CTSNet Podcasts

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

  1. 11h ago

    The Atrium: Aortic Valve Replacement

    In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Filip Casselman, Staff Surgeon and Co-Director of the Cardiovascular Center at OLV Clinic (AZORG), Aalst, Belgium, about aortic valve replacement (AVR). Chapters 00:00 Intro 01:30 Why CT Surgery? 02:36 Anatomy 03:23 Pathology 06:15 History 09:06 Preoperative Planning 15:12 Indications 16:26 TAVR vs SAVR 20:25 Step-by-Step 41:25 Postop Management & Complications 46:32 Training Advice The discussion explores the anatomy of the aortic valve, the pathology of aortic stenosis (AS) and aortic regurgitation (AR), and their respective echo grading, including complex cases like low-flow, low-gradient AS and bicuspid aortic valves. The conversation covers the history of AVR, preoperative planning—including prosthesis selection—and clinical indications for intervention in both symptomatic and asymptomatic severe aortic stenosis. Furthermore, they compare transcatheter aortic valve replacement (TAVI) with surgical aortic valve replacement (SAVR). Technical aspects of the procedure were also addressed, from preparation and positioning to median or J-sternotomy approaches, cannulation, aortotomy, prosthesis sizing, managing patient-prosthesis mismatch, weaning from bypass, and chest closure. Finally, they provide insights into sutureless devices, 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. 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.

    The Atrium: Aortic Valve Replacement

  2. 5d ago

    The Beat With Joel Dunning Ep. 166: The TAVR Heart Team at Risk

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Drs. Michael Mack and Tom Nguyen about the proposed US Centers for Medicare & Medicaid Services changes to how cardiologists and cardiac surgeons interact during transcatheter aortic valve replacement (TAVR) procedures. Chapters 00:00 Intro 01:21 TAVR Heart Team 04:08 JANS 1+2, JACC TAVR vs SAVR 12:19 JANS 3, TAVR Short-Term Outcomes 14:06 JANS 4, SAVR Life Expectancy 17:44 JANS 5, WSJ TAVR Article 19:19 Video 1, Direct AA Cannulation Technique 21:23 Video 2, Endoscopic Redo TVR After CABG 24:25 Video 3, Gaudiani Cox-Maze III 27:33 Dr. Mack & Nguyen, TAVR Heart Team 51:12 Closing Dr. Mack explained the current heart team system, established in 2011 through collaboration with the US Food and Drug Administration (FDA) and CMS, which has been highly successful in ensuring safe and effective TAVR implementation. He argues that the proposed CMS changes could potentially dismantle this collaborative approach by allowing asynchronous patient evaluation and procedures to be performed by single operators without surgeon involvement. Dr. Nguyen provided insights from a system leader's perspective, noting that while the proposed changes raise significant concerns about patient care and data collection, some cardiologists argue that surgeons are already not actively involved in many programs, making the single operator model the norm in practice. Both expressed concern that without mandatory surgeon participation and TAVR registry involvement, smaller programs may adopt practices that lack proper accountability and could lead to inappropriate patient selection and outcomes, potentially creating more contentious debates between TAVR and surgical approaches. Joel also highlights recent JANS articles including a propensity-matched analysis comparing 10-year outcomes after SAPIEN 3 TAVR in the PARTNER 2 SAPIEN 3 Intermediate-risk Registry with surgery in the PARTNER 2A trial; a single-center retrospective study evaluated 61 patients who underwent cardiac surgery after prior TAVR during a 10-year period at a high-volume academic center; whether surgical aortic valve replacement (SAVR) should remain the first choice for aortic stenosis in patients with a life expectancy beyond five years; and an article examining the dramatic rise in the popularity of transcatheter aortic valves, early valve failure, and the impact it has on patients’ lives. In addition, Joel explores axillary cannulation as a primary cannulation strategy, beating-heart endoscopic tricuspid valve replacement for high-risk redo patients after CABG and device-related tricuspid valve injury, and a Cox-Maze III operation combined with a left internal mammary artery (LIMA) to left anterior descending artery (LAD), as well as an ascending aortic replacement and aortic valve resuspension. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned 10-Year Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement or Surgery in Intermediate-Risk Patients A Decade of Cardiac Surgery After Transcatheter Aortic Valve Replacement: Short-Term Clinical Outcomes at a High-Volume Center Great Debate: Surgical Aortic Valve Replacement Is First Choice for Aortic Stenosis in Patients With a Life Expectancy Beyond 5 Years A Breakthrough Heart Procedure Comes With Risky Tradeoffs CTSNet Content Mentioned Direct Axillary Artery Cannulation With the Open Seldinger Technique Endoscopic Redo Tricuspid Valve Replacement After CABG The Cox-Maze III Procedure Combined With Valve-Sparing Aortic Surgery and CABG Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events   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.

