08 Mortality/Morbidity Meetings 28:28 Perfection, Balance 30:33 Coping w Major Complications 35:06 Learning Your Psyche 35:51 Trainee-Consultant Responsibility 37:51 Resilience 39:19 Key Takeaways 41:07 Training Advice They delve into early complications that trainees experience, approaches to managing acute complications, and nonacute and postoperative complications. They also highlight learning from complications, coping strategies, and the emotional impact involved in cardiothoracic surgery. Additionally, they discuss the concepts of growth, resilience, and strength in cardiothoracic surgery. Furthermore, Dr. Nashef provides advice to trainees currently navigating difficult cases, and general guidance for those in training.   The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Be sure to watch for next month's episode!   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Laurens Ceulemans, thoracic surgeon at the University Hospitals Leuven in Belgium, about lung volume reduction. Chapters 00:00 Intro 02:41 Right to Repair, Robotics Re-Use 04:53 REPEAT Trial 06:30 JANS 1, PCI After CABG Randomized Trial 08:01 JANS 2, No-Touch vs Conventional Saph Veins 11:04 JANS 3, Sir Terence English & Keyvyn Mohagissi 12:09 CTSNet Recruitment Guide 12:54 Video 1, JCOG0802 Bombshell & Webinar 16:33 Video 2, Endoscopic Cardiac Foreign Body Extraction 17:56 Video 3, First Europe Robotic AVR Perceval Valve 18:42 Video 4, Bilateral VATS Sympathectomy 20:10 Laurens Ceulemans Interview 34:15 Upcoming Events 34:48 Closing They highlighted key takeaways from the procedure and addressed the issue of air leaks. They also discussed bilateral lung volume reduction and emphasized the importance of a team approach. Additionally, they focused on why surgeons should be selecting the healthiest patients for this operation rather than the most critically ill, as well as the future of lung volume reduction.    Joel also highlights recent JANS articles on a multicenter, randomized trial on the PCI of native coronary artery vs saphenous vein graft after prior bypass surgery, a meta-analysis of randomized trials on the outcomes of no-touch vs conventionally harvested saphenous veins for coronary artery bypass surgery, and the death of transplant pioneer Sir Terence English at 93.  In addition, Joel explores bombshell 10-year JCOG0802 results showing lobectomy is superior to segmentectomy for lung cancer, endoscopic extraction of a cardiac foreign body, the first robotic aortic valve replacement in Europe using a Perceval valve, and bilateral VATS sympathectomy for ventricular tachycardia electrical storm. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) PCI of Native Coronary Artery vs Saphenous Vein Graft After Prior Bypass Surgery: A Multicenter, Randomized Trial  2.) Outcomes of No-Touch Vs Conventionally Harvested Saphenous Veins for Coronary Artery Bypass Surgery: A Meta-Analysis of Randomized Trials  3.) Transplant Pioneer Sir Terence English Dies at 93  CTSNet Content Mentioned  1.) Bombshell 10-Year JCOG0802 Results Show Lobectomy Is Superior to Segmentectomy for Lung Cancer  2.) Military Heart Trauma: Endoscopic Extraction of a Cardiac Foreign Body  3.) First Robotic Aortic Valve Replacement in Europe Using a Perceval Valve   4.) Bilateral VATS Sympathectomy for Ventricular Tachycardia Electrical Storm  Other Items Mentioned  1.) Restore Robotics   2.) 2025 Endoscopic Cardiac Surgeons Club Video Competition  3.) 2025 CTSNet Recruitment Guide   4.) Career Center   5.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Christopher McGregor, professor in the Department of Surgery at the University of Minnesota Twin Cities, about the current state of cardiac and kidney xenotransplantation. Chapters 00:00 Intro  03:10 Sir Terence English  08:00 JANS 1, Cardiac Xenotransplantation  09:13 JANS 2, Coffee Consumption on AF  11:06 JANS 3, Environmental Factors Acute AD  12:49 JANS 4, PROTHOR Trial  15:15 Video 1, Combined AV & Coronary via LAM  17:08 Video 2, ARCA w MV Prolapse  19:32 Video 3, Redo Elephant Trunk After EAR  22:06 Chris McGregor Interview  48:23 Upcoming Events  50:15 Closing  They discussed the three approved trials for xenotransplantation in 2025, the preclinical efficacy assessment, and the various challenges of xenotransplantation. Additionally, they explored the history of orthotopic transplants, heart failure, and antibody-mediated rejection. They also examined the future of xenotransplantation and the anatomy of pig hearts vs human hearts.   Joel also highlights recent JANS articles on the status of cardiac xenotransplantation including preclinical models, the DECAF randomized clinical trial on if caffeinated coffee consumption or abstinence reduces atrial fibrillation; the impact of environmental factors on acute aortic dissection; and a multicenter, international, randomized, controlled, phase 3 trial on the effects of intraoperative higher vs lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR).   In addition, Joel explores combined aortic valve and coronary surgery via left anterior minithoracotomy, management of anomalous right coronary artery in a patient with mitral valve prolapse, and redo frozen elephant trunk after endovascular arch repair. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) 2025: Status of Cardiac Xenotransplantation Including Preclinical Models  2.) Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial  3.) Weathering the Aorta: The Impact of Environmental Factors on Acute Aortic Dissection   4.) Effects of Intraoperative Higher Versus Lower Positive End-Expiratory Pressure During One-Lung Ventilation for Thoracic Surgery on Postoperative Pulmonary Complications (PROTHOR): A Multicentre, International, Randomised, Controlled, Phase 3 Trial  CTSNet Content Mentioned  1.) Combined Aortic Valve and Coronary Surgery via Left Anterior Minithoracotomy: Clinical Experience With Sutureless Bioprosthesis  2.) Management of Anomalous Right Coronary Artery in a Patient With Mitral Valve Prolapse  3.) Redo Frozen Elephant Trunk After Endovascular Arch Repair  Other Items Mentioned  1.) Resident Video Competition  2.) 