2024
Patient-specific ascending aortic intervention criteria
Kalogerakos P, Zafar M, Li Y, Ellauzi H, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Patient-specific ascending aortic intervention criteria. European Journal Of Cardio-Thoracic Surgery 2024, 65: ezae162. PMID: 38632077, DOI: 10.1093/ejcts/ezae162.Peer-Reviewed Original ResearchAdverse aortic eventsRisk of adverse eventsAortic eventsAortic rootAneurysm patientsAscending aortaAdverse eventsIncreased risk of adverse eventsThoracic aortic aneurysm patientsAscending aortic aneurysmHigher risk of adverse eventsAortic aneurysm patientsAscending thoracic aortic aneurysm patientsBody surface areaGeneral populationPersonalized risk stratificationAortic diameterAneurysm locationRisk stratificationAortic aneurysmIncreased riskAscending diameterPatientsHigh riskZ-score
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 types
2022
Long‐term risk of arch complications in Loeys Dietz syndrome patients undergoing proximal ascending aortic replacement
Weininger G, Zafar M, Ziganshin BA, Mori M, Papanikolaou D, Sekar RB, Amabile A, Degife E, O'Marr J, Geirsson A, Elefteriades JA, Assi R, Vallabhajosyula P. Long‐term risk of arch complications in Loeys Dietz syndrome patients undergoing proximal ascending aortic replacement. Journal Of Cardiac Surgery 2022, 37: 3688-3692. PMID: 35989525, DOI: 10.1111/jocs.16855.Peer-Reviewed Original ResearchConceptsLoeys-Dietz syndromeProximal aortic replacementAortic replacementLDS patientsLong-term riskLoeys-Dietz syndrome patientsPathogenic variantsUnknown significanceLower long-term riskRare connective tissue disorderAscending Aortic ReplacementTotal arch replacementAortic valve replacementRecords of patientsConnective tissue disordersWhole-exome genetic testingArch replacementMedian followLatest followValve replacementOperative coursePatient chartsAortic diameterAortic dimensionsAortic archA 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 ResearchConceptsType B dissectionThoracoabdominal aortic aneurysmsB dissectionCause mortalityAortic aneurysmReceiver operator curveAortic diameterOperator curveInitial patient encounterOccurrence of dissectionSurgical intervention criteriaMean followPatient sexMyocardial infarctionPatient encountersRetrospective dataEnd pointPatientsAneurysmsDissectionMortalityRisk predictionComplicationsIntervention criteriaRupture
2021
Accuracy of the “Thumb-Palm Test” for Detection of Ascending Aortic Aneurysm
Blumel R, Patel K, Rizzo JA, Mok S, Barrett A, Wu J, Zafar MA, Ziganshin BA, Elefteriades JA. Accuracy of the “Thumb-Palm Test” for Detection of Ascending Aortic Aneurysm. The American Journal Of Cardiology 2021, 150: 114-116. PMID: 34020772, DOI: 10.1016/j.amjcard.2021.03.041.Peer-Reviewed Original ResearchConceptsAscending aortic diameterAortic aneurysmTransesophageal echocardiographyPalm testAortic diameterIntra-operative transesophageal echocardiographyAscending Aortic AneurysmThoracic aortic aneurysmStandard physical examinationThousands of patientsVariety of disordersAscending aneurysmCardiac surgeryAneurysm patientsPhysical examinationPositive testPatientsNegative testAneurysmsHigher likelihoodNegative resultsAscAASubstantial likelihoodSignsEchocardiographyAortic Delamination—A Possible Precursor of Impending Catastrophe
Saeyeldin A, Zafar MA, Baldassarre LA, Mojibian H, Ziganshin BA, Mukherjee SK, Elefteriades JA. Aortic Delamination—A Possible Precursor of Impending Catastrophe. International Journal Of Angiology 2021, 30: 160-164. PMID: 34054275, PMCID: PMC8159620, DOI: 10.1055/s-0040-1718546.Peer-Reviewed Original ResearchAortic wall thicknessAdverse aortic eventsAortic eventsChest painDeep hypothermic circulatory arrestHypothermic circulatory arrestAortic repairAortic ruptureCirculatory arrestOpen repairAortic catastropheAortic diameterSurgical pathologyLimited evidencePowerful predictorPainPatientsDissectionSurgical videosRepairWall thicknessPathology
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 differences
2019
Ascending 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 informationRiskPatientsA systematic review and meta-analysis of isolated abdominal aortic dissection
Wu J, Zafar M, Qiu J, Huang Y, Chen Y, Yu C, Elefteriades JA. A systematic review and meta-analysis of isolated abdominal aortic dissection. Journal Of Vascular Surgery 2019, 70: 2046-2053.e6. PMID: 31204217, DOI: 10.1016/j.jvs.2019.04.467.Peer-Reviewed Original ResearchConceptsIsolated abdominal aortic dissectionType B aortic dissectionAbdominal aortic dissectionAortic dissectionB aortic dissectionPrevalent risk factorsRisk factorsAverage aortic diameterComplication-specific approachEndovascular aortic repairAbdominal painChest painLate mortalityAortic repairClinical characteristicsConservative managementBack painPooled prevalenceRenal arteryAbdominal examinationAortic diameterAortic diseaseClinical symptomsCommon symptomsOpen surgery
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 casesAneurysmsAorticEchocardiographyPainPatientsSymptomaticsSymptomsThoracicAbnormalitiesDecision-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 applicationSymptomsTotalDescending 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
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 predictorsAneurysmsTAAARiskNatural history of aortic root aneurysms in Marfan syndrome.
Saeyeldin A, Zafar MA, Velasquez CA, Ip K, Gryaznov A, Brownstein AJ, Li Y, Rizzo JA, Erben Y, Ziganshin BA, Elefteriades JA. Natural history of aortic root aneurysms in Marfan syndrome. Annals Of Cardiothoracic Surgery 2017, 6: 625-632. PMID: 29270374, PMCID: PMC5721101, DOI: 10.21037/acs.2017.11.10.Peer-Reviewed Original ResearchAortic root aneurysmAortic root diameterAortic dissectionRoot aneurysmMFS patientsAortic complicationsAdverse eventsAortic rootNatural historyRisk of complicationsAortic root dilatationMarfan syndrome patientsLogistic regression modelsAortic regurgitationCardiovascular complicationsHemodynamic roleDreadful complicationRoot dilatationAortic diameterLarge aneurysmsSyndrome patientsMarfan syndromeComplicationsPatientsAneurysms