This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Nina Fuller-Shavel, co-chair of the British Society for Integrative Oncology (BSIO) from 2021 to 2023 and current co-chair of the BSIO Clinical Practice and Education Committee, about integrative oncology. Chapters 00:00 Intro 01:29 Integrative Medicine 09:13 Bar Dislocation, Pectus 10:53 Effective Circulating Volume Fraction 13:14 Repair vs Replacement, Edge-to-Edge 16:14 Relaxed TAVI Age Threshold? 18:14 Supravalvar Aortic Stenosis Transaxillary 20:09 How-To, AAE Tricuspid Repair 21:49 Modified Robotic Tracheobronchoplasty 23:34 Dr. Fuller-Shavel, Integrative Oncology 56:21 Upcoming Events 58:28 Closing They discuss what integrative oncology entails, mistletoe therapy, oncothermia, and the innovative integrative oncology app called Oncio. They also explore guidelines relating to this topic, nutrition, and immune checkpoint inhibitors. Dr. Fuller-Shavel also provides recommendations for supporting patients’ mindfulness during cancer treatment.   Joel also highlights recent JANS articles on bar dislocation after pectus excavatum repair, effective circulating volume fraction in Type A aortic dissection, surgical mitral valve repair vs replacement after failed mitral transcatheter edge-to-edge repair, and if the age threshold for TAVI can be relaxed to below 65 years.   In addition, Joel explores minimally invasive transaxillary repair of supravalvar aortic stenosis, how to perform an aortic annulus enlargement with tricuspid repair, and modified robotic-assisted tracheobronchoplasty in a patient with severe calcific mediastinal lymphadenopathy. Before closing, he highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Bar Dislocation After Pectus Excavatum Repair: A Systematic Review of Risk Factors, Stabilization Techniques, and Management Strategies  2.) The Effective Circulating Volume Fraction in Type A Aortic Dissection: A New Risk Factor?   3.) Surgical Mitral Valve Repair vs Replacement After Failed Mitral Transcatheter Edge-to-Edge Repair: The CUTTING-EDGE Registry  4.) Could the Age Threshold for TAVI be Relaxed to Below 65 Years? Pros and Cons  CTSNet Content Mentioned  1.) Minimally Invasive Transaxillary Repair of Supravalvar Aortic Stenosis  2.) How to Perform an Aortic Annulus Enlargement With Tricuspid Repair  3.) Modified Robotic-Assisted Tracheobronchoplasty in a Patient With Severe Calcific Mediastinal Lymphadenopathy  Other Items Mentioned  1.) British Society for Integrative Oncology   2.) National Center for Integrative Oncology    3.) Integrative Oncology Approaches to Supporting Immune Checkpoint Inhibitor Treatment of Solid Tumors  4.) Aortic Valve Replacement Series   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. Dibin Mohammed, a consultant at Government Medical College, Kozhikode, Kerala, India, about his WhatsApp group, Young CVTS Surgeons Kerala. Chapters 00:00 Intro 01:22 CTSNet Updates 03:44 Dr. Mohammed Guest 05:20 Allogeneic Mitral Valve Transplant 08:45 Multiple vs Single Arterial Grafting 11:50 AI & Machine Learning in CT Surgery 17:57 3-Port vs 4-Port Robotic Lobectomy 21:28 Redo Pulm Valve Replacement w RAA 24:32 Mitral Ann Disjunction Presentation 27:09 How-To LVOTE & CABG 29:22 Dr. Mohammed, Academic Group Chat 42:30 Upcoming Events 43:43 Closing They discuss the group’s goal and the topics its covers, such as recent academic papers and innovative surgical solutions, as well as the reasons Dr. Mohammed created it. Dr. Mohammed also shares insights into working in India and the training systems for residents in the country.   Joel also highlights recent JANS articles on allogeneic mitral valve transplants, survival outcomes after multiple vs single arterial grafting among patients with reduced ejection fraction, artificial intelligence and machine learning in cardiothoracic surgery, and a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC.   In addition, Joel explores redo pulmonary valve replacement with right atrial appendage, how to perform a left ventricular outflow tract enlargement and CABG, and reviews a presentation from the Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting on mitral annular disjunction and mitral valve repair.   JANS Items Mentioned  1.) Allogeneic Mitral Valve Transplant: Historical Precedent, Current Considerations, and Future Implementation  2.) Survival Outcomes After Multiple vs Single Arterial Grafting Among Patients With Reduced Ejection Fraction  3.) Artificial Intelligence and Machine Learning in Cardiothoracic Surgery: Future Prospects and Ethical Issues  4.) Optimizing Surgical Precision: A Comparative Study of Three-Port vs. Four-Port Robotic-Assisted Lobectomy for NSCLC  CTSNET Content Mentioned  1.) Redo Pulmonary Valve Replacement With Right Atrial Appendage  2.) SCTS 2025 | Mitral Annular Disjunction and Mitral Valve Repair   3.) How to Perform a Left Ventricular Outflow Tract Enlargement and CABG  Other Items Mentioned  1.) Aortic Valve Replacement Series   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 celebrates two years of the podcast and speaks with Dr. Joseph F. Sabik III, president of the Society of Thoracic Surgeons (STS) and chair of the Department of Surgery at University Hospitals Cleveland Medical Center, about the future of cardiothoracic surgery. Chapters 00:00 Intro 01:16 Dr. Sabik Guest 04:13 AATS 2025 20:26 Extended Sleeve Lobectomy Study 23:55 SQUAT Trial Results 26:28 TAVR vs SAVR in Women 27:49 Transition from Training to Practice 31:39 Totally Endoscopic Triple Valve 33:33 Redo AVR via Ministernotomy 35:18 ECMO Podcast Episode 37:19 Dr. Sabik, Future of CT Surgery 56:06 Upcoming Events 57:47 Closing They discuss the future of revascularization, advancements in valve procedures, arterial grafting, robotics training, and the importance of work-life balance. They also highlight the training of the next generation of surgeons, simulation-based education, and Dr. Sabik shares insights into the 62nd STS Annual Meeting. Additionally, Joel recaps the American Association for Thoracic Surgery (AATS) Annual Meeting emphasizing notable presentations and key insights from the event.   