2025 CTSNet Recruitment Guide   3.) Career Center   4.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Evgenij Potapov, a consultant senior surgeon and co-chairman of the mechanical circulatory support program in the Department of Thoracic and Cardiovascular Surgery at the German Heart Center in Berlin, about the guidelines on temporary mechanical circulatory support (tCMS) in adult cardiac surgery. Chapters 00:00 Intro 01:56 Segmentectomy vs Lobectomy News 18:51 JANS 1, CT Residents Emergency Surgery 20:56 JANS 2, Interventional vs Surgical 22:49 JANS 3, Robotic Vascular Surgery 24:32 JANS 4, Surgery vs Surveillance 26:30 Video 1, Branch-First Arch Replacement 28:19 Video 2, Manougian Technique Double Patch 30:14 Video 3, Bentall Surgery via RAM 31:23 Evgenij Potapov Interview 53:55 Upcoming Events They discussed the key elements of the guidelines, active unloading, and current trends and outcomes in tMCS. Additionally, they addressed protected cardiac surgery for high-risk patients, cardiac arrest, and the impact of recent changes to the donor heart allocation system on tMCS. Dr. Potapov also shared valuable insights on hints and tips for tMCS, anticoagulation management, and the future of tMCS. Furthermore, Joel elaborated on recent discussions regarding lobectomy vs segmentectomy in a detailed analysis.  Joel also highlights recent JANS articles on a 10-year propensity-matched analysis on if we can safely train cardiothoracic surgical residents to perform emergency surgery, investigating the personality of interventional and surgical cardiovascular specialists, a clinical perspective on robotic-assisted vascular surgery, and a quality-of-life analysis of patients with moderately dilated aortic root or ascending aorta.  In addition, Joel explores branch-first arch replacement, revisiting the Manougian technique with double-patch, and Bentall surgery via right anterior minithoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Can We Safely Train Cardiothoracic Surgical Residents to Perform Emergency Surgery? A 10-Year Propensity-Matched Analysis   2.) Cut From the Same Cloth? Investigating the Personality of Interventional and Surgical Cardiovascular Specialists  3.) Robotic-Assisted Vascular Surgery: A Clinical Perspective  4.) Surgery Versus Surveillance: A Quality-of-Life Analysis of Patients With Moderately Dilated Aortic Root or Ascending Aorta  CTSNet Content Mentioned  1.) Branch-First Arch Replacement: How to Do It   2.) Revisiting the Manougian Technique With Double-Patch   3.) Bentall Surgery via Right Anterior Minithoracotomy   Other Items Mentioned  1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery   2.) The Cardiac Recovery Room  3.) Resident Video Competition  4.) 2025 CTSNet Recruitment Guide     5.) Career Center   6.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Randas Batista, cardiac surgeon and founder of Vilela Batista Heart Foundation, about the surgical treatment of Eisenmenger syndrome. Chapters 00:00 Intro 02:51 JANS 1, DAMSUN-HF Study 05:41 JANS 2, TAVR vs SAVR Guidelines 07:45 JANS 3, Myocardial Infarction After CABG 10:31 JANS 4, VAD Bridge-to-Transplant 12:27 New Recruitment Guide 13:54 Video 1, Anomalous Right Coronary Artery 15:27 Video 2, Beating Heart Transplant OCS 17:51 Video 3, Aortic Dissection Podcast w Marc Moon 19:26 Randas Batista Interview 37:38 Upcoming Events They explored what Eisenmenger syndrome is and outlined the most common causes of the condition. They also delved into the history of this syndrome, highlighting the significant contributions of Viktor Eisenmenger and Paul H. Wood. Furthermore, they discussed the impact of this syndrome on lung function and extracting oxygen within the pulmonary artery. Dr. Batista shared valuable technical tips for performing the surgical procedure as well as solutions for managing this syndrome.   Joel also highlights recent JANS articles on the DAMSUN-HF study on AI-enabled digital auscultation for detecting heart failure with reduced ejection fraction in Sub-Saharan Africa, transcatheter or surgical aortic-valve replacement in low-risk patients at seven years, current clinical practices and future perspectives on periprocedural myocardial infarction after coronary artery bypass grafting, and an analysis of UNOS.  In addition, Joel explores anomalous right coronary artery, beating heart transplantation using the Organ Care "Heart-in-a-Box" System (OCS), and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Marc Moon about aortic dissection. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) AI-Enabled Digital Auscultation for Detecting Heart Failure With Reduced Ejection Fraction in Sub-Saharan Africa: The DAMSUN-HF Study  2.) Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years  3.) Periprocedural Myocardial Infarction After Coronary Artery Bypass Grafting: Current Clinical Practices and Future Perspectives  4.) Analysis of UNOS: Ventricular Assist Device as Bridge-to-Transplant in Paediatric Patients With Congenital Heart Disease  CTSNet Content Mentioned  1.) Anomalous Right Coronary Artery  2.) Beating Heart Transplantation Using the Organ Care "Heart-in-a-Box" System (OCS)  3.) The Atrium: Aortic Dissection  Other Items Mentioned  1.) The Cardiac Recovery Room  2.) Resident Video Competition  3.) 2025 CTSNet Recruitment Guide   4.) Career Center   5.) CTSNet Events Calendar  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.

