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.