2023
“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 ResearchConceptsBig 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 treatmentAortic 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 typesExtended law of laplace for measurement of the cloverleaf anatomy of the aortic root
Ban E, Kalogerakos P, Khosravi R, Ziganshin B, Ellauzi H, Ramachandra A, Zafar M, Humphrey J, Elefteriades J. Extended law of laplace for measurement of the cloverleaf anatomy of the aortic root. The International Journal Of Cardiovascular Imaging 2023, 39: 1345-1356. PMID: 37046157, PMCID: PMC10250276, DOI: 10.1007/s10554-023-02847-5.Peer-Reviewed Original ResearchFate 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 criteria
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 analysisTreatmentA 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 ResearchProgress 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 ResearchConceptsAortic 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
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 ResearchFate of Preserved Aortic Root Following Acute Type A Aortic Dissection Repair
Ellauzi H, Zafar MA, Wu J, Papanikolaou D, Buntin J, Ziganshin BA, Elefteriades JA. Fate of Preserved Aortic Root Following Acute Type A Aortic Dissection Repair. Seminars In Thoracic And Cardiovascular Surgery 2021, 34: 419-427. PMID: 33979665, DOI: 10.1053/j.semtcvs.2021.04.002.Peer-Reviewed Original ResearchConceptsSevere aortic insufficiencyAortic insufficiencyAortic rootAcute typeAortic dissectionAortic replacementFree ruptureAdverse eventsAcute Type A Aortic Dissection RepairType A Aortic Dissection RepairProximal aortic suture lineSatisfactory long-term outcomeAortic dissection repairAortic root pseudoaneurysmAortic suture lineNon-reoperated patientsProximal aortic reoperationsAortic root diameterLong-term outcomesLong-term survivalAortic reoperationDissection repairOperative mortalityPrior surgeryOverall survivalIs Aortic Z-score an Appropriate Index of Beneficial Drug Effect in Clinical Trials in Aortic Aneurysm Disease?
Elkinany S, Weismann C, Curtis A, Smith T, Zafar MA, Breen T, Li Y, Tranquilli M, Rizzo JA, Mukherjee SK, Ziganshin BA, Elefteriades JA. Is Aortic Z-score an Appropriate Index of Beneficial Drug Effect in Clinical Trials in Aortic Aneurysm Disease? The American Journal Of Cardiology 2021, 143: 145-153. PMID: 33352210, DOI: 10.1016/j.amjcard.2020.12.025.Peer-Reviewed Original ResearchConceptsBody mass indexAortic Z-scoresZ-score decreaseBeneficial drug effectsZ-scoreMarfan patientsClinical trialsAneurysm diseaseDrug effectsChild's ageEcho examAortic dilation rateDecreased Z-scoreConnective tissue diseaseBody surface areaEffects of medicationAortic aneurysm diseaseClinical drug trialsMass indexTissue diseaseAortic diseaseAneurysmal pathologyDrug trialsInvestigational drugsSpontaneous decrease
2020
Direct 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 Research
2019
Natural 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
Descending 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 membersGuidelinesAneurysmectomyPatientsSurgeryAortaPrevention 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