In this inaugural episode of CTSNet's new podcast, The Cardiac Recovery Room, moderator Dr. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society, spoke with Drs. Rakesh Arora, Director of Perioperative and Cardiac Critical Care and Research Director in the Division of Cardiac Surgery at University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio, USA, and Michael C. Grant, Associate Professor at Johns Hopkins University School of Medicine in the Department of Anesthesiology and Critical Care Medicine, about cardiac surgery myths.   Chapters 00:54 Are There Myths? 02:49 Applying Non-Cardiac Surgery Data 04:52 Reducing NPO, Diabetes Carb-Load 08:17 Postop, Crystalloid Volume 10:31 Bicarb Usage 12:10 Hematocrit & Hemoglobin 14:53 Bronchoscopy for Early Extubation 18:54 Routine X-Rays 22:19 Lactates 24:48 Sleeplessness & Delirium 31:14 Final Thoughts They discuss important topics such as the rationale for reducing nothing by mouth (NPO) guidelines, NPO after midnight, and the implications of carbohydrate loading for patients with type 1 diabetes. They examine critical issues of volume resuscitation, comparing the use of albumin vs crystalloids, as well as bicarb usage. Additionally, they evaluate hematocrit and hemoglobin levels, questioning whether specific thresholds should be established. The conversation also covers bronchoscopy for early extubation, inline suctioning for a bronchoalveolar lavage (BAL), and the necessity of daily chest x-rays following cardiac surgery. Furthermore, they address topics such as lactates, sleep aids, and delirium.  The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Zara Shirazi, a congenital cardiac surgery post-fellow at the National Institute of Cardiovascular Diseases, about advancing pediatric cardiac surgery in Pakistan using what she learned from her fellowship in Austria. Chapters 00:00 Intro 02:28 Vince TAVR Roundtables 03:05 Foreign Body, Case of the Month 03:49 JANS 1, Temporary MCS Guidelines 13:50 JANS 2, Parenting as a CT Surgeon 16:20 JANS 3, Utilization of Long Distance Donors 18:20 JANS 5, Multi-A Grafting in Redo CABG 20:58 Career Center 21:20 Video 1, Pulm & Tricuspid Endocarditis 22:35 Video 2, Valvular Heart Disease Guidelines 27:05 Video 3, Thoraflex Hybrid Graft Insertion 28:16 Zara Shirazi Interview 39:30 Upcoming Events 42:42 Closing They explored the advantages of working in a hospital in Pakistan compared to Austria, as well as the different techniques and operations, such as extracorporeal membrane oxygenation (ECMO). Dr. Shirazi also shared her experiences as a fellow in Austria and the valuable insights she gained from that experience. Additionally, she discussed her vision for the growth of her unit over the next five years and provided an overview of what a typical surgical week looks like in Pakistan.   Joel also highlights recent JANS articles on the EACTS/STS/AATS guidelines on temporary mechanical circulatory support in adult cardiac surgery, the unique challenges and positive impacts on children raised by cardiothoracic surgeon mothers, evolving changes in center-level utilization of longer distance donors in heart transplantation, and multiarterial grafting in redo coronary artery bypass grafting.  In addition, Joel explores pulmonary and tricuspid valve endocarditis, an interview with Drs. Borger and Marin-Cuartas on the guidelines for the management of valvular heart disease, and Thoraflex Hybrid graft insertion in a patient with Marfan syndrome. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery   2.) Parenting From the OR: The Unique Challenges and Positive Impacts on Children Raised by Cardiothoracic Surgeon Mothers  3.) Evolving Changes in Centre-Level Utilization of Longer Distance Donors in Heart Transplantation  4.) Multiarterial Grafting in Redo Coronary Artery Bypass Grafting: Type of Arterial Conduit and Patient Sex Determine Benefit  CTSNet Content Mentioned  1.) Pulmonary and Tricuspid Valve Endocarditis: A Late Sequelae of Unrepaired Double Chambered Right Ventricle in an Adult  2.) Guidelines for the Management of Valvular Heart Disease: An Interview With Drs. Borger and Marin-Cuartas  3.) Thoraflex Hybrid Graft Insertion in a Patient With Marfan Syndrome  Other Items Mentioned  1.) Adapting Global Innovations to Local Realities: Advancing Pediatric Cardiac Surgery in Pakistan—Lessons From Austria  2.) Roundtable: Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani   3.) Case of the Month: The Case of a Foreign Body  4.) Resident Video Competition  5.) The Cardiac Recovery Room  6.) Career Center   7.) CTSNet Events Calendar  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.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Marc Moon, Chief of Adult Cardiac Surgery at Texas Heart Institute, Chief of the Division of Cardiothoracic Surgery at Baylor College of Medicine, and Chief of Adult Cardiac Surgery section at Baylor St. Luke's Medical Center, about aortic dissection. Chapters 00:00 Intro 00:33 About Dr. Moon 02:51 Overview 03:33 History 05:27 Pathophysiology & Clinical Presentation 12:14 Diagnosis 15:25 Management 15:36 Step-by-Step, Type A 41:29 Step-by-Step, Type B 44:25 Postop Management 46:51 Complications 51:49 Future of Aortic Dissection 54:38 Key Takeaways 55:16 Training Advice They begin with an overview of aortic dissection, including its history and pathophysiology. They explored imaging techniques and diagnostic approaches, as well as management options. Additionally, they provided the steps for performing aortic dissection for both Type A and Type B, addressing postoperative management and complications. The episode concludes with a look at the future of aortic dissection, and Dr. Moon provides advice to trainees.   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 extended resection with Dr. Erinoangelo Rendina.    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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Liam Burns, CEO of Qaelon Medical, about turning ideas into companies. Chapters 00:00 Intro 02:26 JANS 1, Ross Procedure Consensus Statement 13:59 JANS 2, Novel Anastomotic Device 16:03 JANS 3, Tracheobronchoplasty Disorders Analysis 18:32 JANS 4, Revasc Strategies Non-Acute Myocardial 20:22 JANS 5, EACTS Core Curriculum for Cardiac Surgeon 21:51 Video 1, Giant Right Coronary Artery Aneurysm 24:01 Video 2, Bentall-de Bono Procedure 25:29 Video 3, Democratizing MI Mitral Repair 27:01 Liam Burns Interview 37:15 Upcoming Events 38:38 Closing They explored the challenges faced by innovators and emphasized the importance of having a commercial perspective. Additionally, they discussed product design, the fundraising process, and the challenges that commercial leaders face. Burns also shared valuable advice for aspiring innovators.   Joel also highlights recent JANS articles on the EACTS expert consensus statement on the Ross procedure in adult patients, a human cadaver study on a novel anastomotic device for the sandwich technique in type A aortic dissections, a comparative analysis of distinct airway disorders, revascularization strategies for non-acute myocardial ischemic syndromes, and core curriculum for the cardiac/cardiovascular surgeon.  In addition, Joel explores the surgical repair of a giant right coronary artery aneurysm with saphenous vein interpositional grafting, the Bentall-de Bono procedure, and democratizing minimally invasive mitral repair. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients   2.) Novel Anastomotic Device for the Sandwich Technique in Type A Aortic Dissections—A Human Cadaver Study  3.) Tracheobronchoplasty for Excessive Dynamic Airway Collapse and Tracheobronchomalacia: A Comparative Analysis of Distinct Airway Disorders  4.) Revascularisation Strategies for Non-Acute Myocardial Ischaemic Syndromes  5.) The European Association for Cardio-Thoracic Surgery—Core Curriculum for the Cardiac/Cardiovascular Surgeon  CTSNet Content Mentioned  1.) Surgical Repair of a Giant Right Coronary Artery Aneurysm With Saphenous Vein Interpositional Grafting   2.) The Bentall-de Bono Procedure: A Novel, Time-Efficient Mattress-Type Technique for Aortic Root Anastomosis   3.) Democratizing Minimally Invasive Mitral Repair  Other Items Mentioned  1.