Perspectives in Cardiothoracic Surgery

[Pages:178]Society for Cardiothoracic Surgery in Great Britain and Ireland

Perspectives in Cardiothoracic Surgery

The SCTS Ionescu University Volume I

Edited by Paul Modi

Invited Editor Marian Ion Ionescu

Society for Cardiothoracic Surgery in Great Britain and Ireland

Perspectives in Cardiothoracic Surgery

The SCTS Ionescu University

Volume I

Edited by Paul Modi

Invited Editor Marian Ion Ionescu

Perspectives in Cardiothoracic Surgery: The SCTS-Ionescu University, Volume I

Copyright ? 2016 Society for Cardiothoracic Surgery in Gt Britain and Ireland

ISBN 978-1-5262-0129-4

First published in Great Britain in 2016 by Society for Cardiothoracic Surgery in Great Britain and Ireland, SCTS 5th Floor, Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PE. Tel: 0207 869 6893 Fax: 0207 869 6890 Email: sctsadmin@ Web:

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the author, except for the inclusion of brief quotations in a review.

Cover photo by Lennart Nilsson

Designed, typeset and printed by CPL Associates, London, UK.

Perspectives in Cardiothoracic Surgery

The SCTS Ionescu University Volume I

Edited by

Paul Modi

Invited Editor Marian Ion Ionescu

Section I: Section II:

Cardiac Surgery - Minimally Invasive Surgery for the Mitral and Aortic Valves

Thoracic Surgery - The Treatment of Diseases of the Pleura

Society for Cardiothoracic Surgery in Great Britain and Ireland

5

Preface

Pliny leaves mankind this only alternative: Either of doing what deserves to be written or of writing what deserves to be read.

Caius Plinius Coecillius Secundus (the younger)

The SCTS University was conceived by Ian Wilson and first delivered in 2010 at the Annual Meeting in Liverpool. It initially consisted of four streams of contemporary postgraduate education in the specialty. From 2014, with the benefit of support from Mr Marian Ion Ionescu, the SCTS University has considerably expanded. On its fifth anniversary in 2015, the SCTS Ionescu University ran eleven streams across the breadth of the specialty. Four hundred and twenty delegates from the SCTS and the Association of Cardiothoracic Anaesthetists attended. The SCTS Ionescu University has now become an established day of the SCTS Annual Meeting. The presentations from the SCTS Ionescu University are now available to a wider audience through the SCTS website ( library.aspx). With the publication of `Perspectives in Cardiothoracic Surgery ? The SCTS Ionescu University 2015' we are pleased to be able to publish the key presentations edited in a more scholarly format for the benefit of the SCTS membership and the wider profession. These perspectives are up to date reviews of areas of clinical practice authored and edited by leading experts who have kindly contributed to this next phase of education from the SCTS Education Committee and Annual Meeting.

Tim R Graham President 2014-16

Graham Cooper President 2016-18

Mike Lewis Education secretary

Rajesh Shah Education secretary

6 Perspectives In Cardiothoracic Surgery

7

Contents

Preface

5

Contributors

8

Section 1

1 Current Controversy ? Technique of Aortic Occlusion:

Endoaortic Balloon versus Transthoracic Clamp

13

2 Current Controversy: Antegrade versus retrograde

arterial perfusion

25

3 Debate: Should the First-Line Treatment for Non-Complex

Degenerative Mitral Valve Disease in the 21st Century be

by Minimal Access Surgery?

41

4 Pearls and Pitfalls of Minimally Invasive Mitral Valve Surgery

and the Loop Technique

57

5 Anaesthesia and Transoesophageal Echocardiography for Minimally

Invasive Heart Valve Surgery

71

6 Transcatheter Mitral Valve Repair with The MitraClip ?

The Evidence and Current Indications

83

7 The Anterior Thoracotomy Approach for Aortic Valve Replacement: 95

8 Sutureless Valves and Minimal Access Surgery

101

9 Training in Minimally Invasive Surgery:

The General Surgeons did this years ago, what can we learn?

111

Section 2

10 Surgery for Pleural Sepsis

121

11 Management of Residual Pleural Space

131

12 Thoracoscopy under Local Anaesthesia and Medical Management

of Pleural Disease

139

13 Current Oncological Options for the Treatment of Mesothelioma 149

14 Extended Pleurectomy Decortication:

The new standard of care for Malignant Pleural Mesothelioma

157

15 Extrapleural Pneumonectomy for Mesothelioma

167

Postscriptum

174

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