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SURGICAL VIDEOS

22

March

Aortic Valve replacement


Steps:

1. 00:04.21 Median sternotomy 2. 00:53 Pericardiotomy 3. 01:17.15 Pericardial retraction sutures 4. 01:42 Aortic Purse String 5. 02:08 Aortic Root Purse String 6. 02:15.25 Right Atrium Purse String 7. 02:27.08 Retrograde Purse String 8. 02:39.04 Aortic Cannulation 9. 02:50.30 Right Atrium Cannulation 10. 03:01 Retrograde cannulation 11. 03:22 Root cannulation (Antegrade) 12. 03:30 Cross clamp 13. 03:38 CO2 14. 03:40 Aorta is prepared for aortotomy 15. 03:51 Aortotomy 16. 04:08 Closure sutures (use for retraction as well) 17. 04:30 Commissure retraction sutures 18. 04:43 Native valve excision 19. 05:09.10 Annulus is sized 20. 05:17 Mechanical prosthesis implanted (Continuous suture) 21. 09:40 Aortotomy closure (using sutures placed before) 22. 11:09 Cross clamp removed 23. 11:20 Packing over suture lines 24. 11:23 Ventricular pacing wires 25. 11:48.10 Drains 26. 11:55 Aortic root decannulation (after de-airing) 27. 12:09 Right Atrium decannulation 28. 12:19 Aortic decannulation 29. 13:13 Haemostasis 30. 13:21 Pericardium closure 31. 13:32 Sternal wiring and wound closure .


Surgeon

Dr.James Edwards Fracs

10

March

Coronary Artery bypass graft (LIMA-LAD, SVG-OM, SVG-PDA)


Steps:

00:04 Sternotomy 00:38 Pericardiotomy 01:03 Mammary artery harvesting (Pedicle) 03:16 Pericardial retraction sutures 03:27 Purse string sutures for cannulation 04:09 Cannulation 05:37 Pericardial retraction sutures (Posterior) 05:28 Cross-clamp 05:55 Vein is prepared 06:04 Heart is positioned 06:11 Arteriotomy (coronary) 06:29 Distal anastomosis (SVG-PDA) 07:34 Vein is devided and prepared for next anastomosis 07:55 Heart is positioned for OM anastomosis 08:07 Arteriotomy 08:30 Distal anastomosis (SVG-OM) 09:34 Heart is positioned (for LIMA-LAD anastomosis) 09:45 Arteriotomy 10:07 Artery is probed to check patency (no title in video) 10:17 Distal anastomosis (LIMA-LAD) 12:14 Cross-clamp removed 12:20 Side clamp placed 12:33 Aortotomy punches 12:45 Vein is measured and divided (not title in video) 12:58 Proximal anastomosis (SVG/OM – Aorta) 13:42 Vein is measured and prepared for second proximal anastomosis (not title in video) 14:04 Proximal anastomosis (SVG/PDA –Aorta) 14:51 side clamp is removed 14:55 Sutures are tied (after de-airing) 15:10 Anastomosis reviewed 15:18 Pericardium is closed (Mammary) 15:25 Drains 15:30 Right atrium decannulation 15:37 Aorta is decannulated 15:54 Haemostasis 16:22 Pericardium is closed 16:33 Sternal rewiring and wound closure .


Surgeon

Dr.James Edwards Fracs

6

March

Minimally invasive Mitral valve replacement (Failed repair)


Steps:

00:04 Femoral Cannulation (Groin access) 00:30 Femoral vessels purse strings 00:59 Seldingher cannulation 01:58 Mini-Thoracotomy 02:24 Camera and crossclamp ports 02:30 Alexis and finocheto retractor placed after camera and cross clamp inserted in ports. Any right pleural effusions are drained. 02:35 Pericardiotomy 02:59 Pericardial sutures for retraction 03:14 Aortic purse strings 03:33 Ascending aorta cannulation 03:59 Left atriotomy 04:27 Atrial roof retractor 04:42 Valve assessment 06:05 Prothetic Gore-tex created 06:54 Neochordae implanted 08:35 Excision of restrictive native chordae (attempt to repair) 09:51 Perforation noted, repair abandoned. ] 10:00 Excision of native valve and neochordae for replacement 10:40 Cryoablation for pulmonary valve isolation 11:42 Plication of posterior leaflet to prepare for pledgeted sutures 13:05 Pledgeted sutures implanted in annulus 14:54 Prethesis is placed using the sutures 15:10 Sutures are knotted 16:38 Stem is removed and prosthesis inspected 17:00 Atriotomy closure 18:42 Ventricular pacing wires 19:09 Cross-clamp removed and ascending aorta decannulated 19:47 Pericardium closure 20:08 Thoracotomy closure 20:30 Femoral decannulation .


Surgeon

Dr.James Edwards Fracs

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