WithAScalpel
@WithAScalpel
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MD, PhD. Cutting-edge insights in Cardiology, Intensive Care & Cardiac Surgery — visual, clinical, essential. Full resource hub below👇
Joined July 2025
The Perimembranous VSD from a 3D Heart Model: A perimembranous ventricular septal defect (VSD) is a defect adjacent to the membranous septum, situated at the crossroads of critical cardiac structures, including the tricuspid valve, the aortic valve, and the conduction system.
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Impressive illustration and insightful message. This study underscores that neo-aortic valve and root reoperations following ASO can frequently be addressed through meticulous repair rather than replacement. The refinement of valve-sparing strategies not only preserves native
These valves are perfect to repair! They should not be replaced.🙂 Zhu MZL, et al. Outcomes of neo-aortic valve and root surgery late after arterial switch operation. J Thorac Cardiovasc Surg. 2024;167(4):1391-1401.e3. doi: 10.1016/j.jtcvs.2023.09.038.PMID: 37757970
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Aortic Arch Pattern and Embryology — #4 Right Aortic Arch with Vascular Ring: The ring-forming variant arises when the right 4th arch/right dorsal aorta persist to create a right aortic arch, while the left 4th arch regresses. Critically, a segment of the left dorsal/ventral
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Aortic Arch Pattern and Embryology — #4 Right Aortic Arch with Vascular Ring: The ring-forming variant arises when the right 4th arch/right dorsal aorta persist to create a right aortic arch, while the left 4th arch regresses. Critically, a segment of the left dorsal/ventral
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Lymphatic Circulation — Physiology and Clinical Relevance: Lymphatic circulation clears proteins, lipids, and excess fluid not reclaimed by veins, but elevated venous pressure (e.g., Fontan physiology) critically impairs lymphatic return, leading to complications such as PLE,
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RAA malformations are associated with chromosomal aneuploidy such as trisomy 21 & 22q11 microdeletion. 👉🏻3-week-old, IIA type B, VSD, RAA/right PDA. @WGACHDChair @iamritu @loomba_rohit @alexsfelixecho @CASivaram1 @AEPCcongenital @CardioNeo @alex1708ander @swatigar @dkthekkoott
Aortic Arch Pattern and Embryology — #3 Right Aortic Arch: The right aortic arch forms when the right 4th aortic arch and its continuity with the right dorsal aorta persist, while the left-sided counterparts regress distal to the left 4th arch. The ductus arteriosus is typically
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Aortic Arch Pattern and Embryology — #3 Right Aortic Arch: The right aortic arch forms when the right 4th aortic arch and its continuity with the right dorsal aorta persist, while the left-sided counterparts regress distal to the left 4th arch. The ductus arteriosus is typically
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Aortic Arch Pattern and Embryology — #3 Right Aortic Arch: The right aortic arch forms when the right 4th aortic arch and its continuity with the right dorsal aorta persist, while the left-sided counterparts regress distal to the left 4th arch. The ductus arteriosus is typically
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Embryology explains anatomy! Mortui vivos docent! Konstantinov IE, et al. Isolated subclavian artery: anatomical and surgical considerations. Ann Thorac Surg. 2009;88(5):1685-7. doi: 10.1016/j.athoracsur.2009.03.056.PMID: 19853141
#TechniquesThursday: Surgical repair of an isolated right subclavian artery originating from the right pulmonary artery. See how surgeons treated this exceedingly rare defect: https://t.co/YCbJqU0GYq
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Core Hyperthermia Before Cardiac Surgery: Core hyperthermia often reflects impaired heat dissipation or abnormal circulatory distribution—frequently with elevated SVR—requiring careful afterload management at CPB initiation.
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Embryology of aortic arches is fascinating! What is bovine arch? Does it have anything to do with cows?
Naimo PS, et al. Double-Lumen Aortic Arch: Persistence of the Fifth Aortic Arch. Ann Thorac Surg. 2016;101:e155-6. PMID: 27106464
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Aortic Arch Pattern and Embryology — #2 Retroesophageal RSCA: Aberrant right subclavian artery (RSCA) arises when the right 4th arch and proximal right ventral aorta regress, while the connection between the right ventral aorta and the right 7th intersegmental artery persists.
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Aortic Arch Pattern and Embryology — #2 Retroesophageal RSCA: Aberrant right subclavian artery (RSCA) arises when the right 4th arch and proximal right ventral aorta regress, while the connection between the right ventral aorta and the right 7th intersegmental artery persists.
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VSD Patch Closure for Perimembranous VSD: Perimembranous VSD repair demands careful protection of conduction tissue: ininlet extension, the RBB lies directly at the VSD margin, whereas outlet extension, the posterior limb of the septomarginal trabeculation shields the RBB.
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Excellent educational video demonstrating the meticulous step-by-step technique for septal myectomy in obstructive hypertrophic cardiomyopathy. The clarity of exposure and precise resection make this an outstanding teaching resource.
New how-to article: Step-by-Step Approach for Septal Myectomy in Patients With Obstructive Hypertrophic Cardiomyopathy from @TedySawma98 and Hartzell V. Schaff at @MayoClinicSurg. Log in to Operative Techniques to read: https://t.co/sabPEEYWzs
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Aortic Arch Pattern and Embryology — #1 Normal Aortic Arch: The normal left aortic arch develops as the left 4th arch and left dorsal aorta persist, while the 1st, 2nd, and 5th arches regress. The truncus arteriosus divides into the ascending aorta and pulmonary artery, and the
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Conduction Pathways in Perimembranous VSD with Outlet/Inlet Extension: Conduction tissue pathways differ by VSD type; the RBB course near the VSD margins—emerging posterior to the MPM in outlet extension, while in inlet VSD, the MPM is not a reliable milestone for its emergence.
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HLHS and Shone’s complex represent two ends of the left heart hypoplasia spectrum — one defined by almost absence of development, the other by presence with obstruction. Understanding this distinction is key to surgical planning and prognosis.
👉🏻HLHS, LV is morphologically almost absent 👉🏻Shone’s Complex, LV is morphologically present but obstructed at multiple levels @loomba_rohit
@ACCinTouch @WGACHDChair @iamritu @CASivaram1 @AEPCcongenital @alexsfelixecho @EACVIPresident @dkthekkoott @alex1708ander @DavidWienerMD
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Partial Atrioventricular Septal Defect (AVSD) — #3 Cleft Closure and ASD Patch Closure: In partial AVSD repair, surgical correction restores valve competence and closes the interatrial defect while protecting the conduction axis. The mitral (left AV) valve cleft is first closed
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Partial Atrioventricular Septal Defect (AVSD) — #3 Cleft Closure and ASD Patch Closure: In partial AVSD repair, surgical correction restores valve competence and closes the interatrial defect while protecting the conduction axis. The mitral (left AV) valve cleft is first closed
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