2022
Engineering analysis of aortic wall stress and root dilatation in the V-shape surgery for treatment of ascending aortic aneurysms
Dong H, Liu M, Qin T, Liang L, Ziganshin B, Ellauzi H, Zafar M, Jang S, Elefteriades J, Sun W. Engineering analysis of aortic wall stress and root dilatation in the V-shape surgery for treatment of ascending aortic aneurysms. Interdisciplinary CardioVascular And Thoracic Surgery 2022, 34: 1124-1131. PMID: 35134955, PMCID: PMC9159430, DOI: 10.1093/icvts/ivac004.Peer-Reviewed Original ResearchConceptsRoot dilatationAortic rootAortic wall stressAortic aneurysmWall stressComputed tomography imagesTime pointsAortic root diameterTomography imagesSignificant reductionPost-surgery statesWhole aortaAortic wallSurgeryDilatationClinical cardiacPatientsAverage dilatationStudy objectiveAneurysmsAortaBiomechanical analysisTreatment
2021
Lipid profiles help to explain protection from systemic atherosclerosis in patients with ascending aortic aneurysm
Weininger G, Ostberg N, Shang M, Zafar M, Ziganshin BA, Liu S, Erben Y, Elefteriades JA. Lipid profiles help to explain protection from systemic atherosclerosis in patients with ascending aortic aneurysm. Journal Of Thoracic And Cardiovascular Surgery 2021, 163: e129-e132. PMID: 34635315, DOI: 10.1016/j.jtcvs.2021.09.031.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 ResearchConceptsMid-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 diametersInterstage 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 ResearchConceptsExtensive 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 ResearchCine-Computed Tomography for the Evaluation of Prosthetic Heart Valve Function
Hsu C, Bourganos K, Zafar MA, Huber S, Buntin J, Ziganshin BA, Mojibian H, Elefteriades JA. Cine-Computed Tomography for the Evaluation of Prosthetic Heart Valve Function. Cardiology 2020, 145: 439-445. PMID: 32454507, DOI: 10.1159/000507182.Peer-Reviewed Original ResearchConceptsAortic valve replacementAortic stenosisTransvalvular velocityValve functionECG-gated computed tomographyProsthetic heart valve functionProsthetic valve dysfunctionProsthetic valve functionCine CTHeart valve functionAVR patientsValve thrombosisCardiac eventsRepeat surgeryValve dysfunctionValve replacementSingle surgeonSurgical interventionRepeat evaluationProsthetic valvesComputed tomographyLeaflet excursionFurther evaluationLeaflet functionPatientsNonusefulness of Antithrombotic Therapy After Surgical Bioprosthetic Aortic Valve Replacement
Gryaznov AA, Saeyeldin A, Abdelbaky M, Zafar MA, Tanweer M, Papanikolaou D, Imran M, Li Y, Ziganshin BA, Elefteriades JA. Nonusefulness of Antithrombotic Therapy After Surgical Bioprosthetic Aortic Valve Replacement. The American Journal Of Cardiology 2020, 129: 71-78. PMID: 32605717, DOI: 10.1016/j.amjcard.2020.05.018.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnticoagulantsAortic ValveAortic Valve InsufficiencyAortic Valve StenosisAspirinAtrial FibrillationBicuspid Aortic Valve DiseaseBioprosthesisCoronary Artery DiseaseFactor Xa InhibitorsFemaleHeart Valve DiseasesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHemorrhageHumansKaplan-Meier EstimateMaleMiddle AgedMortalityPlatelet Aggregation InhibitorsPostoperative CareProportional Hazards ModelsPurinergic P2Y Receptor AntagonistsStrokeThromboembolismWarfarinYoung AdultConceptsAortic valve replacementBiological aortic valve replacementAntithrombotic regimensValve replacementSurgical bioprosthetic aortic valve replacementCox proportional hazards regression modelSurgical aortic valve replacementBioprosthetic aortic valve replacementConsecutive adult patientsCoronary artery diseaseKaplan-Meier analysisIncidence of deathHazards regression modelsAntiplatelet groupAVR patientsRoutine anticoagulationAntithrombotic therapyCardiovascular eventsThromboembolic eventsAdult patientsAdverse eventsAnticoagulation groupArtery diseaseTreatment regimensTherapy group
2019
Natural history of descending thoracic and thoracoabdominal aortic aneurysms
Zafar MA, Chen JF, Wu J, Li Y, Papanikolaou D, Abdelbaky M, Vinholo T, Rizzo JA, Ziganshin BA, Mukherjee SK, Elefteriades JA, Investigators Y, Charilaou P, Saeyeldin A, Imran M, Gryaznov A, Tanweer M, Buntin J, Peterss S. Natural history of descending thoracic and thoracoabdominal aortic aneurysms. Journal Of Thoracic And Cardiovascular Surgery 2019, 161: 498-511.e1. PMID: 31982126, DOI: 10.1016/j.jtcvs.2019.10.125.Peer-Reviewed Original ResearchRoutine anterior spinal artery visualization prior to descending and thoracoabdominal aneurysm repair: High detection success