    The Beat With Joel Dunning Ep. 166: The TAVR Heart Team at Risk

  3. Jul 16

    The Beat With Joel Dunning Ep. 165: Valve-Sparing Aortic Root Replacement Techniques

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Chris Malaisrie, a Professor of Surgery in the Division of Cardiac Surgery at Northwestern University and an Attending Cardiac Surgeon at Northwestern Medicine, about valve-sparing aortic root replacement techniques. Chapters 00:00 Intro 02:25 TAVR Heart Team Coverage 03:52 JANS 1, TAVR vs SAVR Perspective 10:50 JANS 2, Gene-Edited Transplant Model 13:13 JANS 3, Long-Term Outcomes Atrial Fib 14:31 JANS 4, 147-Minute Drowning Circ Arrest 18:01 Video 1, Double Ann Enlargement Prosth Mis 20:48 Video 2, Reop Aortic Root Reconstruction 22:24 Video 3, Normothermic AA Aneurysm 24:22 Dr. Malaisrie, Aortic Root Replacement 41:42 Closing The conversation covers a wide range of procedures, including the Bentall, Yacoub, and David operations, as well as the Ross procedure and personalized external aortic root support (PEARS). They further explore approaches to mitral and aortic valve repair, the management of diseased leaky valves, and the advantages of the Stanford modification of the David V procedure. Dr. Malaisrie concludes the discussion by offering advice to surgeons on refining their valve repair skills and shares his prediction for the future of valve repair surgery. Joel also highlights recent JANS articles on age vs lifetime perspective on the transcatheter vs surgical aortic valve implantation, gene-edited pig cardiac xenotransplantation as a bridge to allotransplantation in infants, long-term outcomes of postoperative atrial fibrillation after cardiac surgery, and a case on ice water drowning survival after 147-minute submersion and 7 °C hypothermic circulatory arrest. In addition, Joel explores double annular enlargement as an effective technique to overcome patient-prosthesis mismatch, reoperation for aortic root reconstruction, and normothermic treatment of an aortic arch aneurysm. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned Transcatheter vs Surgical Aortic Valve Implantation: Age vs Lifetime Perspective Gene-Edited Pig Cardiac Xenotransplantation as a Bridge to Allotransplantation in Infants: Progress in a Pig-to-Baboon Model Long-Term Outcomes of Postoperative Atrial Fibrillation After Cardiac Surgery: Results From 19,000 Patients Ice Water Drowning Survival After 147-Minute Submersion and 7 °C Hypothermic Circulatory Arrest CTSNet Content Mentioned Double Annular Enlargement as an Effective Technique to Overcome Patient-Prosthesis Mismatch Reoperation for Aortic Root Reconstruction Normothermic Treatment of an Aortic Arch Aneurysm Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events   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.

