CTSNet Podcasts

CTSNet

Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.

  1. The Beat With Joel Dunning Ep. 152: Utilizing AI in Cardiothoracic Surgery

    1D AGO

    The Beat With Joel Dunning Ep. 152: Utilizing AI in Cardiothoracic Surgery

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Zain Khalpey, an assistant attending surgeon at NewYork-Presbyterian/Columbia University Irving Medical Center, NY, USA, adjunct assistant professor of surgery at Columbia University Irving Medical Center, NY, USA, and Chief Medical AI Officer, Chair of Applied Clinical AI, and Director of Applied Translational Artificial Research Institute (ATARI), AZ, USA, about utilizing artificial intelligence (AI) in cardiothoracic surgery. Chapters 00:00 Intro 01:42 Upcoming CTSNet Activities 03:01 Website Transition 03:54 JANS 1, Mech vs Bio AVR in 50–70 YO 08:16 JANS 2, Abnormal Bleeding in OR 10:26 JANS 3, Intraop Assessment RV Function 11:54 JANS 4, Laser Anastomosis System CABG 14:49 Video 1, RAMT AVR Hemiarch Replacement 16:23 Video 2, Big Cyst & Small Incisions 17:33 Video 3, Left VATS Pneumonectomy 19:55 Dr. Khalpey, AI in CT Surgery 30:28 Upcoming Events 31:48 Closing They discuss the importance of ethical AI being and address risk scores. The conversation also covers the application of AI in preoperative, intraoperative, and postoperative settings, as well as predictive algorithms and the benefits of integrating AI within cardiothoracic surgery. Additionally, they emphasize that there will always be a need for surgeons, as AI cannot replace human expertise.   Joel also highlights recent JANS articles on a systematic review and meta-analysis on mechanical vs biological aortic valve replacement in patients aged 50-70 years, an observational study of inter-rater reliability between anesthetists and surgeons on abnormal bleeding in the cardiac operating room, advancing intraoperative assessment of right ventricular function, and the excimer laser assisted non-occlusive anastomosis (ELANA) anastomotic system surgical technique to construct distal anastomoses using a novel device in coronary artery bypass grafting.  In addition, Joel explores a right anterior minithoractomy aortic valve replacement, ascending aorta, and hemiarch repair, thoracoscopic resection of a large mediastinal cyst, and left VATS pneumonectomy in pediatric pulmonary mucoepidermoid carcinoma. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Mechanical Versus Biological Aortic Valve Replacement in Patients Aged 50-70 Years: A Systematic Review and Meta-Analysis  2. Abnormal Bleeding in the Cardiac Operating Room: An Observational Study of Inter-Rater Reliability Between Anesthetists and Surgeons  3. Echocardiographic Correlates of Pressure-Volume-Derived Indices: Advancing Intraoperative Assessment of Right Ventricular Function  4. The Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) Anastomotic System Surgical Technique to Construct Distal Anastomoses Using a Novel Device in Coronary Artery Bypass Grafting  CTSNet Content Mentioned  1. Right Anterior Minithoractomy Aortic Valve Replacement, Ascending Aorta, and Hemiarch Repair   2. When Size Is Not a Limitation: Thoracoscopic Resection of a Large Mediastinal Cyst   3. Left VATS Pneumonectomy in Pediatric Pulmonary Mucoepidermoid Carcinoma   Other Items Mentioned  1. Website Blackout Notice!  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.