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  2.) Case of the Month: The Case of a Foreign Body  3.) Resident Video Competition  4.) Career Center   5.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning explores the integration of artificial intelligence (AI) in writing medical articles. Chapters 00:00 Intro 01:56 Using AI in Medical Writing 09:07 JANS 1, AI-Writing Article 14:53 JANS 2, Kidney vs Lung Transplant Outcomes 17:04 JANS 3, Harvesting Tech on ITAG 18:56 JANS 4, Phase 2 NeoCOAST-2 Trial 23:01 Career Center 23:41 Video 1, TAVR Explant After CABG w MVR 25:28 Video 2, Updated Y-Incision AA Enlargement 27:05 Video 3, Carotid Artery Cann for CABG 28:16 Upcoming Events He reviews guidelines set by the International Committee of Journal Editors Committee regarding publication ethics and emphasizes the benefits of utilizing AI in writing processes. Joel also highlights the crucial necessity of including disclosures when employing AI tools. Additionally, he delves into other ways AI can be used, such as data analysis, and discusses taking accountability when using these technologies. Furthermore, he addresses the limitations of AI, noting that it cannot be cited as a source or used as a coauthor.   Joel also highlights recent JANS articles on assisted artificial intelligence in medical writing, the impact of kidney transplantation on survival outcomes for lung transplantation, if the harvesting technique affects the production of nitric oxide and endothelin in the internal thoracic artery graft, and the platform phase 2 NeoCOAST-2 trial on perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer.  In addition, Joel explores a TAVR explant after CABG with MVR, tips and tricks for the updated Y-incision aortic annular enlargement, and carotid artery cannulation for cardiopulmonary bypass in minimally invasive cardiac surgery.    JANS Items Mentioned  1.) Assisted Artificial Intelligence in Medical Writing: A Primer for Humans   2.) The Impact of Kidney Transplantation on Survival Outcomes for Lung Transplantation  3.) The Harvesting Technique Affects the Production of Nitric Oxide and Endothelin in the Internal Thoracic Artery Graft  4.) Perioperative Durvalumab Plus Chemotherapy Plus New Agents for Resectable Non-Small-Cell Lung Cancer: The Platform Phase 2 NeoCOAST-2 Trial  CTSNet Content Mentioned  1.) TAVR Explant After CABG With MVR   2.) Tips and Tricks for the Updated Y-Incision Aortic Annular Enlargement   3.) Carotid Artery Cannulation for Cardiopulmonary Bypass in Minimally Invasive Cardiac Surgery   Other Items Mentioned  1.) Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals  2.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  3.) Resident Video Competition  4.) Career Center   5.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Fraser Sutherland, a consultant cardiac surgeon at Ross Hall Hospital and the Golden Jubilee National Hospital, Scotland, about the world's first transcervical robotic aortic valve replacement (AVR) procedures. Chapters 00:00 Intro  02:30 JANS 1, CABG After 60 Years  13:53 JANS 2, Endovascular Arch Repair  16:45 JANS 3, Impact of Age on ARR  18:47 JANS 4, Anterior Mediastinal Teratomas  20:28 Career Center  21:02 Video 1, RUL Without Dissecting SPV  22:58 Video 2, Replacement w Double Patch Repair  23:53 Video 3, TAVR & SAVR Removal w LVOR  24:47 Dr. Sutherland Interview  45:26 Closing  They discuss the history and evolution of these cases, along with the preclinical work that led to this innovative technique. Dr. Sutherland addresses initial challenges such as the uniportal incision, the transcervical retractor system, and enhancing dexterity by incorporating a robotic system. They also detail the first clinical case, including postoperative outcomes and the importance of maintaining safety for the patient. Additionally, they explore the benefits for patients undergoing this procedure and its future potential. Furthermore, Dr. Sutherland provides insights into the procedural steps and key aspects of the procedure.   Joel also highlights recent JANS articles on coronary artery bypass grafting 60 years after its debut, endograft design options and worldwide results for endovascular arch repair, the impact of age on aortic root replacement, and a multicenter retrospective study on if subxiphoid thoracoscopic surgery is safe and feasible for the treatment of anterior mediastinal teratomas.  In addition, Joel explores a multiportal approach for robotic right upper lobectomy without dissecting the superior pulmonary vein, aortic and mitral replacement with double patch repair, and TAVR and SAVR removal with left ventricular outflow reconstruction.  JANS Items Mentioned  1.) Coronary Artery Bypass Grafting: 60 Years After Its Debut  2.) Endovascular Arch Repair: Endograft Design Options and Worldwide Results  3.) The Impact of Age on Aortic Root Replacement  4.) Subxiphoid Thoracoscopic Surgery Is Safe and Feasible for the Treatment of Anterior Mediastinal Teratomas: A Multicentre Retrospective Study  CTSNet Content Mentioned  1.) Robotic Right Upper Lobectomy Without Dissecting the Superior Pulmonary Vein: A Multiportal Approach   2.) Aortic and Mitral Replacement With Double Patch Repair   3.) TAVR and SAVR Removal With Left Ventricular Outflow Reconstruction  Other Items Mentioned  1.) World's First Transcervical Robotic AVR Procedures Successfully Performed in 4 Cleveland Clinic Patients  2.) Resident Video Competition  3.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  4.) Career Center   5.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Marc Pelletier, division chief of cardiac surgery for the Department of Surgery at Yale School of Medicine, about patient blood management. Chapters 00:00 Intro 01:45 EACTS 2025 07:19 JANS 1, HVD Management Guidelines 16:26 JANS 2, Low-Risk AVR Evidence 19:21 JANS 3, Warden Procedure Selection 20:36 JANS 4, Primary Repair of CAT 21:48 JANS 5, NEWTON-CABG Cardiolink-5 23:20 Video 1, Acute Aortic Syndrome 24:54 Video 2, Redo TVR Under Bypass 27:13 Video 3, Giant Tension Bulla 28:47 Dr. Pelletier Interview 34:25 Outro They delve into the Society of Thoracic Surgeons (STS) guidelines on patient blood management, along with key tips. They also explore preoperative optimization, provide an example, and discuss cell savers and reducing dead space during surgery. Additionally, they touch on postoperative transfusion and the importance of performing meticulous surgery.  Joel also highlights recent JANS articles on the 2025 ESC/EACTS guidelines for the management of valvular heart disease, low-risk aortic valve replacement at the crossroads of evidence, ideal age and weight for the Warden procedure in patients with partial anomalous pulmonary venous return, a systematic meta-analysis of short- and long-term outcomes of the primary repair of common arterial trunk, and an international, randomized, double-blind, placebo-controlled trial on the effect of Evolocumab on saphenous vein graft patency after coronary artery bypass surgery.  In addition, Joel explores the surgical treatment of acute aortic syndrome, a redo tricuspid valve replacement technique under right heart bypass for a previously repaired tricuspid valve, and thoracoscopic resection of a giant tension bulla. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease: Developed by the Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)   2.) Low-Risk Aortic Valve Replacement at the Crossroads of Evidence  3.) Is There an Ideal Age or Weight for the Warden Procedure in Patients With Partial Anomalous Pulmonary Venous Return?  4.) Primary Repair of Common Arterial Trunk: A Systematic Meta-Analysis of Short- and Long-Term Outcomes  5.) Effect of Evolocumab on Saphenous Vein Graft Patency After Coronary Artery Bypass Surgery (NEWTON-CABG CardioLink-5): An International, Randomized, Double-Blind, Placebo-Controlled Trial  CTSNet Content Mentioned  1.) Surgical Treatment of Acute Aortic Syndrome   2.) Redo Tricuspid Valve Replacement Technique Under Right Heart Bypass for a Previously Repaired Tricuspid Valve   3.) Thoracoscopic Resection of a Giant Tension Bulla   Other Items Mentioned  1.) STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management  2.) Transcatheter vs Surgical Aortic Valve Replacement in Lower-Risk Patients: An Updated Meta-Analysis of Randomized Controlled Trials  3.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  4.) Career Center   5.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning shares insights from his recent trip to Ghana. Chapters 00:00 Intro  02:18 Ghana Mission Trip  04:35 Failures of a Heart Surgeon   09:27 JANS 1, Accelerometer-Measured Physical Activity   12:57 JANS 2, Utility of GERAADA Score   14:41 JANS 3, Aortic Valve Neocuspidization   17:33 JANS 4, Procedural Planning in Thoracoscopic Segmentectomy  19:09 JANS 5, The Outlet Orifice Diameter   22:28 Video 1, Clampless Aortic Valve Replacement   24:01 Video 2, Multiportal Robot-Assisted Extended LLS S6  25:13 Video 3, The Atrium  26:00 EACTS 2025 & Upcoming Events  27:35 Footage From Ghana  He discusses the various procedures that he and his team performed during their visit, as well as his overall experience collaborating with the local surgeons. The episode also features surgical footage from his time in Ghana and includes discussion with several surgeons about their work. Additionally, Joel addresses a recent news story from the UK regarding the failures of a heart surgeon that have contributed to multiple patient deaths. He provides an overview of the circumstances surrounding these events and emphasizes the critical importance of teamwork in surgical practice.   Joel also highlights recent JANS articles on an analysis of the UK mini mitral randomized controlled trial for accelerometer-measured physical activity after mitral valve surgery, the utility of GERAADA score for predicting long-term survival following surgical repair of aortic dissection, early to mid-term results of aortic valve neocuspidization for rheumatic aortic valve disease, a systematic review and meta-analysis for three-dimensional reconstruction and virtual simulation of patient-specific anatomy for procedural planning in thoracoscopic segmentectomy, and the outlet orifice diameter of surgical bioprosthetic aortic stented valves is predominantly much smaller than the inlet orifice diameter.  In addition, Joel explores a clampless aortic valve replacement in a partial porcelain aorta with aortic root enlargement and CABG with two grafts, multiportal robot-assisted extended lower left segmentectomy, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. John D. Puskas about proximal coronary anastomosis. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Accelerometer-Measured Physical Activity After Mitral Valve Surgery: An Analysis of the UK Mini Mitral Randomized Controlled Trial  2.) Utility of GERAADA Score for Predicting Long-Term Survival Following Surgical Repair of Aortic Dissection  3.) Early to Mid-Term Results of Aortic Valve Neocuspidization for Rheumatic Aortic Valve Disease  4.) Three-Dimensional Reconstruction and Virtual Simulation of Patient-Specific Anatomy for Procedural Planning in Thoracoscopic Segmentectomy: A Systematic Review and Meta-Analysis  5.) The Outlet Orifice Diameter of Surgical Bioprosthetic Aortic Stented Valves Is Predominantly Much Smaller Than the Inlet Orifice Diameter   CTSNet Content Mentioned  1.) Clampless Aortic Valve Replacement in a Partial Porcelain Aorta With Aortic Root Enlargement and CABG With Two Grafts  2.) Multiportal Robot-Assisted Extended Lower Left Segmentectomy: Superior Segment S6 With Lateral S9 Resection  3.) The Atrium: Proximal Coronary Anastomosis   Other Items Mentioned  1.) Joel Dunning YouTube Channel | The Arrhythmia Alliance Hearts of Ghana Mission 2025   2.) Heart Surgeon's Failures Contributed to Multiple Deaths   3.) The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts  4.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  5.) Career Center   6.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Anders Jeppsson, a cardiothoracic surgeon at Sahlgrenska University Hospital in Gothenburg, Sweden, about his paper on “Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome,” published in The New England Journal of Medicine. Chapters 00:00 Intro  01:54 Ghana Mission Trip  06:23 JANS 1, Pig-to-Human Transplant  08:08 JANS 2, CABG Acute Type A AD  10:06 JANS 3, Chylothorax Lymph Node Management  11:22 JANS 4, ICU Resternotomy Adoption  13:38 JANS 5, Octogenarians Repair vs MV Surgery  15:10 Career Center  15:31 Video 1, MVR Patent Bilateral IMammary Grafts  16:36 Video 2, Repeat RA Thoracotomy  17:39 Video 3, Vascular Injuries in Robotics  19:12 Dr. Jeppsson Interview  33:30 EACTS 2025 & Upcoming Events  They began by providing an overview of the study, including the reason for conducting it, the expansion of the study to other Nordic countries, and its results. They also discuss the funding for the research and the recruitment process. Additionally, they cover dual antiplatelet therapy and compare this study with similar research. Finally, they explore registry-based studies and future research on ticagrelor and aspirin, or aspirin alone, following coronary surgery for acute coronary syndrome.  Joel also highlights recent JANS articles exploring whether protective coronary artery bypass grafting improves surgical outcomes in acute type A aortic dissection with coronary ostial involvement, the association of chylothorax with aggressiveness of lymph node management during pulmonary resection, if intensive care unit resternotomy should be practiced in all facilities that perform cardiac surgery, transcatheter edge-to-edge repair vs mitral valve surgery in octogenarians, and research using pig-to-human lung xenotransplantation into a brain-dead recipient.  In addition, Joel explores robotic mitral valve replacement in a patient with patent bilateral internal mammary grafts, repeat right axillary thoracotomy as a safe and feasible approach for repair of recurrent LAVVR after previous AVSD repair, and handling vascular injuries in robotic thoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Protective Coronary Artery Bypass Grafting Improves Surgical Outcomes in Acute Type A Aortic Dissection With Coronary Ostial Involvement  2.) The Association of Chylothorax With Aggressiveness of Lymph Node Management During Pulmonary Resection  3.) Expert Opinion: Intensive Care Unit Resternotomy Should Be Practiced in All Facilities That Perform Cardiac Surgery  4.) Transcatheter Edge-to-Edge Repair Versus Mitral Valve Surgery in Octogenarians: Comparative Analysis of Safety, Durability, and Survival  5.) Pig-to-Human Lung Xenotransplantation Into a Brain-Dead Recipient  CTSNet Content Mentioned  1.) Robotic Mitral Valve Replacement in a Patient With Patent Bilateral Internal Mammary Grafts: A Case Video  2.) Repeat Right Axillary Thoracotomy Is a Safe and Feasible Approach for Repair of Recurrent LAVVR After Previous AVSD Repair   3.) Handling Vascular Injuries in Robotic Thoracic Surgery: Real-Life Cases Using a Fibrin-Based Hemostatic Technique  Other Items Mentioned  1.) Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome   2.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  3.) Career Center   4.) CTSNet Events Calendar  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.

