2023
Bicuspid aortopathy does not require earlier surgical intervention
Zafar M, Wu J, Vinholo T, Li Y, Papanikolaou D, Ellauzi H, Ostberg N, Kalyanasundaram A, Kalogerakos P, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Bicuspid aortopathy does not require earlier surgical intervention. Journal Of Thoracic And Cardiovascular Surgery 2023, 168: 760-769.e4. PMID: 37088130, DOI: 10.1016/j.jtcvs.2023.04.017.Peer-Reviewed Original ResearchBicuspid aortic valveAdverse aortic eventsEvent-free survivalAortic eventsAortic sizeAortic diameterAortic growth rateEarly surgical interventionLong-term complicationsRisk of complicationsThoracic aortic aneurysmAortic deathComplication rateSurgical repairOperative repairProphylactic surgerySurgical interventionAortic aneurysmAortic valveSurgical correctionBicuspid aortopathyRelative riskExpert centersTAV-ATAAPatientsAortic Size at the Time of Type A and Type B Dissections
Perez Z, Zafar M, Velasco J, Sonsino A, Ellauzi H, John C, Kalyanasundaram A, Ziganshin B, Elefteriades J. Aortic Size at the Time of Type A and Type B Dissections. The Annals Of Thoracic Surgery 2023, 116: 262-268. PMID: 37062339, DOI: 10.1016/j.athoracsur.2023.03.037.Peer-Reviewed Original ResearchConceptsType B dissectionTime of dissectionB dissectionAortic sizeAortic diameterBicuspid aortic valveThoracic aortic aneurysmAortic interventionAortic dissectionSurgical interventionAortic aneurysmFemale sexAortic valveThoracic aortaProphylactic repairUnadjusted regressionLeft shiftLogistic regressionDissectionNew guidelinesType ASize criteriaOddsInterventionTime of typesFate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University
Wu J, Zafar M, Liu Y, Chen J, Li Y, Ziganshin B, Ellauzi H, Mukherjee S, Rizzo J, Elefteriades J. Fate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University. European Heart Journal 2023, 44: 4579-4588. PMID: 36994934, DOI: 10.1093/eurheartj/ehad148.Peer-Reviewed Original ResearchConceptsAdverse aortic eventsThoracic aortic aneurysmAortic sizeAortic aneurysmCox regressionAortic growthRisk factorsSignificant independent risk factorsMultivariable Cox regressionIndependent risk factorCohort of patientsUnivariable Cox regressionSignificant protective factorAortic deathATAA patientsAortic eventsPrimary endpointSurgical interventionThree-decade experienceNatural historyYearly riskProtective factorsAneurysmsPatientsIntervention criteriaKIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection
Velasco J, Li Y, Ziganshin B, Zafar M, Rizzo J, Ma D, Zang H, Kalyanasundaram A, Elefteriades J. KIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection. Genes 2023, 14: 252. PMID: 36833179, PMCID: PMC9956195, DOI: 10.3390/genes14020252.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic dissectionOdds ratioVariant statusArg allele carriersThoracic aortic dissectionOccurrence of ADAortic sizeArg alleleMarked adverse impactTAA patientsAortic aneurysmClinical assessmentSurgical decisionAllele carriersIncrease riskVariant patientsArg carriersPilot studyDissectionImportant intracellular functionsConfirmatory findingsPatientsAneurysmsPresent study
2020
Increased Virulence of Descending Thoracic and Thoracoabdominal Aortic Aneurysms in Women
Chen JF, Zafar MA, Wu J, Li Y, Rizzo JA, Papanikolaou D, Kalogerakos P, Abdelbaky M, Ellauzi H, Rohde S, Vinholo TF, Charilaou P, Buntin J, Mukherjee SK, Ziganshin BA, Elefteriades JA. Increased Virulence of Descending Thoracic and Thoracoabdominal Aortic Aneurysms in Women. The Annals Of Thoracic Surgery 2020, 112: 45-52. PMID: 33075319, DOI: 10.1016/j.athoracsur.2020.08.026.Peer-Reviewed Original ResearchConceptsThoracoabdominal aortic aneurysmsAortic deathFatal complicationAortic sizeAortic aneurysmFaster aneurysm growthMean aortic diameterComplication rateComposite endpointAortic diameterSurgical interventionCurrent guidelinesAneurysm sizeSex considerationsNatural historyAneurysm growthThoracicWomenDissectionYearly rateComplicationsDeathAneurysmsHigh rateSex differencesThoracic aortic aneurysm gene dictionary
Rohde S, Zafar MA, Ziganshin BA, Elefteriades JA. Thoracic aortic aneurysm gene dictionary. Asian Cardiovascular And Thoracic Annals 2020, 29: 682-696. PMID: 32689806, DOI: 10.1177/0218492320943800.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic aneurysmRisk of dissectionSpecific causative mutationSmaller aortic sizeSystemic manifestationsAortic sizeDissection patientsLethal complicationGenetic predispositionProgressive enlargementAneurysmsNatural historyPersonalized careAneurysm growthPatientsFamilial casesClinical realityDissectionNon-syndromic thoracic aortic aneurysmsSubstantial proportionGenetic sequencingDisease phenotypeCausative genesHigh rate
2019
Predicting in-hospital rupture of type A aortic dissection using Random Forest
Wu J, Qiu J, Xie E, Jiang W, Zhao R, Qiu J, Zafar MA, Huang Y, Yu C. Predicting in-hospital rupture of type A aortic dissection using Random Forest. Journal Of Thoracic Disease 2019, 11: 4634-4646. PMID: 31903252, PMCID: PMC6940214, DOI: 10.21037/jtd.2019.10.82.Peer-Reviewed Original ResearchAortic height indexArtery involvementPeriaortic hematomaPredictive valueNumbness/painRenal artery involvementSimple clinical informationAcute liver dysfunctionAortic dissection patientsNegative predictive valuePositive predictive valueLiver dysfunctionTAAD patientsAortic dissectionConsecutive patientsAcute phaseAortic sizeDissection patientsPleural effusionRisk stratificationPatient counsellingStudy populationClinical informationSurgical triagePatients
2018
Symptoms Matter: A Symptomatic but Radiographically Elusive Ascending Aortic Dissection
Papanikolaou D, Zafar MA, Tanweer M, Imran M, Abdelbaky M, Ziganshin BA, Elefteriades JA. Symptoms Matter: A Symptomatic but Radiographically Elusive Ascending Aortic Dissection. International Journal Of Angiology 2018, 28: 031-033. PMID: 30880890, PMCID: PMC6417893, DOI: 10.1055/s-0038-1675849.Peer-Reviewed Original ResearchThoracic aortic aneurysmAortic aneurysmAscending aortic dissectionAscending aortic diameterChest painHemiarch replacementAortic dissectionFocal dissectionAortic sizeAortic diameterProphylactic repairSeparate indicationsComputed tomographyVessel abnormalitiesDissectionSimilar casesAneurysmsAorticEchocardiographyPainPatientsSymptomaticsSymptomsThoracicAbnormalitiesDescending threshold for ascending aortic aneurysmectomy: Is it time for a “left-shift” in guidelines?
Ziganshin BA, Zafar MA, Elefteriades JA. Descending threshold for ascending aortic aneurysmectomy: Is it time for a “left-shift” in guidelines? Journal Of Thoracic And Cardiovascular Surgery 2018, 157: 37-42. PMID: 30557953, DOI: 10.1016/j.jtcvs.2018.07.114.Peer-Reviewed Original ResearchConceptsAortic sizeSmaller aortic sizeThoracic aortic diseaseAortic aneurysmectomyAortic surgeryAortic dissectionAortic catastropheAortic diameterAortic diseaseAortic aneurysmCurrent guidelinesLeftward shiftNatural historyGenetic testingMore granular dataCenterline methodGenetic defectsAneurysmsFamily membersGuidelinesAneurysmectomyPatientsSurgeryAorta“Getting beyond diameter”: when to replace the aorta?
Tanweer M, Zafar M, Saeyeldin A, Gryaznov A, Puddifant A, Erben Y, Ziganshin B, Elefteriades J. “Getting beyond diameter”: when to replace the aorta? Journal Of Visualized Surgery 2018, 4: 124-124. DOI: 10.21037/jovs.2018.06.04.Peer-Reviewed Original ResearchAortic sizeThoracic aortic aneurysm patientsProgression of TAAAortic aneurysm patientsTimely surgical interventionBody surface areaProphylactic surgical repairSpecific genetic mutationsUse of biomarkersAdvanced imaging techniquesAortic surgeryAortic dissectionSurgical treatmentCatastrophic complicationSurgical repairPrognostic importancePrognostic significanceSurgical interventionAneurysm patientsTAA patientsPatient heightDisease progressionFamily historyFemale genderAnatomical aberrationsPrevention of Aortic Dissection Suggests a Diameter Shift to a Lower Aortic Size Threshold for Intervention
Mansour AM, Peterss S, Zafar MA, Rizzo JA, Fang H, Charilaou P, Ziganshin BA, Darr UM, Elefteriades JA. Prevention of Aortic Dissection Suggests a Diameter Shift to a Lower Aortic Size Threshold for Intervention. Cardiology 2018, 139: 139-146. PMID: 29346780, DOI: 10.1159/000481930.Peer-Reviewed Original ResearchConceptsRisk of dissectionAortic sizeAortic dissectionAortic diameter increaseGuideline-recommended thresholdNatural history analysisEffect of dissectionConsecutive patientsMultivariable analysisAneurysm patientsMultivariate regression modelControl groupImaging studiesAortaDissectionMultiple studiesAverage timePatientsRiskRegression modelsProportional estimatesStudyPrevention
2017
Height alone, rather than body surface area, suffices for risk estimation in ascending aortic aneurysm
Zafar MA, Li Y, Rizzo JA, Charilaou P, Saeyeldin A, Velasquez CA, Mansour AM, Bin Mahmood SU, Ma WG, Brownstein AJ, Tranquilli M, Dumfarth J, Theodoropoulos P, Thombre K, Tanweer M, Erben Y, Peterss S, Ziganshin BA, Elefteriades JA. Height alone, rather than body surface area, suffices for risk estimation in ascending aortic aneurysm. Journal Of Thoracic And Cardiovascular Surgery 2017, 155: 1938-1950. PMID: 29395211, DOI: 10.1016/j.jtcvs.2017.10.140.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAortic Aneurysm, ThoracicBody HeightBody Surface AreaDatabases, FactualDecision Support TechniquesDisease ProgressionFemaleHumansMaleMiddle AgedPredictive Value of TestsProgression-Free SurvivalRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsYoung AdultConceptsAortic size indexBody surface areaAortic height indexAortic diameterAortic aneurysmYearly riskComplication-free survivalLong-term complicationsRisk of complicationsRisk estimationAortic dissectionComplication rateAortic sizeRisk stratificationComplicationsPredictive valueConcordance statisticInternational guidelinesNatural complicationsPatientsHeight indexSignificant predictorsAneurysmsTAAARisk