    32 min
  2. The Lifeline: Managing Arrest in Patients With tMCS

    2D AGO

    The Lifeline: Managing Arrest in Patients With tMCS

    In this edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Rakesh Arora, Director of Cardiothoracic Critical Care and a professor in the Department of Surgery and Anesthesia at Northwestern Medicine, Chicago, IL, USA. They discuss managing arrest in patients with temporary mechanical circulatory support (tMCS), focusing on a paper Arora authored titled “EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery.”   Chapters  00:00 Intro  01:08 Guidelines Background  02:02 Resuscitation, Monitoring Parameters  07:37 Approach to Patients in Extremis  11:39 Quality Assurance, Internal Data  12:22 End-Tidal  13:17 Bleeding Management  15:33 Arrhythmia, Defibrillation  17:21 Optimizing Tissue Perfusion  18:09 Key Points  20:26 Devices & Flow Patterns  They began by exploring how this paper was developed and how Arora became involved in this project. They discussed the importance of expediting the resuscitation process and examined the recommendations for a tMCS implantation in patients experiencing post-procedural low cardiac output syndrome (LCOS). Key considerations included oxygen saturation levels (SpO2) and point-of-care ultrasound (POCUS), as well as the significance of pulsatility. Additionally, they discussed the interaction between devices and patients and the importance of team training and simulation. They also addressed crucial topics such as coagulation, anticoagulation, and defibrillation. Finally, they examined optimizing tissue perfusion for better patient outcomes.   Every month, The Lifeline features intensive care specialists sharing their expert insights into the rapid and effective management of critically ill cardiac surgical patients. Don’t miss next month’s episode!  Related Resources  EACTS/STS/AATS Guidelines on Temporary Mechanical Circulatory Support in Adult Cardiac Surgery  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.

    23 min
  3. The Beat With Joel Dunning Ep. 151: Percutaneous CABG Technique—The VECTOR Procedure

    APR 2

    The Beat With Joel Dunning Ep. 151: Percutaneous CABG Technique—The VECTOR Procedure

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Adam Greenbaum, an Associate Professor of Medicine at Emory School of Medicine and Co-director of the Emory Structural Heart and Valve Center, Atlanta, GA, USA, about the groundbreaking percutaneous coronary artery bypass graft procedure he developed called the ventriculo-coronary transcatheter outward navigation and reentry (VECTOR) procedure. Chapters 00:00 Intro 02:46 FDA Device Recall 03:52 JANS 1, CDC WONDER Aortic Stenosis 06:10 JANS 2, Free vs In-Situ RIMA-CABG 08:04 JANS 3, AF Worsens Outcome of MVR 09:52 JANS 4, EXCEL Trial 12:29 New Website 13:43 Video 1, Ross Procedure Technique 16:16 Video 2, Total Arch Replacement 18:38 Video 3, Pleural Sepsis Podcast 20:51 Dr. Greenbaum, VECTOR Procedure 40:34 Upcoming Events 41:18 Career Center 41:43 Closing They delved into the development and rationale behind this innovative technique, which aims to provide a solution for patients with no other options, particularly those with narrow sinuses or low-lying coronaries. Additionally, they discussed other leaflet modification methods and the criteria for patient selection for the VECTOR procedure. The conversation also covered the technical steps involved in the procedure, along with specific cases in which it has been utilized, as well as the challenges faced and troubleshooting done by the surgeons. Finally, they explored the future of this procedure.   Joel also highlights recent JANS articles on concerning trends seen in aortic stenosis-related mortality, a meta-analysis on free vs in-situ right internal mammary artery as a conduit in coronary artery bypass surgery, if atrial fibrillation worsens outcome of mitral valve repair for degenerative mitral regurgitation, and the EXCEL trial on spontaneous myocardial infarction after left main revascularization.  In addition, Joel explores the Ross procedure with annular stabilization, interposition graft, and loose-jacket technique, total arch replacement with a novel dual stent device, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Professor Eric Lim about pleural sepsis. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER  2. Free vs In-Situ Right Internal Mammary Artery as a Conduit in Coronary Artery Bypass Surgery: A Meta-Analysis  3. Atrial Fibrillation Worsens Outcome of Mitral Valve Repair for Degenerative Mitral Regurgitation: Long-Term Follow-Up of 959 Patients  4. Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial  CTSNet Content Mentioned  1. Ross Procedure With Annular Stabilization, Interposition Graft, and Loose-Jacket Technique   2. Total Arch Replacement With a Novel Dual Stent Device   3. The Atrium: Pleural Sepsis   Other Items Mentioned  1. Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure  2. Website Blackout Notice!  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.

