Kohei Hashimoto, MD, William Stansfield, MD, Shaf Keshavjee, MD

Slides:

Advertisements

Similar presentations

Shunji Sano, MD, Kozo Ishino, MD, Masaaki Kawada, MD, Osami Honjo, MD

Advertisements

Uterine leiomyoma extension into right atrium: A case report

Living related donor middle lobe lung transplant in a pediatric patient Takahiro Oto, MD, Kentaroh Miyoshi, MD, Seiichiro Sugimoto, MD, Masaomi Yamane,

Sleeve segmentectomy for non–small cell lung carcinoma

Comparative study of single- and double-patch techniques for sinus venosus atrial septal defect with partial anomalous pulmonary venous connection Anand.

Ugonna N. Ihekweazu, BS, William D. Travis, MD, Raja M. Flores, MD

Three-dimensional printing titanium ribs for complex reconstruction after extensive posterolateral chest wall resection in lung cancer Lei Wang, MD,

Shunji Sano, MD, Kozo Ishino, MD, Masaaki Kawada, MD, Osami Honjo, MD

Surgical technique and results of tracheal and carinal replacement with aortic allografts for salivary gland–type carcinoma Alain Wurtz, MD, Henri Porte,

Christopher W. Baird, MD, Joseph M. Forbess, MD

Living related donor middle lobe lung transplant in a pediatric patient Takahiro Oto, MD, Kentaroh Miyoshi, MD, Seiichiro Sugimoto, MD, Masaomi Yamane,

Urgent implantation of the Berlin Heart Excor biventricular assist device as a total artificial heart in a patient with single ventricle circulation

Robotic Segmentectomy

Complete thoracoscopic S9 or S10 segmentectomy through a pulmonary ligament approach Takuma Kikkawa, MD, Masato Kanzaki, MD, PhD, Tamami Isaka, MD, PhD,

Video-assisted thoracoscopic surgical lobectomy with limited en bloc resection of superior sulcus tumor Ivan H.W. Cheung, MBBS, BEng, Eric Lim, MD, MB,

Thrombus in the left superior pulmonary vein after left upper pulmonary lobectomy Eiki Nagaoka, MD, Makoto Yano, PhD, Takahiko Sugano, MD, Takamichi Miyamoto,

Salvaging an accidental superior vena caval transection during a right pneumonectomy by creating a Glenn shunt: A case report and review of the literature

Outcomes of inferior sinus venosus defect repair

Septimiu D. Murgu, MD, FCCP, Henri G. Colt, MD, FCCP

Jean-Paul A. Couetil, MDa, Michael J. Tolan, FRCSIa, Didier F

Harold L. Lazar, MD The Journal of Thoracic and Cardiovascular Surgery

Acute chest pain and tamponading left hemothorax: An unusual presentation of pulmonary arteriovenous malformation Ira R.A. Goldsmith, MD, FRCS CTh, Ihab.

Robert James Cerfolio, MD, FACS, FCCP, Ayesha S

Systemic and regional pulmonary function after segmentectomy

Calcified amorphous tumor of left atrium

Lung adenocarcinoma with intraoperatively diagnosed pleural seeding: Is main tumor resection beneficial for prognosis? Chi Li, MD, Shuenn-Wen Kuo, MD,

Daniel Schmauss, MD, Nicolas Gerber, MSc, Ralf Sodian, MD

Surgery for predominant lesion in nonlocalized bronchiectasis

Computed tomography-guided patent blue vital dye localization of pulmonary nodules in uniportal thoracoscopy Mong-Wei Lin, MD, PhD, Yao-Hui Tseng, MD,

High-resolution computed tomography with three-dimensional reconstruction for assessment of chronic pulmonary thromboembolic disease Thoralf M. Sundt,

Use of the total artificial heart as a bridge to transplant in a 13-year-old with congenitally corrected transposition of the great arteries Ming-Sing.

Tomaso Bottio, MD, PhD, Gino Gerosa, MD

Pedicled posterior pericardial repair of tracheoesophageal fistula after chemoradiotherapy for esophageal cancer Takushi Yasuda, MD, Tomoki Makino, MD,

Right Upper Lobe Sleeve Resection

Intravenous leiomyomatosis extending from the inferior caval vein to the pulmonary artery Giuseppe Virzì, MD, Salvatore Ragazzi, MD, Francesco Bussichella,

Everting mattress running suture: an improved technique of atrial anastomosis in human lung transplantation Marc de Perrot, MD, MS, Shaf Keshavjee, MD,

Main stem bronchus surgery with pulmonary preservation

Thoracoscopic lobectomy

The elusive mass in the right atrium: A liver in the heart

The bad guy, good guy scenario with a scimitar sword: A case to learn from Hani K. Najm, MD, MSc The Journal of Thoracic and Cardiovascular Surgery

Experience from an American Association for Thoracic Surgery Foundation for Thoracic Surgery Training Fellowship: Lung transplantation in Toronto General.

Anterior transpericardial approach for postchemotherapy residual midvisceral mediastinal mass in metastatic germ cell tumors Marc de Perrot, MD, Donna.

The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation P. Michael McFadden, MD,

Demonstration of persistent tumor cells 4 weeks after radiofrequency ablation of a pulmonary adenocarcinoma Stéphane Renaud, Marco Schiavon, MD, Nicola.

A simplified technique for pulmonary artery aneurysm repair in a lung transplant recipient with right ventricular outflow tract obstruction Giorgio Zanotti,

Have you seen an atrium bigger than this?