    The Beat With Joel Dunning Ep. 165: Valve-Sparing Aortic Root Replacement Techniques

  4. Jul 15

    The Cardiac Recovery Room: Readmissions and Rehabilitation

    In this episode of The Cardiac Recovery Room, moderator Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, USA, spoke with Drs. V. Seenu Reddy, a cardiothoracic surgeon at HCA’s TriStar Cardiovascular Surgery in Nashville, TN, USA, and Kevin Lobdell, Professor and Director of Regional Cardiovascular and Thoracic Quality, Education, and Research at Atrium Health, NC, USA, about postoperative rehabilitation and readmission prevention. Chapters  00:00 Intro  01:51 Readmission Risk Factors  05:17 Discharging Patients Living Alone  07:31 Importance of Readmission Reduction  10:21 Reducing Readmissions  15:45 Postop Rehabilitation  19:36 Bringing Rehab to Patients  23:43 Behavior Modification & Engagement  25:55 Coordination of Care  26:36 Personal Engagement  They explore various factors influencing patient readmission following cardiac surgery, encompassing both medical and social determinants. A significant focus is placed on the challenges faced by patients living alone, the associated risks, and the mitigation strategies that can be implemented to support them, noting how success is higher if patients have a social structure around them. Furthermore, the conversation highlights the importance of reducing readmission rates and using remote monitoring. They also examine the survival benefits of rehabilitation and barriers of postoperative rehabilitation, including transportation. 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.

    The Cardiac Recovery Room: Readmissions and Rehabilitation

  5. Jul 10

    The Beat With Joel Dunning Ep. 164: TAVR National Coverage Analysis

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the Centers for Medicare & Medicaid Services proposed decision memo regarding the national coverage analysis for transcatheter aortic valve replacement (TAVR). Chapters 00:00 Intro 01:17 TAVR National Coverage 06:05 JANS 1, EPOCH CardioLink-10 Trial 10:20 JANS 2, Dacron Ross Autograft Analysis 12:23 JANS 3, Mech vs Biopros Valve Outcomes 15:53 Video 1, Ross Procedure I/E Reduction 19:18 Video 2, Hemi-Commando Procedure 22:14 Video 3, Left VATS Enucleation Leiomyoma 24:15 Dr. Meguid, Intraop Molecular Imaging 35:52 Closing He outlines crucial deadlines, actionable steps for surgeons, the importance of submitting public comments, and the necessity of data collection. Additionally, he spoke with Dr. Robert Meguid, Professor of Surgery at the University of Colorado Anschutz Medical Campus, Aurora, CO, USA, about intraoperative molecular imaging. They explore how this technology identifies small nodules, the functionality and use cases of the specialized camera, the associated learning curve, and other available systems. The conversation also touches on robotics, lymph node staging, and cost. Furthermore, Dr. Meguid shares insights on his frequency of use of this technique. Joel also highlights recent JANS articles on a systematic review and meta-analysis on how complete Dacron reinforcement of Ross autograft does not increase neo-aortic valve regurgitation, a randomized trial on superficial parasternal intercostal plane block with ropivacaine vs placebo for opioid exposure after cardiac surgery, and outcomes after conversion from mechanical to bioprosthetic valves for anticoagulation-related complications. In addition, Joel explores the Ross procedure with internal and external reduction annuloplasty using autologous tissue rings, hemi-commando procedure for bioprosthetic aortic valve endocarditis, and left-sided uniportal VATS enucleation of a large esophageal leiomyoma. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned Complete Dacron Reinforcement of Ross Autograft Does Not Increase Neo-Aortic Valve Regurgitation: A Systematic Review and Meta-Analysis Superficial Parasternal Intercostal Plane Block With Ropivacaine Versus Placebo for Opioid Exposure After Cardiac Surgery (EPOCH CardioLink-10): A Multicentre, Double-Blind, Randomised Trial Outcomes After Conversion From Mechanical to Bioprosthetic Valves for Anticoagulation-Related Complications CTSNet Content Mentioned Ross Procedure With Internal and External Reduction Annuloplasty Using Autologous Tissue Rings Hemi-Commando Procedure for Bioprosthetic Aortic Valve Endocarditis Left-Sided Uniportal VATS Enucleation of a Large Esophageal Leiomyoma Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events   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.