Abdelbaky M, Zafar MA, Saeyeldin A, Wu J, Papanikolaou D, Vinholo TF, Huber S, Buntin J, Ziganshin BA, Mojibian H, Elefteriades JA. Routine anterior spinal artery visualization prior to descending and thoracoabdominal aneurysm repair: High detection success. Journal Of Cardiac Surgery 2019, 34: 1563-1568. PMID: 31705825, DOI: 10.1111/jocs.14310.Peer-Reviewed Original ResearchConceptsAnterior spinal arterySpinal cord blood supplyMagnetic resonance angiographyCT angiographyAneurysm repairTransient lower extremity weaknessThoracoabdominal aortic aneurysm repairLower paraplegia ratesThoracoabdominal aneurysm repairLower extremity weaknessAortic aneurysm repairOpen surgical repairModality of choiceParaplegia rateTAAA repairExtremity weaknessPermanent paraplegiaSpinal arteryEnhanced imaging techniquesSurgical repairSpinal angiographySurgical techniqueBlood supplyDual-energy CT scanningModern imaging technologiesNatural history and management of Kommerell's diverticulum in a single tertiary referral center
Erben Y, Brownstein AJ, Velasquez CA, Li Y, Rizzo JA, Mojibian H, Tanweer M, Zafar MA, Ziganshin BA, Elefteriades JA. Natural history and management of Kommerell's diverticulum in a single tertiary referral center. Journal Of Vascular Surgery 2019, 71: 2004-2011. PMID: 31708305, DOI: 10.1016/j.jvs.2019.08.260.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAortaAortic RuptureAortographyCardiovascular AbnormalitiesComputed Tomography AngiographyConnecticutDatabases, FactualDisease ProgressionDiverticulumFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsSex FactorsSubclavian ArteryTertiary Care CentersTreatment OutcomeVascular MalformationsVascular Surgical ProceduresYoung AdultConceptsAberrant subclavian arteryKommerell's diverticulumNatural historyOperative interventionBack painCT scanChest/back painLeft aberrant subclavian arteryRight aberrant subclavian arterySingle tertiary referral centerRight-sided aortaSingle-center experienceTertiary referral centerDeep vein thrombosisSerial CT scansComputed tomography scanMultivariable regression analysisRare developmental abnormalityAsymptomatic patientsHemorrhagic transformationDistal emboliEndovascular repairIschemic strokeMost patientsReferral centerAscending Aortic Length and Risk of Aortic Adverse Events The Neglected Dimension
Wu J, Zafar MA, Li Y, Saeyeldin A, Huang Y, Zhao R, Qiu J, Tanweer M, Abdelbaky M, Gryaznov A, Buntin J, Ziganshin BA, Mukherjee SK, Rizzo JA, Yu C, Elefteriades JA. Ascending Aortic Length and Risk of Aortic Adverse Events The Neglected Dimension. Journal Of The American College Of Cardiology 2019, 74: 1883-1894. PMID: 31526537, DOI: 10.1016/j.jacc.2019.07.078.Peer-Reviewed Original ResearchConceptsAortic height indexAortic elongationAdverse eventsAortic diameterAortic lengthAneurysmal ascending aortaThoracic aortic aneurysmLogistic regression modelsATAA patientsRisk stratificationAscending aortaAortic aneurysmNatural historyYearly riskLongitudinal changesHeight indexNovel predictive toolYearly rateIntervention criteriaAverage yearly rateDissectionRegression modelsLittle informationRiskPatientsFate of preserved bicuspid valves at time of ascending aortic aneurysmectomy
Vinholo T, Zafar MA, Baldwin GE, Buntin J, Mansour A, Imran M, Papanikolaou D, Ziganshin BA, Elefteriades JA. Fate of preserved bicuspid valves at time of ascending aortic aneurysmectomy. Journal Of Cardiac Surgery 2019, 34: 318-322. PMID: 30900354, DOI: 10.1111/jocs.14024.Peer-Reviewed Original ResearchConceptsBicuspid aortic valveAortic valveAortic stenosisConcomitant bicuspid aortic valveAortic aneurysm surgeryAortic valve replacementAortic aneurysm patientsIntraoperative transesophageal echocardiographyAortic aneurysmectomyPostoperative echocardiogramsPreoperative echocardiogramValve replacementSingle surgeonAneurysm surgeryBicuspid valveTransesophageal echocardiographyAneurysm patientsSignificant abnormalitiesStudy groupValve functionPatientsSurgeryEchocardiogramStenosisAverage time
2018
Decision-making algorithm for ascending aortic aneurysm: Effectiveness in clinical application?
Saeyeldin A, Zafar MA, Li Y, Tanweer M, Abdelbaky M, Gryaznov A, Brownstein AJ, Velasquez CA, Buntin J, Thombre K, Ma WG, Erben Y, Rizzo JA, Ziganshin BA, Elefteriades JA. Decision-making algorithm for ascending aortic aneurysm: Effectiveness in clinical application? Journal Of Thoracic And Cardiovascular Surgery 2018, 157: 1733-1745. PMID: 30579535, DOI: 10.1016/j.jtcvs.2018.09.124.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAlgorithmsAortic Aneurysm, ThoracicAortic DissectionAortic RuptureClinical Decision-MakingComorbidityDatabases, FactualDecision Support TechniquesDisease ProgressionFemaleHumansMaleMiddle AgedPatient CompliancePatient SelectionPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsTreatment OutcomeTriageVascular Surgical ProceduresConceptsThoracic aortic aneurysmAortic aneurysmAortic diameterMean aortic diameterRisk of ruptureAortic causesAortic eventsSymptomatic aneurysmsElective surgeryMedical managementSafe patientsClinical effectivenessPreemptive surgerySurgical recommendationsWorse outcomesPatientsSurgeryAneurysmsClinical settingAneurysm increasesMedical observationComorbiditiesClinical applicationSymptomsTotalPrevention 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 predictorsAneurysmsTAAARiskPositive family history of aortic dissection dramatically increases dissection risk in family members
Ma WG, Chou AS, Mok SCM, Ziganshin BA, Charilaou P, Zafar MA, Sieller RS, Tranquilli M, Rizzo JA, Elefteriades JA. Positive family history of aortic dissection dramatically increases dissection risk in family members. International Journal Of Cardiology 2017, 240: 132-137. PMID: 28502736, DOI: 10.1016/j.ijcard.2017.04.080.Peer-Reviewed Original ResearchConceptsFirst-degree relativesAortic dissectionFamily historyExposure yearsMore first-degree relativesNew aortic dissectionFamily membersDetailed family history informationPositive family historyLower mean ageTime of dissectionFamily history informationAOD patientsPrognostic valueMean ageIndex patientsHigh riskDissection riskPatientsYounger ageDissectionAgeShort durationRiskFHADsElective surgery for ascending aortic aneurysm in the elderly: should there be an age cut-off?†
Peterss S, Mansour AM, Zafar MA, Thombre K, Rizzo JA, Ziganshin BA, Darr UM, Elefteriades JA. Elective surgery for ascending aortic aneurysm in the elderly: should there be an age cut-off?†. European Journal Of Cardio-Thoracic Surgery 2017, 51: 965-970. PMID: 28369431, DOI: 10.1093/ejcts/ezw437.Peer-Reviewed Original ResearchConceptsOperative mortalityLow cardiac output syndromeYounger counterpartsElective aneurysm repairHigh operative riskMid-term survivalMulti-organ failureMultivariate regression analysisOutput syndromeElderly patientsOperative riskSurgical groupAneurysm repairIndependent predictorsOperative outcomesSurgical riskElective surgeryOrgan failureSurgical outcomesAortic aneurysmAdvanced ageHigh incidencePatientsAgeRegression analysis
2012
Carotid Intima-Media Thickness Provides Evidence that Ascending Aortic Aneurysm Protects against Systemic Atherosclerosis
Hung A, Zafar M, Mukherjee S, Tranquilli M, Scoutt LM, Elefteriades JA. Carotid Intima-Media Thickness Provides Evidence that Ascending Aortic Aneurysm Protects against Systemic Atherosclerosis. Cardiology 2012, 123: 71-77. PMID: 23006774, DOI: 10.1159/000341234.Peer-Reviewed Original ResearchConceptsIntima-media thicknessCarotid intima-media thicknessAortic aneurysmCalcium scoreAortic calcium scoreAverage intima-media thicknessAortic aneurysm patientsCarotid IMT valuesDegree of atherosclerosisPositive family historyAortic aneurysm developmentDevelopment of atherosclerosisCommon carotid arterySystemic atherosclerosisAneurysm patientsIMT valuesMale genderRisk factorsCarotid arteryFamily historyMultiple linear regression analysisAtherosclerosisEarly markerAneurysm developmentAneurysmsAre Thromboembolic and Bleeding Complications a Drawback for Composite Aortic Root Replacement?
Zafar MA, Farkas EA, Javier A, Anderson M, Gilani O, Elefteriades JA. Are Thromboembolic and Bleeding Complications a Drawback for Composite Aortic Root Replacement? The Annals Of Thoracic Surgery 2012, 94: 737-743. PMID: 22626762, DOI: 10.1016/j.athoracsur.2012.04.007.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalysis of VarianceAortic ValveBioprosthesisCirculatory Arrest, Deep Hypothermia InducedCohort StudiesFemaleHeart Valve DiseasesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHospital MortalityHumansIncidenceKaplan-Meier EstimateMaleMiddle AgedPostoperative ComplicationsPostoperative HemorrhagePrognosisProportional Hazards ModelsRetrospective StudiesRisk AssessmentSafety ManagementSurvival AnalysisThromboembolismTreatment OutcomeUltrasonographyConceptsComposite aortic root replacementAortic root replacementComposite graft replacementAortic root reconstructionRoot replacementGraft replacementRoot reconstructionValve-preserving aortic root reconstructionSocial Security Death IndexSex-matched populationKaplan-Meier curvesMechanical valve conduitBleeding complicationsHospital mortalityDistal embolismLatest followAortic databaseBiologic conduitDeath IndexPatient interviewsMinimal morbidityAortic rootExcellent survivalNative valveValve conduits