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 extended resection with Dr. Erinoangelo Rendina.   Related Resources   The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts   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.

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  3.) Clinical Success of Re-Redo Pulmonary Valve and Pulmonary Trunk Homograft Replacement During the Second Trimester of Pregnancy  4.) Lessons Learned From Various 3D-Printed Tracheal Grafts in an Extensive Porcine Model for De Novo Tracheal Regeneration  CTSNet Content Mentioned  1.) EXIT-to-Open Atrial Septectomy for Hypoplastic Left Heart Syndrome With Intact Atrial Septum: Gone in 90 Seconds!  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  1.) Career Center   2.) CTSNet Events Calendar  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.

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  1.) External Validation of SYNTAX Score II in a Real-World Cohort Undergoing Coronary Artery Bypass Grafting  2.) Successful Extracorporeal Membrane Oxygenation Bridge to Lung Transplant With a Patient Transported From Hawaii to Nashville, Tennessee  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  1.) Career Center   2.) CTSNet Events Calendar  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.

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  2.) An Artificial Intelligence and Machine Learning Model for Personalized Prediction of Long-Term Mitral Valve Repair Durability  3.) Effect of Duration of Donor Ventilation on Lung Transplant Outcomes  4.) Surgical Decision-Making for Concomitant Tricuspid Valve Repair in Minimally Invasive Mitral Valve Surgery  5.) A Soft Robotic Total Artificial Hybrid Heart  CTSNET Content Mentioned  1.) Right Ventricular Outflow Tract Injury During Deep Dissection in Valve-Sparing Aortic Root Replacement   2.) Minimally Invasive Approach for Atrial Septal Defect Closure  3.) Redo Aortic Valve Replacement Via Partial Upper Resternotomy  Other Items Mentioned  1.) Voom Foundation   2.) Career Center   3.) CTSNet Events Calendar  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.

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  1.) World's First Transcervical Robotic AVR Procedures Successfully Performed in 4 Cleveland Clinic Patients  2.) Comparison of Outcomes Post Cor-Knot Versus Manual Tying in Valve Surgery: Our 8-year Analysis of Over 1000 Patients  3.) Endobronchial Valve Therapy Versus Lung Volume Reduction Surgery in the United States  4.) Early Extraction Versus Conservative Management in Patients With Noninfected Cardiac Implantable Electronic Devices Undergoing Cardiac Surgery for Left-Sided Infective Endocarditis  CTSNET Content Mentioned  1.) Repair of Ruptured Right Coronary Artery Aneurysm  2.) Removal of a Right Atrial Myxoma From the IVC Junction With Patch Repair Using the Left Atrial Appendage  3.) Modified Re-Do Commando Procedure in a Patient With Septic Shock Due to Aortic and Mitral Valve Endocarditis   Other Items Mentioned  1.) A Surgeon's Toolkit for Mitral Valve-Induced Left Ventricular Outflow Tract Obstruction With Minimal Septal Hypertrophy  2.) Cardiac Surgical Arrest—An International Conversation Series    3.) Career Center   4.) CTSNet Events Calendar  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.

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  2.) The Current Landscape and Challenges Facing International Medical Graduates in Cardiothoracic Surgery Training  3.) Chest Wall Injury Society Guidelines for Surgical Stabilization of Rib Fractures: Indications, Contraindications, and Timing  4.) Foundational Endovascular Concepts and Devices for Cardiac Surgeons  CTSNET Content Mentioned  1.) Redo Aortic Root Surgery: The David Procedure in a Patient With a Previous Type A Dissection Surgery  2.) Removal of a Left Atrial Myxoma With a Ministernotomy  3.) Surgical Correction of the Posterior Mitral Annular Disjunction Associated With Structural Abnormalities of the Mitral Valve  Other Items Mentioned  1.) Best Hospitals for Cardiology, Heart & Vascular Surgery  2.) NYU Langone Health Leads the Nation with Four No. 1–Ranked Specialties by U.S. News & World Report  3.) Cardiac Surgical Arrest—An International Conversation Series    4.) Resident Video Competition  5.) Career Center   6.) CTSNet Events Calendar  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.

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.

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  1.) Surgical Implications of the 2023 ESC Endocarditis Guidelines Endorsed by EACTS: Bridging Guidelines and Practice   2.) Durable Effectiveness and Safety of Hybrid Ablation Versus Catheter Ablation: 2-year Results From the Randomized CEASE-AF Trial  3.) Superficial Parasternal Intercostal Plane Block and Full Sternotomy; A Randomized Trial  4.) Comparison of Short- and Long-Term Outcomes in Patients Undergoing Sleeve Lobectomy With or Without Buttressing the Bronchial Anastomosis  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    3.) Career Center   4.) CTSNet Events Calendar  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.

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  1.) The 10 Commandments of On-Table Extubation After Cardiac Surgery: Why and How to Increase Adoption  2.) Can We Rely on Intraoperative Bronchoscopic Biopsies for Surgical Decision Making? 78 Single Anesthetic Robotic Bronchoscopy to Anatomic Resections  3.) Increased Prevalence of Stroke After Heart Transplant in the New Allocation System Era  4.) Surgical Management of Both Stage III and Stage IV Pulmonary Carcinoid Tumors Confers Survival Benefit  CTSNET Content Mentioned  1.) Robotic Left Atrial Appendage Occlusion   2.) Bedside Veno-Venous Extracorporeal Membrane Oxygenation Cannulation Technique in an Awake Patient  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    3.) Career Center   4.) CTSNet Events Calendar  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.

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  2.) Valve Replacement During Pregnancy: Literature Review Including New Data From the Registry of Pregnancy and Cardiac Disease III  3.) Bronchopleural Fistula: A Multi-Institutional Analysis of the Treatment Outcomes and Prognostic Factors in the ESSG-01 Study   4.) The Choice of Surgical Aortic Valve Replacement Type and Mid-Term Outcomes in 50 to 65-Year-Olds: Results of the AUTHEARTVISIT Study   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    3.) Career Center   4.) CTSNet Events Calendar  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.