    The Beat With Joel Dunning Ep. 164: TAVR National Coverage Analysis

  6. Jul 8

    The Lifeline: ECMO vs Emergency Resternotomy for Cardiac Surgical Arrest

    In this edition of the 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 Amy Hackmann, adult cardiac surgeon at Brigham and Women's Hospital, Boston, MA, USA. Together, they explore extracorporeal membrane oxygenation (ECMO) vs emergency resternotomy for cardiac surgical arrest. Chapters  00:00 Intro  01:36 Resuscitation Algorithm  02:14 Current State of ECMO  04:25 Speed, Quality Assurance  08:28 ECMO Concerns  12:16 Performance Metrics, Decision-Makers  15:08 Prime Circuits  15:24 Non-Surgical Arrest Training  17:42 MCS Devices  18:41 Instances to Avoid ECMO  20:16 Time Targets  21:58 Avoiding Complications, VIS Score  25:09 Key Points  The discussion covers quality assurance metrics, patient-specific decisions regarding ECMO vs resternotomy, and chest compressions. The experts also review the importance of advanced preparation, common causes of cardiac arrest following cardiac surgery, and small-incision surgeries, including the use of surgical saws. Furthermore, the discussion emphasizes the importance of mock drills and team training, as well as the use of ECMO on patients who have not experienced cardiac arrest. Finally, they explore scenarios where ECMO would not be used, vasoactive-inotropic score (VIS), and lactate levels. 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!   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.

    The Lifeline: ECMO vs Emergency Resternotomy for Cardiac Surgical Arrest

  7. Jul 2

    The Beat With Joel Dunning Ep. 163: Is the TAVR Heart Team About to Lose a Member?

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the transcatheter aortic valve replacement (TAVR) heart team potentially losing a member. He explores the current composition of the TAVR heart team, proposed changes, the thoughts of cardiothoracic societies, and future actions regarding this issue. Chapters  00:00 Intro  01:53 TAVR Heart Team  07:48 JANS 1, Base Editing of PCSK9  09:47 JANS 2, High Volume Valve Sparing ARR  12:03 JANS 3, Western Rheumatic Heart Disease  14:05 JANS 4, Non-Intubated Uniportal VATS SL  15:38 Video 1, Miami Method-Bentall  17:02 Video 2, ALCAPA Repair  18:29 Video 3, Robotic Cardiac Podcast  22:17 Dr. Sundt, Mantle Radiation Patients  31:17 Upcoming Events  Additionally, he spoke with Dr. Thoralf Sundt, Chief of the Division of Cardiac Surgery and Director of the Corrigan Minehan Heart Center at Massachusetts General Hospital, Boston, MA, USA, about patients who have undergone mantle radiation. They discuss the challenges these patients face postoperatively, including the mortality rate associated with reoperations. The conversation also highlights the significance of employing a heart team approach for these patients, emphasizing the importance of preoperative planning and the application of TAVR, which is potentially suitable for these patients. Furthermore, they touch upon topics such as mechanical valves, porcelain aorta, and the importance of conducting careful operations on these patients. Joel also highlights recent JANS articles on in vivo base editing of PCSK9 with VERVE-102 for hypercholesterolemia, defining high-volume centers using prospective data for valve-sparing aortic root replacement, insights from the Netherlands Heart Registration on surgical care for rheumatic heart disease patients, and a cohort study on surgical techniques and outcome analysis of non-intubated uniportal VATS sleeve lobectomy. In addition, Joel explores a step-by-step technique for a minimally invasive Bentall procedure via right axillary access, the repair of an anomalous left coronary artery from the pulmonary artery via direct coronary transfer, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Husam Balkhy about multi-spectrum robotic cardiac surgery. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned In Vivo Base Editing of PCSK9 With VERVE-102 for Hypercholesterolemia Valve-Sparing Aortic Root Replacement: Defining High-Volume Centres Using Prospective Data Surgical Care for Rheumatic Heart Disease Patients: Insights From the Netherlands Heart Registration Surgical Techniques and Outcome Analysis of Non-Intubated Uniportal VATS Sleeve Lobectomy: A Cohort Study CTSNet Content Mentioned Minimally Invasive Bentall Procedure via Right Axillary Access: A Step-by-Step Technique Repair of Anomalous Left Coronary Artery From the Pulmonary Artery via Direct Coronary Transfer The Atrium: Multi-Spectrum Robotic Cardiac Surgery Other Items Mentioned Cardiac Reoperations in Patients With Prior Thoracic Radiation: A Single-Center Analysis of Outcomes and Key Lessons CTSNet Innovation Video Competition Career Center CTSNet Events   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.