    43 min
  4. The Beat With Joel Dunning Ep. 150: Concerning Trends Seen in Aortic Stenosis Related-Mortality

    MAR 26

    The Beat With Joel Dunning Ep. 150: Concerning Trends Seen in Aortic Stenosis Related-Mortality

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Sameer Hirji, an associate surgeon at Brigham and Women's Hospital in Boston, MA, USA, about a paper he presented on at the 62nd Society of Thoracic Surgeons Annual Meeting titled “Concerning Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER.” Chapters 00:00 Intro  02:38 JANS 1, Female CT Surgeons NYT Article  04:38 JANS 2, Biopros vs Mech SAVR >65 YO  07:32 JANS 3, Fissure Last Tech, Randomized Trial  09:58 JANS 4, Ozaki Procedure, Perf & Durability  12:46 Video 1, MI Left Atrial Myxoma Resection  14:43 Video 2, Conduction System-Sparing Modified AVR  16:42 Video 3, RCAA w Coronary SF  18:55 Dr. Hirji, CDC WONDER Aortic Stenosis  31:40 Upcoming Events  32:11 Closing They discussed the study itself, including its overall results, as well as the demographic factors analyzed—such as race, gender, and location—and the results related to these demographics. They also addressed the limitations of the data used and explored possible reasons for the observed results, such as intervention strategies, underdiagnosis, and the prevalence of asymptomatic patients. The conversation further emphasized the importance of patient selection and the heart team.  Joel also highlights recent JANS articles on female cardiothoracic surgeons, unlocking the male fortress, bioprosthetic versus mechanical surgical aortic valve replacement in patients ≥65 years of age, results from a prospective randomized controlled trial on if the fissure last technique really reduces postoperative air leak after lung resection, and mid-term valve performance and durability of the Ozaki procedure in patients on chronic dialysis.  In addition, Joel explores a minimally invasive left atrial myxoma resection, safety and efficacy of a cardiac conduction system-sparing modified aortic valve replacement, and a surgical approach to right coronary artery aneurysm with coronary sinus fistula. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Female Cardiothoracic Surgeons, Unlocking the Male Fortress  2. Bioprosthetic Versus Mechanical Surgical Aortic Valve Replacement in Patients ≥65 Years of Age  3. Does the Fissure Last Technique Really Reduce Postoperative Airleak After Lung Resection? Results From a Prospective Randomized Controlled Trial   4. Mid-Term Valve Performance and Durability of the Ozaki Procedure in Patients on Chronic Dialysis  CTSNet Content Mentioned  1. Minimally Invasive Left Atrial Myxoma Resection   2. Safety and Efficacy of a Cardiac Conduction System-Sparing Modified Aortic Valve Replacement   3. Surgical Approach to Right Coronary Artery Aneurysm With Coronary Sinus Fistula   Other Items Mentioned  1. ‘Concerning’ Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER   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.

    34 min
  5. MAR 24

    The Atrium: Pleural Sepsis

    In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Professor Eric Lim, Professor of Thoracic Surgery at Imperial College London and Consultant Thoracic Surgeon at the Royal Brompton Hospital in London, UK, about pleural sepsis.   Chapters  00:00 Intro  00:30 Dr. Lim Background  01:26 Why CT Surgery & Clinical Research?  05:09 Definition & Overview  07:50 Causes  09:29 Clinical Presentations & Investigations  16:03 Management, RAPID Score  19:49 Medical Management  22:15 Chest Tube Management (ICD)  25:12 IF, Medical Decortication  25:48 Surgical Management  29:30 History  30:34 Debridement & Decortication, Approach  34:30 Patient Positioning  35:18 Thoracotomy  38:43 VATS  39:37 Technical Steps  43:18 Postoperative Management  49:37 Complications  50:58 Summarizing Points  51:50 Surgery Training Advice  They provide an overview of pleural sepsis, highlighting its three stages: the exudative stage, fibrinopurulent stage, and organizing stage. The discussion covers its history and causes, including complications from pneumonia. They also examine symptoms, failure to progress, and imaging techniques such as ultrasound. Additionally, they delve into pleural fluid analysis, the RAPID score, and management strategies, including medical interventions, chest tube drainage, and intrapleural fibrinolytics. Various surgical management strategies are discussed as well, including thoracotomy, video-assisted thoracoscopic surgery (VATS), and robotic approaches. Finally, they address chest tube management, respiratory physiotherapy, acute complications, and long-term complications.    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.

