2023
Genetic Overlap of Spontaneous Dissection of Either the Thoracic Aorta or the Coronary Arteries
Jeoffrey S, Kalyanasundaram A, Zafar M, Ziganshin B, Elefteriades J. Genetic Overlap of Spontaneous Dissection of Either the Thoracic Aorta or the Coronary Arteries. The American Journal Of Cardiology 2023, 205: 69-74. PMID: 37591066, DOI: 10.1016/j.amjcard.2023.07.046.Peer-Reviewed Original ResearchConceptsCorresponding molecular pathwaysSpontaneous coronary artery dissectionGenetic overlapMolecular pathwaysGenome-wide association studiesGenetic commonalityGenetic variantsThoracic aortic dissectionIndependent genesGenetic pathwaysSmooth muscle cell functionGenetic methodsAortic dissectionMuscle cell functionAssociation studiesGenetic studiesSudden deathConnective tissue genesGenesTGFβ pathwayCausative genesCoronary artery dissectionTissue genesEarly-onset myocardial infarctionBiologic processesAortic 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 typesNonsize Criteria for Surgical Intervention on the Ascending Thoracic Aorta
Elefteriades J, Ziganshin B, Zafar M. Nonsize Criteria for Surgical Intervention on the Ascending Thoracic Aorta. Aorta 2023, 11: 071-086. PMID: 37172942, PMCID: PMC10232037, DOI: 10.1055/s-0043-1766114.Peer-Reviewed Original ResearchThoracic aortic aneurysmSurgical interventionAortic eventsAortic dissectionSubsternal chest painBlood pressure elevationBicuspid aortic valveAfferent neural pathwaysAscending thoracic aortaEmission Tomography ImagingPositron emission tomography (PET) imagingAortic stressAscending aneurysmAortic surgeryChest painEarly surgerySpecific genetic aberrationsHigh rupture riskMural thickeningRoot dilatationBicuspid valvePressure elevationAneurysm patientsAortic aneurysmAortic riskKIF6 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
2022
Ultimate tensile strength and biaxial stress–strain responses of aortic tissues—A clinical-engineering correlation
Dong H, Liu M, Lou X, Leshnower B, Sun W, Ziganshin B, Zafar M, Elefteriades J. Ultimate tensile strength and biaxial stress–strain responses of aortic tissues—A clinical-engineering correlation. Applications In Engineering Science 2022, 10: 100101. DOI: 10.1016/j.apples.2022.100101.Peer-Reviewed Original ResearchThoracic aortic dissectionAortic dissectionAortic tissueDissection eventsBicuspid aortic valveUnderlying genetic abnormalitiesHuman aortic tissueHypertensive episodesAortic arch morphologyAortic valveAdvanced ageTissue injuryConnective tissue ingrowthAged animalsAortic wallInciting factorsGenetic abnormalitiesClinical contextArch morphologyDissectionDissected tissuesTissueResponseTissue ingrowthInjuryProgress 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
Delayed Surgery for Acute Aortic Dissection
Pinkhasova P, Zafar M, Ziganshin B, Elefteriades J. Delayed Surgery for Acute Aortic Dissection. 2021, 535-551. DOI: 10.1007/978-3-030-66668-2_37.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 diametersFate 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 survival
2019
Chronologic and Climatic Factors of Acute Aortic Dissection: Study of 1642 Patients in Two Continents
Ma WG, Li B, Zhang W, Sarkar AEH, Tufail R, Peterss S, Zheng J, Zafar MA, Ziganshin B, Zhu JM, Sun LZ, Elefteriades JA. Chronologic and Climatic Factors of Acute Aortic Dissection: Study of 1642 Patients in Two Continents. The Annals Of Thoracic Surgery 2019, 110: 575-581. PMID: 31891696, DOI: 10.1016/j.athoracsur.2019.11.013.Peer-Reviewed Original ResearchPredicting 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 triagePatientsSubacute/chronic type A aortic dissection: a retrospective cohort study