Joel also highlights recent JANS articles on extended sleeve lobectomy after neoadjuvant immunochemotherapy for centrally located non-small cell lung cancer, neoadjuvant concurrent chemo-immuno-radiation therapy followed by surgery and adjuvant immunotherapy for resectable Stage III N2 NSCLC, transcatheter vs. surgical aortic valve replacement in women, and a guide for transition from cardiothoracic surgery training to practice.   In addition, Joel explores totally endoscopic triple valve surgery, redo aortic valve replacement through a ministernotomy, and a new podcast episode from Dr. Alice Copperwheat, “The Atrium: ECMO,” with expert guest Dr. Jose Fernandes. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Extended Sleeve Lobectomy After Neoadjuvant Immunochemotherapy for Centrally Located Non-Small Cell Lung Cancer  2.)  Neoadjuvant Concurrent Chemo-Immuno-Radiation Therapy Followed by Surgery and Adjuvant Immunotherapy for Resectable Stage III N2 NSCLC: Primary Results From the SQUAT Trial (WJOG 12119L)   3.) Transcatheter vs. Surgical Aortic Valve Replacement in Women: The RHEIA Trial  4.) A Guide for Transition from Cardiothoracic Surgery Training to Practice  CTSNET Content Mentioned  1.) Totally Endoscopic Triple Valve Surgery: AVR, MVr, TVr  2.) Redo Aortic Valve Replacement Through a Ministernotomy    3.) The Atrium: ECMO  Other Items Mentioned  1.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration   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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Cristiano Spadaccio, an attending cardiac surgeon and associate professor of surgery at the University of Cincinnati College of Medicine, Ohio, USA, about totally tissue-engineered valves for tricuspid replacement. Chapters 00:00 Intro 01:48 Tissue-Engineered Valves 05:48 Compensatory Sweating After BETS 10:05 5Y Outcomes TAVR vs SAVR 13:34 ChatGPT CT Surgery Insights 17:24 Retraction Speed Pain RC Trial 21:21 Ross Procedure, All-Native Valve 25:43 Endoscopic Mechanical MVR 28:10 Double Patch Double Valve Exploration 31:42 Dr. Spadaccio, Generative Valves 50:38 Upcoming Events 51:52 Closing They focus on the CorMatrix Cor TRICUSPID ECM Valve, including the technique for valve implantation, the functionality of the valve and its underlying concept, and the valve’s history, particularly its applications in pediatric patients. The episode features videos and photos showcasing the valve, the implantation procedure, and more. Additionally, they discuss the critical role of identifying the papillary muscle in this surgery and whether an anoplasty ring is necessary. They also explore the current status of the valve and its future prospects.   Joel also highlights recent JANS articles on the long-term outcomes and predictors of compensatory sweating after bilateral endoscopic thoracic sympathectomy, five-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis, navigating the future of pediatric cardiovascular surgery using Chat Generative Pre-trained Transformer (ChatGPT), and a randomized controlled trial on retraction speed and chronic poststernotomy pain.   In addition, Joel explores the Ross procedure using the right atrial appendage valve instead of a homograft, totally endoscopic mechanical mitral valve repair, and an exploration on reoperation technique for double patch double valve with Drs. Leonard Lee and Vince Gaudiani. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Long-Term Outcomes and Predictors of Compensatory Sweating After Bilateral Endoscopic Thoracic Sympathectomy  2.) 5-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis  3.) Navigating the Future of Pediatric Cardiovascular Surgery: Insights and Innovation Powered by Chat Generative Pre-Trained Transformer (ChatGPT)  4.) Retraction Speed and Chronic Poststernotomy Pain: A Randomized Controlled Trial  CTSNET Content Mentioned  1.) Ross Procedure Using the Right Atrial Appendage Valve Instead of a Homograft: An All-Native Valve Approach  2.) Totally Endoscopic Mechanical Mitral Valve Repair  3.) Reoperation Technique for Double Patch Double Valve: An Exploration With Leonard Lee and Vince Gaudiani  Other Items Mentioned  1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach  2.) Expert Discussion Videos   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 month’s episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Jose Fernandes from the Department of Clinical Perfusion at Royal Papworth Hospital, Cambridge, UK, about extracorporeal membrane oxygenation (ECMO). Chapters 00:00 Introduction 01:47 History 04:46 Basics 09:58 Circuit 14:09 Cannulation 22:44 Indications for Use 28:14 VV ECMO 32:18 VA ECMO 36:44 Monitoring 42:31 Complications 47:03 ECMO CPR 49:17 Trainee Tips 50:57 Guest Advice They discuss cannulation, general indications and contraindications, venovenous (VV) ECMO, venoarterial (VA) ECMO, peripheral VA ECMO, and central VA ECMO. They also explore monitoring, cardiac function monitoring in VA ECMO, complications, ECMO cardiopulmonary resuscitation (CPR), and important tips for 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 one-year anniversary episode with a very special guest.   