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  1.) Open Atrial Septectomy on Placental Support: A Novel and Logistic Approach for Hypoplastic Left Heart Syndrome With Intact Atrial Septum  2.) Fit2Perform: European Society of Thoracic Surgery Survey on Member Well-Being  3.) Transcatheter Management of Left-Sided Valvular Heart Disease Following Heart Transplantation  4.) A Multi-Institutional Study on the Prevalence and Clinical Impact of Patient-Prosthesis Mismatch in Surgical Aortic Valve Replacement  5.) The German Registry of Acute Aortic Dissection Type A Score for 30-Day Mortality Prediction in Type A Acute Aortic Dissection Surgery: A Systematic Review and Meta-Analysis  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 4.) Career Center   5.) CTSNet Events Calendar 

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.

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?  3.) Summary of the International Society for Heart and Lung Transplantation Consensus Conference on Emerging Understanding of Antibodies and Antibody-Mediated Rejection in Heart Transplantation  4.) Inflammatory Diseases and Risk of Lung Cancer Among Individuals Who Have Never Smoked  5.) Active Chest Tube Clearance Added to an Enhanced Recovery After Cardiac Surgery (ERAS) Program Improves Outcomes and Reduces Resource Utilization  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  3.) Reconstruction of the Left Trigone During the Commando Procedure for Invasive Prosthetic Aortic Valve Endocarditis  Other Items Mentioned  1.) Guest Editor Series: Coronary Arterial Anomalies—Pediatric and Adult Congenital   2.) Cardiac Surgical Arrest—An International Conversation Series   3.) Career Center   4.) CTSNet Events Calendar  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.

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  2.) Social Media Use Among Cardiothoracic Surgeons: The Online Landscape and Comparisons Between Subgroups  3.) A Surgeon's Toolkit for Mitral Valve-Induced Left Ventricular Outflow Tract Obstruction With Minimal Septal Hypertrophy  4.) Trans-Atlantic Analysis of Gender Representation in General Thoracic Surgery: Challenges Permeate the Academic Community  5.) Extent of Coronary Artery Disease and Clinical Outcomes With Ticagrelor Monotherapy Versus Aspirin After Coronary Artery Bypass Grafting: Insights From the TiCAB Trial  CTSNET Content Mentioned  1.) Infarct Exclusion Technique for Posterior Ischemic Ventricular Septal Defect in a Patient With Impella 5.5 Support  2.) Mastering Robotic Lung Resection: The French Lobectomy Technique for Standardized Surgical Education  3.) Mitral Annular Calcification: Assessment, Debridement, and Annular Support for Valve Replacement  Other Items Mentioned  1.) Cardiac Surgical Arrest—An International Conversation, Part 3  2.) Career Center   3.) CTSNet Events Calendar  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.

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  3.) Comparison Between Robot- and Video-Assisted Thoracoscopic Surgeries for Anterior Mediastinal Lesions  4.) Cost-Effectiveness of Left Ventricular Assist Device for Transplant-Ineligible Patients  5.) Three-Dimensional Tracheo-Bronchial Reconstruction to Plan Endoscopic Stent Insertion for Malignant Upper Airway Stenosis CTSNET Content Mentioned  1.) Excision of a Subvalvular Ring With Preservation of the Aortic Valve  2.) VATS Intrapericardial Left Pneumonectomy for Centrally Located Lung Tumor: Step-by-Step Approach With Technical Pearls  3.) Repair of Rheumatic Mitral Stenosis Using the SCORE Technique  Other Items Mentioned  1.) Cardiac Surgical Arrest—An International Conversation, Part 2   2.) Career Center   3.) CTSNet Events Calendar  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.

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  2.) Time to Surgery in Early-Stage Non-Small Cell Lung Cancer: Defining the Optimal Diagnosis-to-Resection Interval to Reduce Mortality  3.) Concurrent Spread Through Air Spaces in Dominant Tumors Impacts Prognosis in Synchronous Multiple Primary Lung Adenocarcinoma   4.) The Impact of Preoperative Invasive Nodal Staging on Unexpected Mediastinal Upstaging in Early-Stage Non-small Cell Lung Cancer   CTSNET Content Mentioned  1.) Robot-Assisted Intrapericardial Pneumonectomy With Bronchoplasty and Thymic Flap Post Neoadjuvant Chemo/IO  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  2.) Career Center   3.) CTSNet Events Calendar 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.

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  1.) Mitral Valve Surgery After Failed Transcatheter Intervention for Mitral Regurgitation: Techniques, Challenges, and Outcomes  2.) Distal Anastomotic New Entry Tears Predict Long-Term Outcomes After Hemi-Arch Repair for DeBakey I Aortic Dissection  3.) Pain Catastrophizing Scale as a Predictor for Acute Postoperative Pain Following Video-Assisted Thoracoscopic Surgery Lobectomy  4.) Sex Difference in Aortic Root Replacement With a Stentless Bioprosthesis  CTSNET Content Mentioned  1.) Open Implantation of a Transcatheter Aortic Valve via Redo Sternotomy, Mitral Valve Replacement, and Tricuspid Valve Repair in a High-Risk-Patient  2.) Challenging Pulmonary Arterial Reconstruction: Repeat Sternotomy With Completion Unifocalization and Extensive Pulmonary Arterial Reconstruction in ToF/PA/MAPCAs   3.) Direct Aortic Impella 5.5 in Post-Cardiotomy Shock  Other Items Mentioned  1.) Allogeneic Mitral Valve Transplant: Historical Precedent, Current Considerations, and Future Implementation  2.) Cardiac Surgical Arrest—An International Conversation, Part 1  3.) Winners of the 2025 CTSNet Instructional Video Competition  4.) Career Center   5.) CTSNet Events Calendar  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.

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.

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  1.) Creating Opportunities From Challenging Anatomy: Left Axillary Thoracotomy for Closure of Ventricular Septal Defect in an Infant With Situs Solitus and Extreme Levoposition of the Heart  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   4.) Career Center   5.) CTSNet Events Calendar  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.