Imaging of tumor infiltration of the pulmonary artery amenable to sleeve resection Anna Maria Ciccone, MD, Antonio D'Andrilli, MD, Federico Venuta, MD,

Transient right ventricular dysfunction caused by retractor during lower hemisternotomy mitral valve repair in a patient with pectus excavatum Homare.

A new method for implanting a total artifical heart in the patient with a Fontan circulation Ronald K. Woods, MD, PhD, Robert Niebler, MD, Steve Kindel,

Extended Pneumonectomy With Partial Resection of the Left Atrium, Without Cardiopulmonary Bypass, for Lung Cancer Lorenzo Spaggiari, MD, PhD, Massimiliano.

Heart transplantation in situs inversus totalis

Left atrial myxoma: The role of multisclice computed tomography

The multi–purse string maze procedure: A new surgical technique to perform the full maze procedure without atriotomies Niv Ad, MD The Journal of Thoracic.

Shunt right or left? Decision 2016

Bryan M. Burt, MD The Journal of Thoracic and Cardiovascular Surgery

Uterine leiomyoma extension into right atrium: A case report

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

A fenestrated stent graft for surgical resection of lung cancer invading the aortic arch Toshiyuki Nagata, MD, Yoshihiro Nakamura, MD, PhD, Hiroyuki Yamamoto,

The patent internal thoracic artery graft: Increased degree of difficulty for left-sided pulmonary resections Robbin G. Cohen, MD, MMM The Journal of.

Uniportal video-assisted thoracoscopic surgery wedge lung biopsy in the diagnosis of interstitial lung diseases Gaetano Rocco, MD, Mohamed Khalil, MD,

Anthony Azakie, MD, Natalie C. Johnson, BS, Petros V

Karin M. Dunst, MD, Ludwig C. Mueller, MD

Apples remain apples NO matter what

Energized lung resections

Preoperative PFTs: The answer is blowing in the wind

Who should decide margin length in pulmonary excision of lung cancer?

Bilobectomy with superior pulmonary vein reconstruction with a greater saphenous vein autograft to avoid pneumonectomy Kazuhiro Wakida, MD, Goichi Yotsumoto,

Awais Ashfaq, MD, Holenarasipur R. Vikram, MD, Janis E

Edward Y. Chan, MD, Michael J. Reardon, MD

Presentation transcript:

Pulmonary and atrial resection and reconstruction for sarcoma with intracardiac extension Kohei Hashimoto, MD, William Stansfield, MD, Shaf Keshavjee, MD The Journal of Thoracic and Cardiovascular Surgery Volume 153, Issue 4, Pages e61-e63 (April 2017) DOI: 10.1016/j.jtcvs.2016.12.007 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Chest CT. Before (A, B) and after (C, D) chemoradiotherapy. A, Right pulmonary lesion 11 cm in diameter with a left atrial invasion (arrow). B, Left lower lobe lesion 4 cm in diameter on the diaphragm (arrow). C, Shrunken tumor (7.5 cm) with remaining atrial invasion (arrow). D, Left lower lobe lesion reduced to 1.8 cm in diameter (arrow). Each scale in images represents 1 cm. The Journal of Thoracic and Cardiovascular Surgery 2017 153, e61-e63DOI: (10.1016/j.jtcvs.2016.12.007) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Intraoperative procedures. A 2-cm margin was secured using an open atrial resection technique with confirmed negative margin using intraoperative frozen-section diagnosis (A). Autologous pericardial patch was obtained (B) and anastomosed to the atrial defect (C). An intact tumor was protruding into the left atrium in the resected specimen (D). The Journal of Thoracic and Cardiovascular Surgery 2017 153, e61-e63DOI: (10.1016/j.jtcvs.2016.12.007) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

A pulmonary metastasis of sarcoma with extensive cardiac extension in the left atrium. The Journal of Thoracic and Cardiovascular Surgery 2017 153, e61-e63DOI: (10.1016/j.jtcvs.2016.12.007) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 1 (1) We deflated the right lung. We then dissected the right hilum and encircled the right main pulmonary artery with a tourniquet. (2) Before manipulation of the inferior vein and left atrium, we put the patient on cardiopulmonary bypass and stopped ventilation to both lungs. (3) We then dissected Waterston's interatrial groove and identified the tumor protruding into the left atrium through the inferior pulmonary vein. (4) After the crossclamp induction of cardioplegic arrest, we opened the left atrium and resected the tumor with an approximately 2-cm margin. The right superior pulmonary vein was not involved. Intraoperative frozen-section confirmed that the atrial margin was negative. (5) The atrial wall defect was closed using an autologous pericardial patch. (6) The left atrium was allowed to fill and de-air as we finished the closure. After further de-airing of the heart, the crossclamp was removed. (7) We snared the right main pulmonary artery to control flow from the open pulmonary side of the atrium. We then weaned from cardiopulmonary bypass, ventilating only the left lung and keeping the right lung deflated for the subsequent lobectomy. We then also over-sewed the atrial resection stump to control the bleeding through the right lung due to bronchial circulation. (8) We performed a wedge resection of the left lower lobe tumor while the left lung was ventilated, with a brief apneic period for the actual stapling of the wedge resection. (9) We then decannulated. Pump time was 69 min, and crossclamp time was 39 min. (10) We then completed the right lower lobectomy. (11) The pulmonary artery and bronchus of the right lower lobe were transected with staplers. (12) The remaining right lung inflated without difficulty. (13) Specimen of right lower lobe. The intact tumor is seen protruding from the end of vein cuff. Video available at: http://www.jtcvsonline.org/article/S0022-5223(16)31670-1/addons. The Journal of Thoracic and Cardiovascular Surgery 2017 153, e61-e63DOI: (10.1016/j.jtcvs.2016.12.007) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions