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Cosmetic surgery aortic Videos

Shawn's heart surgery

Quick video demonstrating aortic root replacement using a plastic model of a human heart.

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tradnwal commented on 23 Feb 2007

Hi... This is Joe Grover. I don't know if you remember me but I used to work at MetaCtreations and am a friend of Steve Rathmann. I just wanted to send a quick note to say that Shawn is in our heart and our prayers. I hope that all went well with Shawn's surgery today. Blassings, Joe

grenouil1970 commented on 10 May 2008

Super ! :o)

Vascular Surgery: Infra Renal Abdominal Aortic Aneurysm Repair: Surgical Technique

Abdominal Aortic Aneurysm (AAA or Triple A) is an abnormal increase in the size of abdominal aorta which carries blood from the heart to supply the viscera and ...

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TheHHCF commented on 23 Mar 2013

Nice question. EVAR is always preferable when there is a good neck and no important arteries come in the way as it is less painful and faster recovery. But the question is that you have told that there is a narrowing (stenosis) below the aneurysm.How tight is the stenosis?If its much it will be better to do open surgery and tackle the narrowing at the same time. Can you post the CT picture here?In developing countries EVAR becomes a costly affair and hence open surgeries are commonly performed.

luca arnuzzo commented on 23 Sep 2013

Impotence in such a case may be related to injury of lombo-aortic plexus and presacral nerves which lie on anterior face of aortic bifurcation in the retoperitoneal space and therefore may be damaged during aorto-iliac exposition. Better way to avoid this is to open posterior peritoneum slightly on right aspect of aorta (beware vena cava!) and actually don't cut down retroperitoneal tissue around aortic biforcation: prepare only common iliac arteries just for clamping, don't completely open sac

Jr Tarsoly commented on 03 Sep 2013

Good day Dr. Rajnish Duara, great video and, most of all, very good choice in view angle, as one can clearly see the operation from head to toe. Being a medical student, hoping to specialize in the surgical field, I feel the need to ask you several question regarding this procedure, as so: 1. What suture/thread material did you choose to suture the graft to the AA? And what was the thread's thickness ? 2. Was the suture or anastomosis done in an interrupted or noninterrupted manner? Thank you.

oceantrolls73 commented on 22 Mar 2013

Thank you Dr. Duara for explanation. I was also wondering what the white deposit was. My layman understanding of an aneurysm was just that the walls become weak and and herniated and cause a bubble to form. However, in case of the aorta there are 3 linings involved and now i understand that the white matter may not be fat but layered blood clots. Thanks again. My father in law has to undergo this procedure soon and he is being offered a stent graft. However, he is a survivor of LV rupture.

oceantrolls73 commented on 30 Apr 2013

Thank you Dr. Duara for your concern. It is really appreciated. My father in law underwent EVAR with some complication where he was not put to sleep and an additional interventional procedure from his upper arm area was performed. I am not sure what it was as I am waiting for his full report. I will also forward it to you. It has been 13 days and post op, he is feeling a "stretchy" feeling in his abdomen otherwise fine. His urine and stool movement is normal. Again, thank you and God Bless

TheHHCF commented on 12 Sep 2013

Stephen, Usually Infrarenal aortic aneurysms do not have major arteries involved as Coeliac and SMA had already taken off. IMA is usually thrombosed in the involved aorta and the distal colon gets the supply from the Marginal Artery of Drummond which is formed both by SMA and IMA. When IMA is gone the SMA collateral supply via the marginal artery helps preserve the blood supply. Next time, your anatomy professor asks you, tell him that. And I hope he will know that too ;-)

TheHHCF commented on 18 Feb 2013

Eric, The cottage cheese like material is thrombus which lines the aneurysmally dilated aortic wall. Thrombus is nothing but blood clots. When the aortic wall enlarges there are changes in the endothelial layer (intima and intima-media interface) which incites a reaction on blood which results in layered thrombus. This is the material which you have seen me removing so that no particles can get inside the anastomotic part and cause embolism distally to the lower limbs.

Jr Tarsoly commented on 03 Sep 2013

Thank you so much for your prompt answer. I'm currently in my 4th year of med school, and had underwent 4 months in the OR, seconding through various general surgery procedures, ranging from Inguinal Hernias, to classic and laparoscopic cholecystectomies and so forth. I enjoy general surgery, but I also like cardiovascular surgery. I still have 3 years of school until I choose an actual branch of surgery to specialize in. Thank you, you have quite a video collection.

TheHHCF commented on 23 Sep 2013

Thanks for chipping in Luca. Our friend Stephen got confused between impotence and infertility. Erectile impotence as you have rightly pointed out is due to nerve related problems. I also would like to hare that minimal handling and limited dissection is the key to a good surgery. Any extra dissections lead to lymphatic and nerve plexus injuries. Targeted dissections is the rule. That is one reason why Laparoscopic AAA repair has very good results too.

oceantrolls73 commented on 22 Mar 2013

... continued My father in laws report states the following: CT Angiogram: Sacular intrarenal/aortic aneurysm with mural thrombus. starting almost 3cm below the level of renal arteries. A stenosis was seen in distal aorta below the level of aneurysm. Aneurysm measures 59x52x51mm with a thin wall in ventral aspect. Would it be riskier to perform an EVAR repair on a patient like this Dr. Duara? Your kind thoughts would be highly appreciated. Thank you.

Jr Tarsoly commented on 04 Sep 2013

Thank you. I'm with Oradea's Faculty of Pharmacy & Medicine of Bihor county, Romania. I have sustained my OR practice during summer time in my hometown of Piatra-Neamt, it's the county's main Emergency Hospital. It is a good exposure, but I still have a lot to learn, and a long way to go, but I'm optimistic. I wish there'd be more doctors, like yourself, willing to film operations, so students like myself could learn more. Wish you best of luck.

TheHHCF commented on 01 May 2013

Don't worry. Most people need anesthesia and it is better that way. I was worried about the stenosis in the lower part of aorta and I believe that was also tackled. Usually you require 3 vascular access, two from groin and one from arm for EVAR. So it is routine. Maybe there was a complication with the vascular access from the arm that required some intervention.

TheHHCF commented on 22 Apr 2013

Yes, Mr Tom. Autopsies are also done in this manner as it is done in dead bodies by forensic doctors and you have to do the same thing to avoid cutting vital structures. The only difference is that the person is alive after the surgery and the forensic doctor need not bother about that 'small little part' of life and death ;-) Adios.

TheHHCF commented on 18 Sep 2013

Stephen: The testicular arteries may get involved in the aortic aneurysm. Even if they are compromised due to the pathology or grafting, the testes will receive collateral from cremasteric, pudendal, etc. So virility will not be a problem. Impotence is related to erectile dysfunction which is not at all related to testes!!!!!

Stephen Abracadabra commented on 12 Sep 2013

Great Video!! Really helpful for my anatomy and physiology class. However, I got one question regarding what will happen to the arteries leading to the gonads and the intestine? Will they not get no more blood supply since that section is now covered with the graft? Thank you in advance.

TheHHCF commented on 03 Sep 2013

1. Suture material used in this case is 4-O polypropylene suture. 2. It was done by Matas's inclusion technique in a continuous fashion. Thanks for the wonderful comments. Much appreciated. Wish you all the best for your future surgical career. Where are you studying?

oceantrolls73 commented on 27 Mar 2013

Thank you for your reply Dr. Duara. It is much appreciated. Unfortunately, I am unable to get those details at this time. If you could furnish you contact details i would be more than willing to send them to you directly when I receive them. Many thanks again.

Stephen Abracadabra commented on 17 Sep 2013

Great explanation, I really appreciate it! Just one more thing though. What happens to the gonadal arteries? I read that one of the complications of aneurysm repair is impotence. So, I assume the arteries got blocked, but am not sure. Thanks again :D

Ivar the Boneless commented on 17 Feb 2013

What was the cottage chesse like glob that was excised just befor the shunt was put in? I am guessing plaque build up? and if so is this a contributer to the anurism? no bacon for me thak you!

TheHHCF commented on 12 Sep 2013

Thanks for the information. Medical education can be shared between continents in the virtual world. This is a great tool for education and sharing knowledge. Thanks for showing interest.

TheHHCF commented on 18 Feb 2013

Sm0keddhany: The answer to Eric's question is thrombus. The atherosclerotic lipid deposition is sub intimal and is within the wall of the aorta.

TheHHCF commented on 27 Mar 2013

My Email is given at the beginning of the video. You can send all the details including scanned reports and films there. Thanks.

Stephen Abracadabra commented on 18 Sep 2013

Thanks a lot for the clarification Dr. Duara. You help me learn more than what I learn in class/textbook.

John Spillman commented on 11 Feb 2015

Iam a 58 yr old male with a AAA at 4.2 and was wondering what to expect post surgery please

Sm0keddhany commented on 17 Feb 2013

Atherosclerosis can sometimes weaken underlying media sometimes leading to aneurysm formation.

TheHHCF commented on 22 Apr 2013

Oceantrolls, I hope everything went off well with your father in law? All the best.

TheHHCF commented on 04 Sep 2013

Thats already good exposure. Which medical college are you associated with?

Abdominal Aortic Aneurysm - Open Repair Surgery - PreOp® Patient Education HD

//www.PreOp.com Patient Education Company Before we talk about treatment, let's start with a discussion about the human body and about your medical ...

User Comments

MohamedMahrous71995 commented on 03 May 2013

why is the stapling technique used in the final closure? why not the normal sutures ?

Abdul soliman commented on 25 May 2013

good

Aortic Dissection with Tear of Right Coronary Artery

Subscribe For More Videos: //youtube.com/subscription_center?add_user=heartfixer100 This video includes a short case presentation followed by an ...

User Comments

Faiq Abdul Rahman commented on 09 May 2014

Amazing operation Dr. Blitz. What do you think of the patient's prognosis considering the Marfan's syndrome and old age? And I always wonder on how do you prevent ischemic-reperfusion injury during the surgery particularly to the heart? Thanks.

Arie Blitz commented on 05 Jun 2014

This patient's prognosis is reasonable, given the constraints of the Marfan syndrome. The good news is that she won't die of a proximal rupture, since that segment of aorta has been replaced. The answer to the question of ischemia-reperfusion injury is quite complex and fills textbooks. The bottom line is that one needs to protect the heart well and limit the degree of ischemia. I do that by systemic hypothermia and ample doses of cardioplegia, both antegrade and retrograde.

Lei Meng commented on 04 Apr 2014

Thanks Doctor! This is so educational to our layman. I have a few questions. 1) Can all patients undergo this procedure? Is this procedure related to the patient's artery condition (for example, is it more difficult or undoable for a patient who has a serious ASVD?) 2) Is the risk of the aortic surgery with DHCT and ACP higher than other procedures without hypothermic circulatory arrest? Thank you!

Arie Blitz commented on 27 Apr 2014

Thank you for your questions, Lei Meng. Most patients can undergo an aortic dissection repair. However, if a patient presents too late, he may not be a candidate for surgery. We do not know much about most patients who undergo the procedure prior to surgery, since most arrive very ill and incapable of giving their history. However, there are no absolute contraindications for the surgery. The risk of any type of surgery under HCA, with or without ACP, is definitely higher than for most other types of cardiac surgery. This elevated risk arises from both the nature of the disease being treated and from HCA itself.

Aortic Valve Replacement Surgery Video

Learn about Aortic Valve Replacement.

User Comments

Vitesse1971 commented on 23 Sep 2011

I was surprised that the straight replacement of the aortic valve using a 'tissue valve' (pig's or bovine valve) or a metal/plastic was not mentioned - just using the pulmonory valve. Also in a 1st World country such as the USA or UK, getting a second opinion is simple - here in South Africa the costs are prohibitive, as our medical aids are most unhelpful!

grykslpix commented on 26 Oct 2010

@cocoashunterz Did you die?

therasia commented on 18 Nov 2010

Amamzing vid ^^ thanks

MICS (Minimally Invasive) Aortic Valve Replacement by Dr Sathyaki Nambala, Bangalore

Aortic valve replacement may be required for various reasons. A leaking or stenotic valve are the most common reasons. The standard approach to replacing the ...

Day 7 recovery from open heart surgery to replace aortic val

I am trying to film the recovery process following my open heart surgery to replace the aortic valve with a bovine valve. Hopefully, others needing this surgery in ...

User Comments

kntcole commented on 02 Jan 2015

It hurts when I cough and laugh, I have yet to sneeze wonder how bad that will hurt!!! I want you to know your videos were VERY HELPFUL and thanks for sharing! I had my valve replacement Dec18 and was released Dec 23rd have NOT had a pain pill since they took the chest tubes and wires out on the 20th. I was scared to death about this surgery since a friend of mine had the same surgery and died from it ( bloodclot ) a few years ago. Since I have a mechanical valve I have to be on Coumadin, they forgot to prescribe it to me so I went 2 and half days with out it until we figured it out. I just want everyone to know double check everything ask lots of questions too. It gets a lot better when you get home and get some sleep!

Alex C. commented on 08 Jan 2015

So comforting to hear your surgery went well! My surgery is next Thursday to replace my bicuspid aortic valve with a mechanical one, as well as a possible aortic root repair.

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