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  1.) Safety and Feasibility of Novel Single-Port Robotic-Assisted Lobectomy/Segmentectomy for Lung Cancer  2.) Touching (Proximity) as a Companion Diagnostic Test   3.)  Long-Term Outcomes After Removal of Rib Stabilization Hardware in Patients With Blunt Chest Trauma  4.) Advancing the Needle on the Management of Resectable EGFR-Positive NSCLC: Is Neoadjuvant Osimertinib the Answer?  CTSNET Content Mentioned  1.) On-Pump Beating Heart Mitral Valve Repair Through Right Anterior Mini Thoracotomy  2.) Drain, Patch, Unload: Post-Infarction Myocardial Rupture Treated With Surgical Repair and Graded Mechanical Support  3.) Head-First Graft Technique in Aortic Arch Replacement  Other Items Mentioned  1.) Career Center   2.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning recaps the 33rd European Society of Thoracic Surgeons (ESTS) annual meeting in Budapest. Chapters 00:00 Intro 01:30 ESTS 2025 Conference 09:11 SHURUI Robot Study 10:04 Willard A. Fry 12:44 Transplant Recipient Pregnancy Outcomes 15:25 Low-Flow, Low-Gradient Aortic Stenosis 17:12 Warm Ischemic Intervals Effect 19:16 Extracorp Circulation vs Conventional 23:23 Femoral Cannulation for CPB Min Invasive 24:25 Valve Sparing Aortic Root Replacement 25:27 Valve Surgery Podcast w Michael Mack 27:21 Upcoming Events 27:54 Closing He discusses the key themes and takeaways from the event, the SHURUI single-port robotic system, the hands-on experience with the da Vinci Single-Port system led by Dr. Tom Routledge, and the extraordinary guest lecture from Ernő Rubik, the inventor of the Rubik's cube. Joel also highlights various presentations from the meeting, including “Does the Fissureless Technique Really Reduce Air Leak? Results of the Prospective Randomized Study Fissureless Versus Fissurefirst (3F Trial)” by Tom Routledge, “Tour D'Horizon About Potential Newcomings in the 10th Edition” by Valerie Rusch, and much more. Additionally, he pays tribute to Willard A. Fry and his significant accomplishments.   Joel also highlights recent JANS articles on pregnancy outcomes in 53 female lung transplant recipients, outcomes of surgical versus transcatheter aortic valve replacement in patients with low-flow, low-gradient aortic stenosis, the effect of warm ischemic intervals on primary graft dysfunction in normothermic regional perfusion for donation after circulatory death heart transplant, and minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery.  In addition, Joel explores femoral cannulation for CPB during minimally invasive cardiac surgery, a presentation from the Society for Cardiothoracic Surgery in Great Britain and Ireland annual meeting on “Valve Sparing Aortic Root Replacement—Tips and Tricks,” and the one-year anniversary episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with cardiothoracic surgery pioneer Dr. Michael Mack on the future of valve surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Pregnancy Outcomes in 53 Female Lung Transplant Recipients  2.) Outcomes of Surgical Versus Transcatheter Aortic Valve Replacement in Patients With Low-Flow, Low-Gradient Aortic Stenosis  3.) The Effect of Warm Ischemic Intervals on Primary Graft Dysfunction in Normothermic Regional Perfusion for Donation After Circulatory Death Heart Transplant  4.) Minimal Invasive Extracorporeal Circulation Versus Conventional Cardiopulmonary Bypass in Cardiac Surgery: A Contemporary Systematic Review and Meta-Analysis  CTSNET Content Mentioned  1.) Femoral Cannulation for CPB During Minimally Invasive Cardiac Surgery  2.) SCTS 2025 | Valve Sparing Aortic Root Replacement—Tips and Tricks  3.) The Atrium: The Future of Valve Surgery  Other Items Mentioned  1.) Safety and Feasibility of Novel Single-Port Robotic-Assisted Lobectomy/Segmentectomy for Lung Cancer  2.) A Eulogy for Willard A. Fry  3.) 2025 SCTS Annual Meeting Videos   4.) The Atrium—All Episodes   5.) Career Center   6.) CTSNet Events Calendar  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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with cofounders Courtney Maxey-Jones and Connor Wasilnak about their charity, Global Outreach for Medical Equity and Development (GOMED), which exists to deliver essential medical supplies to underresourced regions. Chapters 00:00 Intro 01:33 Surgical Instrument Donations 02:43 Adverse Outcomes in Surgery 10:05 Lymph Node NSCLC Study 12:45 Pleural Invasion by AI Analysis 15:54 Robotic vs Conventional MVR 18:55 Postop Atrioventricular Block 22:36 Extra-Anatomical Bypass & AVR 24:25 Redo MV w Different Strategies 27:57 Manage Aorto-Mitral Abscess Endocarditis 30:41 GOMED Interview 43:04 Closing They discuss the reasons behind its creation, its mission, the current status of the organization, and how individuals and companies can get involved. Additionally, they explored some of the equipment GOMED has and what it needs, and the various locations it serves. Joel also shares insights about a recent patient of his with Marfan Syndrome and pectus excavatum, emphasizing the ongoing importance of the N=1 trial in clinical research.  Joel also highlights recent JANS articles on lymph node sampling and survival in non-small cell lung cancer, pleural invasion of peripheral cT1 lung cancer by deep learning analysis of thoracoscopic images, clinical outcomes and costs of robotic-assisted vs conventional mitral valve repair, and postoperative atrioventricular block after surgery for congenital heart disease.   In addition, Joel explores extra-anatomical aortic bypass and aortic valve replacement in a patient with aortic coarctation and severe aortic insufficiency, totally endoscopic redo mitral valve surgery with different myocardial protection strategies, and managing aorto-mitral abscess endocarditis after previous AVR with an LVOT enlargement procedure. Before closing, he highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Lymph Node Sampling and Survival in Non-Small Cell Lung Cancer: A 10-Year Danish Cohort Study  2.) Pleural Invasion of Peripheral cT1 Lung Cancer by Deep Learning Analysis of Thoracoscopic Images: A Retrospective Pilot Study  3.) Clinical Outcomes and Costs of Robotic-Assisted vs Conventional Mitral Valve Repair: A National Analysis  4.) Postoperative Atrioventricular Block After Surgery for Congenital Heart Disease: Incidence, Recovery and Risks  CTSNET Content Mentioned  1.) Extra-Anatomical Aortic Bypass and Aortic Valve Replacement in a Patient With Aortic Coarctation and Severe Aortic Insufficiency  2.) Totally Endoscopic Redo Mitral Valve Surgery With Different Myocardial Protection Strategies  3.) Managing Aorto-Mitral Abscess Endocarditis After Previous AVR With an LVOT Enlargement Procedure  Other Items Mentioned  1.) Global Outreach for Medical Equity and Development  2.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach  3.) Aortic Valve Replacement Series   4.) Career Center   5.) CTSNet Events Calendar  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.