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. Mario Castillo-Sang, the Surgical Director of Mitral Valve and Heart Failure Therapies at St. Elizabeth Healthcare, Edgewood, Kentucky, USA, about totally endoscopic cardiac surgery. Chapters 00:00 Intro 01:17 Minimal Access Bedside Cardiac 04:37 Lung Cancer, Histological Subtype 09:29 TAVR vs SAVR, AS & CAD 12:22 Biopros TVR Outcomes 15:48 Mitral Annular Disjunction, MVR 18:47 Ozaki Technique, AV Reconst 20:46 Redo LVOT Reconst for Endocarditis 22:33 Totally Endoscopic ASD Closure TVR 24:08 Dr. Castillo-Sang, MI Bedside Endoscopy 40:51 Closing They explore key highlights from Dr. Castillo-Sang’s CTSNet series Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach, his journey in performing endoscopic surgeries, and how he learned the techniques. Dr. Castillo-Sang shares the advantages of endoscopic surgery, as well as tips and recommendations for those wanting to learn this approach. He emphasizes the importance of the instruments he has worked with, detailing how these have improved over time. Additionally, they explore Dr. Castillo-Sang’s involvement with the Endoscopic Cardiac Surgeons Club, discussing how he got involved and providing details about the club’s upcoming annual meeting.   Joel also highlights recent JANS articles on the estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time, transcatheter vs surgical aortic valve replacement in Medicare beneficiaries with aortic stenosis and coronary artery disease, long-term outcomes after bioprosthetic tricuspid valve replacement, and outcomes of patients with mitral annular disjunction undergoing mitral valve repair.  In addition, Joel explores aortic valve reconstruction using the Ozaki technique, redo LVOT reconstruction for endocarditis, and totally endoscopic ASD closure with tricuspid valve repair. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Estimated Worldwide Variation and Trends in Incidence of Lung Cancer by Histological Subtype in 2022 and Over Time: A Population-Based Study  2.) Transcatheter vs Surgical Aortic Valve Replacement in Medicare Beneficiaries With Aortic Stenosis and Coronary Artery Disease  3.) Long-Term Outcomes After Bioprosthetic Tricuspid Valve Replacement: A Multicenter Study  4.) Outcomes of Patients With Mitral Annular Disjunction Undergoing Mitral Valve Repair  CTSNET Content Mentioned  1.) Aortic Valve Reconstruction—The Ozaki Technique  2.) Redo LVOT Reconstruction for Endocarditis  3.) Totally Endoscopic ASD Closure With Tricuspid Valve Repair  Other Items Mentioned  1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach  2.) Endoscopic Cardiac Surgeons Club  3.) Mini Heart Valves   4.) Aortic Valve Replacement Series     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 examines the first-ever transcontinental uniportal thoracic surgery. Chapters 00:00 Intro 01:26 100th Episode, Future 03:01 Transcontinental Uniportal Robotics 09:52 Infective Endo in Octogenerians 12:39 Kidney Replacement Therapy, Cardiac Outcomes 15:50 Stenotic Lesions Simulation 18:59 One-Lung Ventilation, Difficult Airway 21:06 Simplified Approach to Bentall Procedure 24:25 Semi-Skeletonized Harvesting ITA 27:06 AVR and AAR in 85 YO 30:30 Swiss Army Knife Approach Series 32:21 AATS 2025 32:38 Closing He explores the details of this significant case—location, latency, and the procedure performed—while highlighting the importance of this case, the future of robotics, and the surgeons behind this operation, Dr. Diego Gonzalez Rivas and Dr. Mugurel Bosînceanu. He also discusses Dr. Gonzalez Rivas’s new book, Healing the World, and its impact on the field of medicine.   Joel also highlights recent JANS articles on infective endocarditis in octogenarians, national outcomes of cardiac surgery in patients receiving kidney replacement therapy, computational fluid dynamics to simulate stenotic lesions in coronary end-to-side anastomosis, and the management of the expected difficult airway with planned one-lung ventilation.   In addition, Joel explores a simplified approach to the Bentall procedure, semi-skeletonized harvesting of internal thoracic arteries, and aortic valve replacement and ascending aortic replacement in an 85-year-old patient. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Infective Endocarditis in Octogenarians—A Multicenter Analysis  2.) National Outcomes of Cardiac Surgery in Patients Receiving Kidney Replacement Therapy  3.) Computational Fluid Dynamics to Simulate Stenotic Lesions in Coronary End-to-Side Anastomosis  4.) Management of the Expected Difficult Airway With Planned One-Lung Ventilation: A Retrospective Analysis of 44 Cases  CTSNET Content Mentioned  1.) A Simplified Approach to the Bentall Procedure  2.) Semi-Skeletonized Harvesting of Internal Thoracic Arteries  3.) Aortic Valve Replacement and Ascending Aortic Replacement in an 85-Year-Old Patient  Other Items Mentioned  1.) Endoscopic Cardiac Surgery Series: The Swiss Army Knife Approach    2.) Aortic Valve Replacement 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 Professor Robert Sneyd, Vice Chair of Aortic Dissection Awareness UK & Ireland, about the charity’s dedication to promoting awareness of aortic dissection. Chapters 00:00 Intro 03:52 RLAAO Isolated MR Study 09:07 Early Outcomes Reop Aortic Root 11:39 Fallot and Its Variants 16:55 Low-Dose Warfarin, Mech AV 22:02 AVR w LIMA-LAD & AAR 23:40 Pulm Thromboendarterectomy 25:28 Modified Birmingham Technique 27:32 Dr. Sneyd, Aortic Dissection Awareness 31:16 Upcoming Events 32:33 Closing They discuss Professor Sneyd’s experience with an acute Type A aortic dissection and the lifesaving operation he underwent. Additionally, they explore his involvement with Aortic Dissection Awareness UK & Ireland and the charity’s new programs. They also cover the organization’s outreach efforts and the important patient guide available on their website.   Joel also reviews recent JANS articles on mortality and stroke after routine left atrial appendage occlusion in patients undergoing isolated mitral repair without atrial fibrillation in the United States, if early outcomes of reoperative aortic root surgery is impacted by previous root procedures and indicate reintervention, Fallot and its variants from diagnosis to pulmonary valve replacement, and low-dose warfarin with a novel mechanical aortic valve.   In addition, Joel explores aortic valve replacement with LIMA to LAD artery and an ascending aortic replacement, step-by-step pulmonary thromboendarterectomy for chronic thromboembolic disease, and Norwood-Sano Stage I palliation for hypoplastic left heart syndrome. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Mortality and Stroke After Routine Left Atrial Appendage Occlusion in Patients Undergoing Isolated Mitral Repair Without Atrial Fibrillation in the United States  2.) Are Early Outcomes of Reoperative Aortic Root Surgery Impacted by Previous Root Procedure and Indication for Reintervention?  3.) Fallot and Its Variants: From Diagnosis to Pulmonary Valve Replacement  4.) Low-Dose Warfarin With a Novel Mechanical Aortic Valve: Interim Registry Results at 5-Year Follow-Up  CTSNET Content Mentioned  1.) Aortic Valve Replacement With LIMA to LAD Artery and an Ascending Aortic Replacement  2.) Step-by-Step Pulmonary Thromboendarterectomy for Chronic Thromboembolic Disease  3.) Norwood-Sano Stage I Palliation for Hypoplastic Left Heart Syndrome: The Modified Birmingham Technique  Other Items Mentioned  1.) Aortic Dissection Awareness UK & Ireland Website   2.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration   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. Salim Aziz, thoracic and cardiovascular surgeon and clinical professor at George Washington University, about computed tomography (CT) scan-negative type A dissection. Chapters 00:00 Intro 00:57 Dr. Aziz Preview 02:01 Bringing International Colleagues to Centers 07:01 Ambulation Protocol ECMO 09:12 COPD Severity, Aortic Aneurysm 11:37 Robotic Mitral Repair Learning Curve 15:43 Ross Procedure in Neonates, Analysis 19:21 Tirone David Keynote 21:52 AVR 101 23:08 Robotic Beating-Heart TECAB: LIMA-LAD 25:17 Dr. Aziz, CT Scan-Negative Type A Dissection 43:52 Closing They discuss Dr. Aziz’s experience with cases that present as CT scan-negative, discussing the details of these cases and the concerning frequency with which aortic dissections are overlooked. They also explore routine transesophageal echocardiogram (TEE) in the operating room, finding tears, and aortic aneurysms.   Joel also reviews recent JANS articles on the ambulation protocol for adult patients receiving extracorporeal membrane oxygenation, if the severity of chronic obstructive pulmonary disease is associated with adverse outcomes after open thoracoabdominal aortic aneurysm repair, the learning curve of robotic mitral repair, and long-term outcomes following the Ross procedure in neonates and infants.   In addition, Joel explores a 2024 London Core Review Cardiothoracic Surgery Course on “Surgical Treatments of Aortic Root Aneurysms,” aortic valve replacement 101 through an upper ministernotomy, and robotic beating-heart totally endoscopic coronary bypass. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Ambulation Protocol for Adult Patients Receiving Extracorporeal Membrane Oxygenation: A Quality Improvement Initiative  2.) The Severity of Chronic Obstructive Pulmonary Disease Is Associated With Adverse Outcomes After Open Thoracoabdominal Aortic Aneurysm Repair  3.) Learning Curve of Robotic Mitral Repair: Prospective Two-Centre Study of Proficiency and Clinical Outcomes  4.) Long-Term Outcomes Following the Ross Procedure in Neonates and Infants: A Multi-Institutional Analysis  CTSNET Content Mentioned  1.) Surgical Treatments of Aortic Root Aneurysms: 2024 London Core Review Cardiothoracic Surgery Course  2.) Aortic Valve Replacement 101 Through an Upper Ministernotomy  3.) Robotic Beating-Heart Totally Endoscopic Coronary Bypass (TECAB): LIMA to LAD  Other Items Mentioned  1.) Putative Computed Tomography Scan-Negative Type A Dissection  2.