    54 min
  6. The Beat With Joel Dunning Ep. 149: Female CT Surgeons—Unlocking the Male Fortress

    MAR 19

    The Beat With Joel Dunning Ep. 149: Female CT Surgeons—Unlocking the Male Fortress

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Shanda Blackmon, a thoracic surgeon and Professor of Surgery, as well as the Director of the Lung Institute at Baylor College of Medicine, Houston, TX, USA, about an article from The New York Times in which she was featured, titled “Female CT Surgeons, Unlocking the Male Fortress.” Chapters 00:00 Intro  01:35 JANS 1, Fractured Sternal Wires Post-Surgery  05:21 JANS 2, ERAS Protocols in Spain, Consensus Study  07:00 JANS 3, Preserving Native MVs in VSD & MR Patients  09:53 JANS 4, Sternal Closure After Norwood  12:15 Video 1, LIMA Harvest, Robotic Harmonic Scalpel  13:55 Video 2, Butterfly Resection for MV Leaflets  15:26 Video 3, Bidirectional Glenn via Axill Thorac  17:18 Dr. Blackmon, Women in CT Surgery  33:17 Upcoming Events  35:13 Closing  They discussed her experience working with The New York Times and the goal of the article. Key highlights included the pay disparity, with women cardiothoracic surgeons receiving lower pay than their male counterparts, as evidenced by the Society of Thoracic Surgeons (STS) compensation survey. Additionally, they addressed the rewarding aspects of cardiothoracic surgery, the challenges surgeons face, and the initiatives that women cardiothoracic surgeons are starting to tackle, such as the pay equity and leadership opportunities.   Joel also highlights recent JANS articles on a cross-sectional study examining wire configurations, sternal locations, and breakage sites for fractured sternal wires post-coronary surgery, a Delphi consensus study on the standardized recommendations for the implementation of enhanced recovery protocols in thoracic surgery in Spain, surgical strategy for preserving native mitral valves in infants with ventricular septal defects and mitral regurgitation, and routine primary sternal closure after the Norwood procedure.  In addition, Joel explores robotic-assisted left internal mammary harvest with the robotic harmonic scalpel, butterfly resection for prolapsed posterior mitral valve leaflets, and minimally invasive bidirectional Glenn via vertical right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Fractured Sternal Wires Post-Coronary Surgery: A Cross-Sectional Study Examining Wire Configurations, Sternal Locations, and Breakage Sites  2.) Standardized Recommendations for the Implementation of Enhanced Recovery Protocols in Thoracic Surgery in Spain: A Delphi Consensus Study  3.) Surgical Strategy for Preserving Native Mitral Valves in Infants With Ventricular Septal Defects and Mitral Regurgitation  4.) Routine Primary Sternal Closure After the Norwood Procedure  CTSNet Content Mentioned  1.) Robotic-Assisted Left Internal Mammary Harvest With the Robotic Harmonic Scalpel​   2.) Butterfly Resection for Prolapsed Posterior Mitral Valve Leaflets   3.) Pushing Boundaries in Pediatric Cardiac Surgery: Minimally Invasive Bidirectional Glenn Via Vertical Right Axillary Thoracotomy   Other Items Mentioned  1.) Female Cardiothoracic Surgeons, Unlocking the Male Fortress  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.