    The Beat With Joel Dunning Ep. 163: Is the TAVR Heart Team About to Lose a Member?

  8. Jun 25

    The Beat With Joel Dunning Ep. 162: Lifetime Management of Aortic Valve Disease

    This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Isaac George, CTSNet Board Member and Co-Director of the Structural Heart and Valve Center, Surgical Director of Structural Heart Disease, and Co-Director of the Mitral and Tricuspid Center at Columbia University Medical Center/NewYork-Presbyterian, NY, USA, about the lifetime management of aortic valve disease. Chapters 00:00 Intro 02:11 AATS-CTSN Randomized Trials 04:37 JANS 1, Consensus Statement ALAD 10:28 JANS 2, Lung Re-Transplantation Outcomes 12:19 JANS 3, Aortic Homografts, EURECAH 15:15 JANS 4, Lobectomy Cost Analysis 18:10 Video 1, Anomalous L Coronary Artery 19:38 Video 2, Pulm Valve Replacement Reop 21:38 Video 3, Giant Pulm Artery Aneurysm 23:28 Dr. George Discussion 33:18 Upcoming Events 34:05 Closing They explored the expansion of transcatheter aortic valve replacement (TAVR), emphasizing the crucial role of the heart valve team in this process. The discussion highlighted the necessity for surgeons to be actively involved in the decision-making process surrounding TAVR, particularly in the early stages. They also addressed the importance of lifetime management of the valve, selecting the appropriate valve, and valve durability. Additionally, they discussed the significance of providing patients with multiple surgical options, the Ross procedure, mechanical valves, and explored which procedures patients are choosing. Joel also highlights recent JANS articles on the ISHLT consensus statement on acute lung allograft dysfunction, aortic homografts for native and prosthetic aortic valve and root endocarditis, how outcomes after lung re-transplantation for restrictive allograft syndrome have not improved over two decades, and the financial burden of postoperative adverse events following lobectomy. In addition, Joel explores the surgical repair of an anomalous left coronary artery from the right pulmonary artery, minimally invasive pulmonary valve replacement in reoperative settings, and surgical management of giant pulmonary artery aneurysm using a T-shaped graft-valve strategy. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned ISHLT Consensus Statement on Acute Lung Allograft Dysfunction (ALAD): Definition, Etiology, Diagnostic and Therapeutic Approaches, and Research Priorities Aortic Homografts for Native and Prosthetic Aortic Valve and Root Endocarditis: Results From the EUropean REgistry of Cryopreserved Aortic Homografts EURECAH Outcomes After Lung Re-Transplantation for Restrictive Allograft Syndrome Have Not Improved Over Two Decades Financial Burden of Postoperative Adverse Events Following Lobectomy: Cost Analysis From 10 High-Volume Canadian Hospitals CTSNet Content Mentioned Surgical Repair of an Anomalous Left Coronary Artery From the Right Pulmonary Artery Minimally Invasive Pulmonary Valve Replacement in Reoperative Settings Surgical Management of Giant Pulmonary Artery Aneurysm Using a T-Shaped Graft-Valve Strategy Other Items Mentioned CTSNet Innovation Video Competition Career Center CTSNet Events   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.

    The Beat With Joel Dunning Ep. 162: Lifetime Management of Aortic Valve Disease
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About

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

Information

  • Creator
    CTSNet
  • Years Active
    2019 - 2026
  • Episodes
    100
  • Rating
    Clean
  • Copyright
    Copyright © 2020 CTSNet, Inc. All rights reserved.
  • Show Website
    CTSNet Podcasts

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