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration  3.) President's Series With Husam Balkhy | ISMICS President  4.) London Core Review Registration   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 recaps two presentations delivered at the Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting 2025. Chapters 00:00 Intro 02:57 "Teamship," Sir Woodward 09:23 Virtual Surgery Training, Dr. Ahmed 12:55 Upcoming Lung Surgery Trials 14:48 Needle Aspiration & Forceps Biopsy 17:26 Approaches to Clinical Trial Designs 22:10 Noninvasive Ventilation Cardiac Impact 24:59 Lung Volume Reduction, Severe Emphysema 29:22 How To—Upper Ministernotomy 30:45 Valve-Sparing ARR Using Reimplant Tech 32:02 ARCA Management Exploration 33:59 Upcoming Events 34:41 WTS Webinar Series 35:32 Closing The first presentation was delivered by Sir Clive Woodward, the Rugby World Cup-winning coach, who gave an inspiring talk on "Teamship" and winning behaviors. The second presentation that Joel recaps was delivered by Professor Shafi Ahmed, a multiaward-winning surgeon and an evangelist for augmented and virtual reality, who discussed livestreaming operations, using virtual reality in surgical operations, and virtual medical school.   Joel also reviews recent JANS articles on the diagnostic yield and synergistic impact of needle aspiration and forceps biopsy with electromagnetic navigation bronchoscopy for peripheral pulmonary lesions, the challenges of conventional and novel approaches to clinical trial designs in cardiovascular medicine, the impact of noninvasive ventilation before and after cardiac surgery for preventing cardiac and pulmonary complications, and surgical and bronchoscopic lung volume reduction for severe emphysema.   In addition, Joel explores how to perform an upper ministernotomy, valve-sparing aortic root replacement using the reimplantation technique, and an exploration of anomalous right coronary artery management with Drs. Sameh Said and Vince Gaudiani. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Diagnostic Yield and Synergistic Impact of Needle Aspiration and Forceps Biopsy With Electromagnetic Navigation Bronchoscopy for Peripheral Pulmonary Lesions (CONFIDENT-ENB)  2.) Challenges of Conventional and Novel Approaches to Clinical Trial Designs in Cardiovascular Medicine  3.) Impact of Noninvasive Ventilation Before and After Cardiac Surgery for Preventing Cardiac and Pulmonary Complications   4.) Surgical and Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Systematic Review and Network Meta-Analysis  CTSNET Content Mentioned  1.) How to Perform an Upper Ministernotomy  2.) Valve-Sparing Aortic Root Replacement Using the Reimplantation Technique  3.) Anomalous Right Coronary Artery Management: An Exploration With Sameh Said and Vince Gaudiani  Other Items Mentioned  1.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration  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.

In this month’s episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Thomas D'Amico about VATS lobectomy. Chapters 00:00 Introduction 01:47 Background 04:11 Indications 04:51 Preoperative Assessment 07:12 Setup 08:21 Patient Positioning 11:26 Basics 13:36 D'Amico's Port Placement 16:46 Uniportal 22:03 Steps 22:44 Anterior-Posterior Order 25:45 Anatomy 26:45 Instruments 30:54 Pleural Dissection 31:33 Inferior Pulmonary Ligament 31:39 Pulmonary Vein 32:01 Artery/Bronchus Dissection 33:38 Nodal Resection 36:25 Tips & Tricks 38:48 Specimen Removal 39:10 Closure 40:02 Postoperative Care 45:01 Outcomes 45:31 CT Surgery Training Advice They discuss the set-up, patient positioning, port placement, dissection of hilar structures, tips and tricks, and more. They also discuss preoperative assessment, nodal resection, specimen removal, closure, and outcomes.   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 ECMO.   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 examines future cardiothoracic surgery robotic systems. Chapters 00:00 Intro 01:05 SCTS 2025 02:50 Intuitive Single-Port System 10:00 Other Robotics in Development 12:49 Medtronic Innovations 15:53 Tumor Air Spaces Spread 18:21 Virtual Reality Effect on Patients 19:58 MR for Isolated Leaflet Lesion 21:48 Post-Surgery Proning Obese ARS Syndrome 23:31 Robotic Bi Ortho Lung Transplant 25:51 Video Competition 2nd and 3rd Place 26:59 Repair of Bileaflet MV Prolapse 27:46 Robotic ASD Closure via LA 28:46 Upcoming Events 29:42 Women in Thoracic Surgery Webinar 30:46 Closing He discusses the new da Vinci Single-Port surgical system, single-port robotic systems, and the cost difference between single-port and multiport robotic systems. He also examines DV5 technology, the potential of utilizing lasers in robotics, and other practices that are interested in robotic systems.    Joel also reviews recent JANS articles addressing whether tumors spread through air spaces is a determinant for treatment of clinical stage I non-small cell lung cancer, the effect of virtual reality on postoperative anxiety and pain in patients following cardiac surgery, long-term results of edge-to-edge and neochordal mitral repair for isolated anterior leaflet lesions, the prone position in obese patients with acute respiratory distress syndrome after cardiothoracic surgery.   