    38 min
  7. The Cardiac Recovery Room: Optimizing the Preoperative Patient

    MAR 18

    The Cardiac Recovery Room: Optimizing the Preoperative Patient

    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 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 Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, about preoperative optimization of cardiac patients.   Chapters 00:00 Intro 01:27 Vulnerable Patients, Identifying Risk 04:24 Assessing Patients, Biological Prep 09:57 Psychological & Cognitive Prep 12:09 Time Between Discharge & Follow-Up 15:40 Anemic Patients, Iron Studies 20:12 Nutrition Screening & Malnutrition 25:30 Future Optimization Topics They discussed the importance of identifying risks, conducting thorough assessments before the operation, and preoperative education. They also emphasized psychological and cognitive preparation, as well as the time frame between discharge and follow-up. Additionally, they addressed issues related to iron deficiency without anemia, anemic patients, and iron studies. Furthermore, they highlighted the importance of nutrition screening and addressing malnutrition as essential aspects of preoperative care.    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.

    27 min
  8. The Beat With Joel Dunning Ep. 148: Six-Year Outcomes After TAVR vs SAVR in Low-Risk Patients

    MAR 12

    The Beat With Joel Dunning Ep. 148: Six-Year Outcomes After TAVR vs SAVR in Low-Risk Patients

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. John Forrest, a cardiologist and Director of both Interventional Cardiology and the Structural Heart Disease Program at Yale Medicine, New Haven, CT, USA, about a paper he authored titled “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis,” published by the Journal of the American College of Cardiology. Chapters 00:00 Intro  02:38 TAVR vs SAVR Context  03:54 CDC WONDER Data, TAVR SAVR  05:37 JANS 1, TAVR vs SAVR 5-Year Outcomes  07:31 JANS 2, Temporary MCS Devices Landscape  09:17 JANS 3, Pulm Resection Post-CABG  10:23 JANS 4, PRE-HIIT Randomized Trial  12:36 Career Center  13:10 Video 1, Redo MVR After VIV TAVR  15:37 Video 2, Repair After Acute Intramural Hematoma  18:01 Video 3, Acute Severe MR Repair  19:36 Dr. Forrest, 6-Year TAVR vs SAVR  44:49 Upcoming Events  45:33 The Lifeline Podcast  They explored other randomized trials involving high-risk and intermediate-risk patients with aortic stenosis and examined the specific goals of this low-risk trial. The discussion then delved into the trial’s results, highlighting that there was no significant difference in the composite endpoint of all-cause mortality or disabling stroke. However, a noteworthy finding was that the transcatheter aortic valve replacement (TAVR) arm experienced a higher reintervention rate compared to surgery, primarily due to an increased incidence of aortic regurgitation. They also addressed factors such as valve dilation, stents, and various reasons for surgical valve failure. Additionally, they examined the similarities between this trial and other partner trials and the future for low-risk patients with aortic stenosis.   Joel also highlights recent JANS articles on the updated five-year outcomes of transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis at low- to intermediate-surgical risk, a United States nationwide analysis on the changing landscape of temporary mechanical circulatory support devices in the new heart allocation system, pulmonary resection post-coronary artery bypass grafting, and a randomized controlled trial on the preoperative exercise to improve fitness in patients undergoing complex surgery for cancer of the lung or esophagus (PRE-HIIT).  In addition, Joel explores redo mitral valve replacement after previous valve-in-valve mitral TAVR, aortic repair after acute intramural hematoma, and repair of acute severe mitral regurgitation due to iatrogenic papillary muscle rupture. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk  2.) The Changing Landscape of Temporary Mechanical Circulatory Support Devices in the New Heart Allocation System—A United States Nationwide Analysis  3.) Pulmonary Resection Post-Coronary Artery Bypass Grafting: Feasible, but Right-Sided Procedures Demand Caution  4.) Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Esophagus (PRE-HIIT): A Randomized Controlled Trial  CTSNet Content Mentioned  1.) Redo Mitral Valve Replacement After Previous Valve-in-Valve Mitral TAVR  2.) Aortic Repair After Acute Intramural Hematoma   3.) Repair of Acute Severe Mitral Regurgitation Due to Iatrogenic Papillary Muscle Rupture  Other Items Mentioned  1.) Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis  2.) The Lifeline: End-Tidal Carbon Dioxide Monitoring in Cardiac Surgical Emergencies  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.

    46 min
4.6
out of 5
8 Ratings

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Discussions about the most relevant topics in cardiothoracic surgery from CTSNet, the Cardiothoracic Surgery Network.

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