The Beat With Joel Dunning Ep. 121: Managing LVOT Obstruction With Minimal Septal Hypertrophy

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Nicholas Smedira, a cardiac surgeon at the Cleveland Clinic, about mitral valve-induced left ventricular outflow tract (LVOT) obstruction with minimal septal hypertrophy. Chapters  00:00 Intro 02:25 JANS 1, Transcervical Robotic AVR 07:49 JANS 2, Post Cor-Knot vs Manual Tying 10:18 JANS 3, Valve Therapy vs Volume Reduction 12:55 JANS 4, Cardiac Early Extraction vs Management 15:17 Career Center 16:18 Video 1, Repair of Ruptured RCAA 17:57 Video 2, Right Atrial Myxoma from IVC Junction 20:05 Video 3, Modified Re-Do Commando 22:43 Dr. Smedira Interview 45:44 Upcoming Events 46:58 Closing They discuss the importance of understanding the anatomy and physiology of the papillary muscles, as well as flow vortices. They also cover various techniques for mitral valve repair and replacement, emphasizing the importance of making the leaflet coaptation zone as posterior as possible. Additionally, they explore how learning techniques for mitral valve-induced LVOT obstruction with minimal septal hypertrophy have evolved through exposure and experience.   Joel also highlights recent JANS articles on the world's first transcervical robotic AVR procedures successfully performed in four Cleveland Clinic patients, a comparison of outcomes post Cor-Knot vs manual tying in valve surgery, endobronchial valve therapy vs lung volume reduction surgery in the United States, and early extraction vs conservative management in patients with noninfected cardiac implantable electronic devices undergoing cardiac surgery for left-sided infective endocarditis.   In addition, Joel explores the repair of a ruptured right coronary artery aneurysm, removal of a right atrial myxoma from the IVC junction with patch repair using the left atrial appendage, and a modified redo Commando procedure in a patient with septic shock due to aortic and mitral valve endocarditis. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) World's First Transcervical Robotic AVR Procedures Successfully Performed in 4 Cleveland Clinic Patients  2.) Comparison of Outcomes Post Cor-Knot Versus Manual Tying in Valve Surgery: Our 8-year Analysis of Over 1000 Patients  3.) Endobronchial Valve Therapy Versus Lung Volume Reduction Surgery in the United States  4.) Early Extraction Versus Conservative Management in Patients With Noninfected Cardiac Implantable Electronic Devices Undergoing Cardiac Surgery for Left-Sided Infective Endocarditis  CTSNET Content Mentioned  1.) Repair of Ruptured Right Coronary Artery Aneurysm  2.) Removal of a Right Atrial Myxoma From the IVC Junction With Patch Repair Using the Left Atrial Appendage  3.) Modified Re-Do Commando Procedure in a Patient With Septic Shock Due to Aortic and Mitral Valve Endocarditis   Other Items Mentioned  1.) A Surgeon’s Toolkit for Mitral Valve-Induced Left Ventricular Outflow Tract Obstruction With Minimal Septal Hypertrophy  2.) Cardiac Surgical Arrest—An International Conversation 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.

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