2023
Evidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease
Waldron C, Zafar M, Ziganshin B, Weininger G, Grewal N, Elefteriades J. Evidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease. International Journal Of Molecular Sciences 2023, 24: 15640. PMID: 37958625, PMCID: PMC10650782, DOI: 10.3390/ijms242115640.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic aneurysmCarotid intima-media thicknessLow-density lipoprotein levelsIntima-media thicknessDevelopment of atherosclerosisMatrix metalloproteinase proteinsAscending aneurysmAortic calcificationAtherosclerotic diseaseLipoprotein levelsMyocardial infarctionLeading causeAneurysmsMetalloproteinase proteinsGrowth factorProtective relationshipDiseasePossible mechanismCurrent understandingMorbidityInfarctionAtherosclerosisPatientsPathophysiology“Big Data” Analyses Underlie Clinical Discoveries at the Aortic Institute
Zafar M, Ziganshin B, Li Y, Ostberg N, Rizzo J, Tranquilli M, Mukherjee S, Elefteriades J. “Big Data” Analyses Underlie Clinical Discoveries at the Aortic Institute. The Yale Journal Of Biology And Medicine 2023, 96: 427-440. PMID: 37780996, PMCID: PMC10524815, DOI: 10.59249/lndz2964.Peer-Reviewed Original ResearchMeSH KeywordsAortaAortic Aneurysm, ThoracicAortic DissectionArtificial IntelligenceFemaleHumansMaleProspective StudiesConceptsBig dataArtificial intelligenceThoracic aortic aneurysmArtificial intelligence techniquesData setsAortic aneurysmLarge clinical data setsIntelligence techniquesAdvanced machineYale-New Haven HospitalClinical data setsAortic aneurysm patientsAortic root dilatationBicuspid aortic valveProspective clinical databaseNew Haven HospitalLarge genetic data setsIntelligenceSequencing filesThoracoabdominal aortaAortic dilatationMale patientsRisk prognosticationRoot dilatationSurgical treatmentNatural History and Intervention Thresholds for Ascending Thoracic Aortic Aneurysm—Not an Easy Nut to Crack
Zafar M, Elefteriades J. Natural History and Intervention Thresholds for Ascending Thoracic Aortic Aneurysm—Not an Easy Nut to Crack. JAMA Cardiology 2023, 8: 512-512. PMID: 36920367, DOI: 10.1001/jamacardio.2023.0153.Peer-Reviewed Original ResearchAortic 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 ResearchMeSH KeywordsAortaAortic Aneurysm, ThoracicAortic DissectionBicuspid Aortic Valve DiseaseFemaleHumansMaleRisk FactorsConceptsType 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 ResearchMeSH KeywordsAortaAortic AneurysmAortic Aneurysm, ThoracicAortic DissectionAortic RuptureHumansRetrospective StudiesRisk FactorsUniversitiesConceptsAdverse 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 criteria
2022
Ascending aneurysmectomy: Should we shift to the left? ∗
Elefteriades J, Rizzo J, Zafar M, Ziganshin B. Ascending aneurysmectomy: Should we shift to the left? ∗. Journal Of Thoracic And Cardiovascular Surgery 2022, 166: 435-441. PMID: 36109210, DOI: 10.1016/j.jtcvs.2022.07.033.Peer-Reviewed Original ResearchBovine Aortic Arch: A Result of Chance or Mandate of Inheritance?
Shang M, Vinholo TF, Buntin J, Zafar MA, Ziganshin BA, Elefteriades JA. Bovine Aortic Arch: A Result of Chance or Mandate of Inheritance? The American Journal Of Cardiology 2022, 172: 115-120. PMID: 35321803, PMCID: PMC9978865, DOI: 10.1016/j.amjcard.2022.02.030.Peer-Reviewed Original ResearchMeSH KeywordsAneurysmAorta, ThoracicAortic Aneurysm, ThoracicFemaleHumansIncidenceLikelihood FunctionsMaleRetrospective StudiesConceptsBovine archThoracic aortic aneurysmAortic aneurysmThoracic aortic aneurysm diseaseAortic arch configurationAortic aneurysm diseaseSecond-degree relativesInstitutional databaseAneurysm diseaseChest imagingPatientsAneurysmsAvailable scansGenetic mutationsArch resultsArchArch configurationFamily membersSample populationProbandsScansMagnetic resonanceResult of chancePrevious studiesChestA novel computational growth framework for biological tissues: Application to growth of aortic root aneurysm repaired by the V-shape surgery
Dong H, Liu M, Qin T, Liang L, Ziganshin B, Ellauzi H, Zafar M, Jang S, Elefteriades J, Sun W, Gleason RL. A novel computational growth framework for biological tissues: Application to growth of aortic root aneurysm repaired by the V-shape surgery. Journal Of The Mechanical Behavior Of Biomedical Materials 2022, 127: 105081. PMID: 35092917, DOI: 10.1016/j.jmbbm.2022.105081.Peer-Reviewed Original ResearchA machine learning approach for predicting complications in descending and thoracoabdominal aortic aneurysms
Ostberg NP, Zafar MA, Mukherjee SK, Ziganshin BA, Elefteriades JA. A machine learning approach for predicting complications in descending and thoracoabdominal aortic aneurysms. Journal Of Thoracic And Cardiovascular Surgery 2022, 166: 1011-1020.e3. PMID: 35120761, DOI: 10.1016/j.jtcvs.2021.12.045.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicAortic Aneurysm, ThoracoabdominalHumansHypertensionRetrospective StudiesConceptsType B dissectionThoracoabdominal aortic aneurysmsB dissectionCause mortalityAortic aneurysmReceiver operator curveAortic diameterOperator curveInitial patient encounterOccurrence of dissectionSurgical intervention criteriaMean followPatient sexMyocardial infarctionPatient encountersRetrospective dataEnd pointPatientsAneurysmsDissectionMortalityRisk predictionComplicationsIntervention criteriaRupturePhenotyping Zebrafish Mutant Models to Assess Candidate Genes Associated with Aortic Aneurysm
Prendergast A, Ziganshin BA, Papanikolaou D, Zafar MA, Nicoli S, Mukherjee S, Elefteriades JA. Phenotyping Zebrafish Mutant Models to Assess Candidate Genes Associated with Aortic Aneurysm. Genes 2022, 13: 123. PMID: 35052463, PMCID: PMC8775119, DOI: 10.3390/genes13010123.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsAortic Aneurysm, ThoracicDisease Models, AnimalEmbryo, NonmammalianHumansLoss of Function MutationPhenotypePilot ProjectsZebrafishZebrafish ProteinsConceptsAortic aneurysmSkeletal abnormalitiesThoracic aortic aneurysmWhole-exome sequencingDirect microscopic assessmentSilico genetic analysisVisualized abnormalitiesTAA patientsClinical managementGeneral populationClinical practiceRoutine assessmentClinical testingCell countEvidence-based decisionsUnknown significanceUncertain significanceExperimental modelPilot studyExome sequencingAbnormalitiesMicroscopic assessmentPatientsPositive controlAneurysmsProgress in surgical interventions for aortic root aneurysms and dissections
Parameswaran S, Ziganshin BA, Zafar M, Elefteriades JA. Progress in surgical interventions for aortic root aneurysms and dissections. Expert Review Of Cardiovascular Therapy 2022, 20: 65-79. PMID: 35037567, DOI: 10.1080/14779072.2022.2029702.Peer-Reviewed Original ResearchMeSH KeywordsAortaAortic Aneurysm, ThoracicAortic DissectionAortic ValveAortic Valve InsufficiencyHeart Valve Prosthesis ImplantationHumansTreatment OutcomeConceptsAortic root aneurysmRoot aneurysmAortic root replacement surgeryAortic root surgeryAortic valve leafletsValve dysfunctionAortic dissectionAortic pathologyProgressive dilatationSurgical optionsAneurysmal diseaseSurgical interventionCoronary arteryRoot surgeryAortic rootAortic tubeReplacement surgerySurgical investigationAnatomic patternsPubMed databaseRisk profileValve leafletsSystematic searchSurgeryAneurysms
2021
Nationwide collaboration produces valuable data regarding arch and descending aorta
Elefteriades JA, Zafar MA, Ziganshin BA. Nationwide collaboration produces valuable data regarding arch and descending aorta. European Heart Journal 2021, 43: 2370-2372. PMID: 34904151, DOI: 10.1093/eurheartj/ehab854.Peer-Reviewed Original ResearchAneurysmAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationHumansQuality of LifeGetting to the root of aortic dissection in congenital heart disease
Zafar MA, Ziganshin BA, Elefteriades JA. Getting to the root of aortic dissection in congenital heart disease. European Journal Of Cardio-Thoracic Surgery 2021, 61: 318-319. PMID: 34718492, DOI: 10.1093/ejcts/ezab464.Peer-Reviewed Original ResearchRoot Dilatation Is More Malignant Than Ascending Aortic Dilation
Kalogerakos PD, Zafar MA, Li Y, Mukherjee SK, Ziganshin BA, Rizzo JA, Elefteriades JA. Root Dilatation Is More Malignant Than Ascending Aortic Dilation. Journal Of The American Heart Association 2021, 10: e020645. PMID: 34238012, PMCID: PMC8483477, DOI: 10.1161/jaha.120.020645.Peer-Reviewed Original ResearchMeSH KeywordsAgedAorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionDilatation, PathologicEchocardiographyFemaleFollow-Up StudiesHumansMaleRetrospective StudiesRisk FactorsTime FactorsConceptsMid-ascending aortaAortic rootAdverse eventsRoot dilatationNatural historyAcute aortic dissectionLong-term complicationsAortic root dilatationSignificant higher riskThoracic aortic aneurysmSerious risk factorAortic interventionAortic dilatationAortic dilationAortic dissectionAortic aneurysmInternational registryRisk factorsAortic segmentsGuideline criteriaHigh riskExpert centersAortaShort statureResult diametersRisk reduction and pharmacological strategies to prevent progression of aortic aneurysms
Weininger G, Chan SM, Zafar M, Ziganshin BA, Elefteriades JA. Risk reduction and pharmacological strategies to prevent progression of aortic aneurysms. Expert Review Of Cardiovascular Therapy 2021, 19: 619-631. PMID: 34102944, DOI: 10.1080/14779072.2021.1940958.Peer-Reviewed Original ResearchMeSH KeywordsAortic AneurysmAortic Aneurysm, ThoracicHumansMarfan SyndromePharmaceutical PreparationsRisk Reduction BehaviorConceptsAortic aneurysmAbdominal aortic aneurysmß-blockersAngiotensin II receptor blockersAngiotensin-converting enzyme inhibitorAnti-platelet medicationDifferent pharmacologic therapiesII receptor blockersAortic aneurysm patientsThoracic aortic aneurysmRisk reductionAortic aneurysm growthPharmacologic managementReceptor blockersPharmacologic therapyMedical therapySurgical interventionAneurysm patientsMiscellaneous drugsAneurysm diseasePharmacological strategiesSyndrome patientsMarfan syndromeEnzyme inhibitorsAneurysmsInterstage mortality in two‐stage elephant trunk surgery
Saeyeldin A, Gryaznov AA, Zafar MA, Wu J, Mukherjee S, Vallabhajosyula P, Ziganshin BA, Elefteriades JA. Interstage mortality in two‐stage elephant trunk surgery. Journal Of Cardiac Surgery 2021, 36: 1882-1891. PMID: 33634489, DOI: 10.1111/jocs.15441.Peer-Reviewed Original ResearchMeSH KeywordsAgedAorta, ThoracicAortic Aneurysm, ThoracicAortic RuptureBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationHumansMiddle AgedTreatment OutcomeConceptsExtensive thoracic aortic aneurysmThoracic aortic aneurysmInterstage intervalStage IIET procedureStage II procedureHospital mortalityInterstage mortalityMega aortaTrunk surgeryAortic ruptureOverall mortalitySingle surgeonAortic diseasePatient groupAortic aneurysmPatientsStage IMortalityCumulative mortalityI procedureInterval periodRupturePrior studiesSafety
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 differencesDirect measurement of ascending aortic diameter by intraoperative caliper assessment
Faggion Vinholo T, Zafar MA, Papanikolaou D, Chung J, Ellauzi H, Ziganshin BA, Elefteriades JA. Direct measurement of ascending aortic diameter by intraoperative caliper assessment. Journal Of Thoracic And Cardiovascular Surgery 2020, 161: e143-e146. PMID: 32891453, DOI: 10.1016/j.jtcvs.2020.08.001.Peer-Reviewed Original ResearchThoracic 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 ResearchMeSH KeywordsAortic Aneurysm, ThoracicAortic DissectionGenetic Predisposition to DiseaseHumansMutationPhenotypeConceptsThoracic 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 rateThe Genetics of Thoracic Aortic Aneurysms and Dissection: A Clinical Perspective
Ostberg NP, Zafar MA, Ziganshin BA, Elefteriades JA. The Genetics of Thoracic Aortic Aneurysms and Dissection: A Clinical Perspective. Biomolecules 2020, 10: 182. PMID: 31991693, PMCID: PMC7072177, DOI: 10.3390/biom10020182.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicAortic DissectionGenetic Predisposition to DiseaseGenetic TestingHumansMutationConceptsAortic aneurysmThoracic aortic aneurysmHigh mortality rateGenetic screening testsClinical manifestationsSurgical interventionNon-syndromic TAADHigh riskMortality rateClear genetic basisScreening testNatural historyClinical perspectiveTAADDegenerative diseasesDissectionCellular mechanismsBiomechanical stressPatientsAneurysmsDiseaseAortaExtensive investigation