In addition, Joel explores minimally invasive bilateral orthotopic lung transplant with robotic assistance, repair of bileaflet mitral valve prolapse through an upper ministernotomy, and robotic-assisted atrial septal defect closure via the left atrium. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Tumour Spread Through Air Spaces Is a Determiner for Treatment of Clinical Stage I Non-Small Cell Lung Cancer: Thoracoscopic Segmentectomy vs Lobectomy  2.) The Effect of Virtual Reality on Postoperative Anxiety and Pain in Patients Following Cardiac Surgery: A Randomized Controlled Trial  3.) Long-Term Results of Edge-to-Edge and Neochordal Mitral Repair for Isolated Anterior Leaflet Lesion: A Propensity Match Analysis   4.) Prone Position in Obese Patients With Acute Respiratory Distress Syndrome After Cardio-Thoracic Surgery  CTSNET Content Mentioned  1.) Minimally Invasive Bilateral Orthotopic Lung Transplant With Robotic Assistance  2.) Repair of Bileaflet Mitral Valve Prolapse Through an Upper Ministernotomy  3.) Robotic-Assisted Atrial Septal Defect Closure Via the Left Atrium: Dual Case Reports  Other Items Mentioned  1.) Webinar Series: Women in Cardiothoracic Surgery—Advancement Through Collaboration  2.) 2024 CTSNet Resident Video Competition Winners  3.) President's Series With Husam Balkhy | ISMICS President  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 examines how to prevent adverse publicity by patients on social media. Chapters 00:00 Intro 02:01 Patient-Social Media Interaction 11:56 Lung Cancer Screening Recommendations 15:29 Perc vs Surg Revasc, SWEDEHEART Registry 18:06 Down Syndrome Patient Outcomes 19:20 Nighttime Cardiovascular Staffing Impact 23:42 Samurai Cannulation 28:30 Off-Pump AAD Via Upper Ministernotomy 30:35 Robotic Thoracic Truncal Vagotomy 31:59 Upcoming Events 33:02 Closing He explores the benefits and drawbacks of patient groups on social media, explains how social media impacted the Shanghai Pulmonary Hospital, and provides examples of online patient groups. He also discusses whether surgeons should encourage patients to post on social media, what roles surgeons should have in online patient groups, and discusses his own experience with online patient groups.   Joel also reviews recent JANS articles on lung cancer screening and USPSTF recommendations, percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease, outcomes in adult congenital heart disease patients with Down syndrome undergoing a cardiac surgical procedure, and the impact of nighttime cardiovascular intensive care unit staffing on failure to rescue and revenue.   In addition, Joel explores Samurai (the Direct True Lumen Technique) cannulation in acute type I aortic dissection, off-pump aortic arch debranching via upper ministernotomy, and robotic thoracic truncal vagotomy. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Lung Cancer Screening and USPSTF Recommendations   2.) Percutaneous vs. Surgical Revascularization of Non-ST-Segment Elevation Myocardial Infarction With Multivessel Disease: The SWEDEHEART Registry  3.) Outcomes in Adult Congenital Heart Disease Patients With Down Syndrome Undergoing a Cardiac Surgical Procedure  4.) Impact of Nighttime Cardiovascular Intensive Care Unit Staffing on Failure to Rescue and Revenue  CTSNET Content Mentioned  1.) Samurai (the Direct True Lumen Technique) Cannulation in Acute Type I Aortic Dissection  2.) Off-Pump Aortic Arch Debranching Via Upper Ministernotomy  3.) Robotic Thoracic Truncal Vagotomy  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 examines surgical staplers. He explores the history of surgical staplers, the evolution of surgical staplers, and discusses the company that created the first automated minimally invasive surgical stapler—United States Surgical Corporation (USSC). He also discusses details about the AutoSuture Premium Poly stapler and why it is still being created. Joel also shares details about when he visited a production line that is responsible for creating surgical staplers. He discusses his experience and his highlights from this event, which includes meeting Dr. Rene Petersen and Dr. Laurens Ceulemans.  Joel also reviews recent JANS articles on heart transplantation and donation after circulatory death in children, priorities for medical device regulatory approval, transplantation of a genetically modified porcine heart into a live human, and mechanisms of repair failure after mitral valve repair using chordal replacement.   In addition, Joel explores treating intractable hiccups by clipping the phrenic nerve using VATS, robotic totally endoscopic CryoMaze ablation under ventricular fibrillatory arrest, and a new podcast episode from Dr. Alice Copperwheat, “The Atrium: Internal Mammary Artery Harvesting,” with expert guest Dr. David Taggart. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Heart Transplantation and Donation After Circulatory Death in Children. A Review of the Technological, Logistical and Ethical Framework  2.) Priorities for Medical Device Regulatory Approval: A Report From the European Society of Cardiology Cardiovascular Round Table  3.) Transplantation of a Genetically Modified Porcine Heart Into a Live Human  4.) Mechanisms of Repair Failure After Mitral Valve Repair Using Chordal Replacement  CTSNET Content Mentioned  1.) Treating Intractable Hiccups by Clipping the Phrenic Nerve Using VATS  2.) The Atrium: Internal Mammary Artery Harvesting  3.) Robotic Totally Endoscopic Cryo-Maze Ablation Under Ventricular Fibrillatory Arrest  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 Dr. Mujtaba Mubashir, CTSNet JANS editor and surgical resident at Beth Israel Deaconess Medical Center, about being a JANS editor. They discuss what JANS is, their favorite part about JANS, and their favorite articles. They also explore highlights from the 61st Society of Thoracic Surgeons Annual Meeting, including how to manage chest tubes after surgery and their favorite part of the meeting. Joel also shares details about his recent trip to Accra, Ghana, for the first Pan-African Society for Cardiothoracic Surgery (PASCaTS) and Global Heart Forum summit. He discusses different organizations, including Emergency NGO Sudan and Every Heartbeat Matters, examines various mission models, and discusses patients and surgeons he met at the summit.   Joel also reviews recent JANS articles on moving toward standardization in robotic lung transplants, how single lung transplantation is safe when the other lung is declined, perioperative outcomes and survival of modified subxiphoid video-assisted thoracoscopic surgery thymectomy for T2-3 thymic malignancies, and robotic thoracic surgery using the single-port robotic system.  In addition, Joel explores how to replace a severely calcified mitral valve, preoperative management of patients at high risk for recurrent laryngeal nerve injury during esophagectomy, and a presentation from the 10th Annual International Coronary Congress, “Maintaining CABG as a Gold Standard in 2024.” Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Towards Standardization in Robotic Lung Transplant: A Novel Approach in Minimally Invasive Thoracic Surgery  2.) Single Lung Transplantation Is Safe When the Other Lung Is Declined  3.) Perioperative Outcomes and Survival of Modified Subxiphoid Video-Assisted Thoracoscopic Surgery Thymectomy for T2-3 Thymic Malignancies: A Retrospective Comparison Study   4.) Robotic Thoracic Surgery Using the Single-Port Robotic System: Initial Experience With More Than 100 Cases  CTSNET Content Mentioned  1.) How to Replace a Severely Calcified Mitral Valve  2.) ICC 2024 | Maintaining CABG as a Gold Standard In 2024  3.) Preoperative Management of Patients at High Risk for Recurrent Laryngeal Nerve Injury During Esophagectomy  Other Items Mentioned  1.) Utter Shock as Unreel Robotics Stuns the World of Surgery With the World’s First Fully Autonomous Soft Tissue Surgical Robot   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.

In this month’s episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. David Taggart about internal mammary artery harvesting. They discuss indications, patient preparation, internal thoracic artery anatomy, and key steps—sternotomy, free parietal pleura, incised endothoracic fascia, cutting of IMA, and more. They also discuss the pedicled technique, the skeletonized technique, 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 VATS lobectomy.   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. Husam Balkhy, Professor of Surgery and the Director of Robotic and Minimally Invasive Cardiac Surgery at University of Chicago Medicine and President of The International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS), about robotic totally endoscopic cardiac surgery procedures. They discuss potential ways to get the world to perform more robot-assisted surgeries, the building blocks to learning robotics, the future of learning robotics, and what to expect this year at the ISMICS 2025 Annual Meeting. They also explore Dr. Balkhy’s new President’s Series on CTSNet and provide insights into the first video of this series. Joel also highlights some of the videos in the CTSNet Resident Video Competition and the robotics vs VATS debate in Britain.   Joel also reviews recent JANS articles on the impact of restricted chests on long-term lung function parameters following lung transplantation in patients with interstitial lung disease, determinants of inadequate cardioprotection in adult patients with left ventricular dysfunction, engineered heart muscle allografts for heart repair in primates and humans, and risk factor analysis for 30-day mortality after surgery for infective endocarditis.  In addition, Joel explores open repair of descending thoracic and thoracoabdominal aortic aneurysms, totally 3D endoscopic third tricuspid valve replacement, and how to use the Impella for on-pump CABG in patients with low EF. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) The Impact of Restricted Chests on Long-Term Lung Function Parameters Following Lung Transplantation in Patients With Interstitial Lung Disease    2.) Determinants of Inadequate Cardioprotection in Adult Patients With Left Ventricular Dysfunction  3.) Engineered Heart Muscle Allografts for Heart Repair in Primates and Humans  4.) Risk Factor Analysis for 30-Day Mortality After Surgery for Infective Endocarditis   CTSNET Content Mentioned  1.) Open Repair of Descending Thoracic and Thoracoabdominal Aortic Aneurysms  2.) Totally 3D Endoscopic Third Tricuspid Valve Replacement  3.) ICC 2024 | How I Use the Impella for On-Pump CABG in Patients With Low EF: Insertion, Intraoperative Management, and Weaning/Removal  Other Items Mentioned  1.) President's Series With Husam Balkhy | ISMICS President   2.) ISMICS 2025 Annual Meeting   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 Tom D’Amico, professor and vice chairman of surgery and chief medical officer of the Duke Cancer Institute, about oligometastatic disease. They discuss the current updates of oligometastatic disease, The Society of Thoracic Surgeons (STS) guidelines on the surgical management of oligometastatic non-small cell lung cancer, and the importance of choosing the right patient. They also explore where the new boundaries of this procedure are, radiation therapy, and shared decision-making. Joel also highlights a surgical robot (spaceMIRA) at the International Space Station that completed its first surgery demo in zero gravity, the state of lung transplants in the United Kingdom, and the Priority Setting Partnership (PSP).   Joel also reviews recent JANS articles on perioperative extra corporeal membrane oxygenation in neonates with transposition of the great arteries, a randomized controlled trial on the effects of postoperative glucocorticoids on mitigation of organ dysfunction in patients with Type A aortic dissection, if socioeconomic factors impair uptake of neoadjuvant therapy for patients with locoregional esophageal cancer, and a nationwide analysis on malperfusion in patients with acute Type A aortic dissection.  In addition, Joel explores a case report on a chest injury with an arrow penetrating the right lung with rent in the right atrium, an interview with Marko Turina, and an Onyx mechanical mitral valve replacement after previous mitral repair. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Perioperative Extra Corporeal Membrane Oxygenation in Neonates With Transposition of the Great Arteries: 15 Years of Experience  2.) Effects of Postoperative Glucocorticoids on Mitigation of Organ Dysfunction in Patients With Type A Aortic Dissection: A Randomized Controlled Trial  3.) Do Socioeconomic Factors Impair Uptake of Neoadjuvant Therapy for Patients With Locoregional Oesophageal Cancer?  4.) Malperfusion in Patients with Acute Type A Aortic Dissection: A Nationwide Analysis  CTSNET Content Mentioned  1.) Injury to the Chest With an Arrow Penetrating the Right Lung With Rent in the Right Atrium: A Case Report  2.) Giants in CT Surgery: An Interview With Marko Turina  3.) Redo Mitral Surgery: Onyx Mechanical Mitral Valve Replacement After Previous Mitral Repair   Other Items Mentioned  1.) The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer  2.) Surgery in Space: Tiny Remotely Operated Robot Completes First Simulated Procedure at the Space Station  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. Vinay Badhwar, the current vice president of the Society of Thoracic Surgeons (STS), about his groundbreaking achievement in combining robotic aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) through a single small incision. They discuss the background and premise of this technique, the process of taking this technique from an idea to performing it on a patient, differences between this approach and other cardiac approaches, and the future of cardiac surgery. They also explore the first operation performed using this technique in immense detail with visuals of the procedure.   Joel also highlights recent JANS articles on multisociety endorsement of the 2024 European guideline recommendations on coronary revascularization and bioprosthetic vs mechanical aortic valve replacement in patients 40-75 years. He also reviews short- and long-term outcomes of lung transplantation from brain death vs circulatory death donors and intracavitary cisplatin-fibrin followed by irradiation improved tumor control compared to the single treatments in a mesothelioma rat model.  In addition, Joel explores a Dacron graft double inversion for ascending aorta surgery, a redo mitral valve surgery with previous aortic valve replacement, and a right sinus of Valsalva aneurysm causing right ventricular tract obstruction. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) Multisociety Endorsement of the 2024 European Guideline Recommendations on Coronary Revascularization  2.) Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients 40-75 Years  3.) Short- and Long-Term Outcomes of Lung Transplantation From Brain Death vs. Circulatory Death Donors: A Meta-Analysis of Comparative Studies  4.) Intracavitary Cisplatin-Fibrin Followed by Irradiation Improved Tumor Control Compared to the Single Treatments in a Mesothelioma Rat Model  CTSNET Content Mentioned  1.) Dacron Graft Double Inversion for Ascending Aorta Surgery  2.) Redo Mitral Valve Surgery With Previous Aortic Valve Replacement  3.) Right Sinus of Valsalva Aneurysm Causing Right Ventricular Tract Obstruction  Other Items Mentioned  1.) CTSNet 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.

In this month’s episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Kim Thompson about cardiopulmonary bypass. They discuss cardiopulmonary bypass setup, the equipment—cannulas, reservoir container, pumps, heat exchangers, oxygenators, cardioplegia, adjuncts—preparation, priming, and heparinization. They also discuss cannulation, going on bypass, maintenance of bypass, coming off bypass, 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 internal mammary artery harvesting.   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.