Wu J, Xie E, Qiu J, Huang Y, Jiang W, Zafar MA, Zhang L, Yu C. Subacute/chronic type A aortic dissection: a retrospective cohort study. European Journal Of Cardio-Thoracic Surgery 2019, 57: 388-396. PMID: 31317195, DOI: 10.1093/ejcts/ezz209.Peer-Reviewed Original ResearchConceptsChronic TAADAcute TAADLate survival ratesPropensity scoreAortic dissectionChronic typeClinical presentationSurvival rateRetrospective cohort studyEarly mortality rateCurrent surgical strategiesFifteen patientsMild painChest tightnessCohort studySharp painSurgical treatmentSurgical strategyExcellent outcomesLate outcomesTAADMortality ratePainPatientsTypical symptomsA 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 surgerySimple renal cysts and bovine aortic arch: markers for aortic disease
Brownstein AJ, Bin Mahmood SU, Saeyeldin A, Velasquez Mejia C, Zafar MA, Li Y, Rizzo JA, Dahl NK, Erben Y, Ziganshin BA, Elefteriades JA. Simple renal cysts and bovine aortic arch: markers for aortic disease. Open Heart 2019, 6: e000862. PMID: 30774963, PMCID: PMC6350752, DOI: 10.1136/openhrt-2018-000862.Peer-Reviewed Original ResearchBovine aortic archSimple renal cystsThoracic aortic diseaseAbdominal aortic aneurysmType B aortic dissectionB aortic dissectionAortic dissectionAortic aneurysmAortic diseaseAortic archRenal cystsChronic kidney diseasePresence of hypertensionAortic aneurysm developmentAbdominal CTMultivariable analysisKidney diseaseRetrospective searchPatientsAneurysm developmentAneurysmsPropensity scoreDiseaseDissectionPrevalence
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 casesAneurysmsAorticEchocardiographyPainPatientsSymptomaticsSymptomsThoracicAbnormalitiesDiabetes Mellitus: Is It Protective against Aneurysm? A Narrative Review
Patel K, Zafar MA, Ziganshin BA, Elefteriades JA. Diabetes Mellitus: Is It Protective against Aneurysm? A Narrative Review. Cardiology 2018, 141: 107-122. PMID: 30453299, DOI: 10.1159/000490373.Peer-Reviewed Original ResearchConceptsAbdominal aortic aneurysmAortic aneurysmDiabetic patientsAortic dissectionDipeptidyl peptidase-4 inhibitorsCommon antidiabetic medicationsPrevalence of TAAsPeptidase-4 inhibitorsAneurysm growth rateSmaller aneurysm diameterAortic wall stressRate of mortalityLow rupture ratesAntidiabetic medicationsAortic surgeryHospital stayDiabetic stateAortic growthAneurysm diameterAntidiabetic agentsDecreased lengthAneurysmsProtective roleRupture rateMatrix metalloproteinasesDescending 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 aberrationsOpen Replacement of the Thoracoabdominal Aorta: Short- and Long-term Outcomes at a Single Institution
Carino D, Erben Y, Zafar MA, Singh M, Brownstein AJ, Tranquilli M, Rizzo J, Ziganshin BA, Elefteriades JA. Open Replacement of the Thoracoabdominal Aorta: Short- and Long-term Outcomes at a Single Institution. International Journal Of Angiology 2018, 27: 114-120. PMID: 29896044, PMCID: PMC5995682, DOI: 10.1055/s-0038-1649517.Peer-Reviewed Original ResearchThoracoabdominal aortic diseaseLong-term outcomesOpen surgeryOpen replacementThoracoabdominal aortaAortic dissectionDissection groupConcomitant aortic dissectionDifferent aortic pathologiesEnd-organ dysfunctionAortic reinterventionEarly morbidityOperative mortalityOverall deathPermanent paraplegiaPrimary endpointSecondary endpointsTAAD patientsAneurysmal degenerationAortic pathologyCerebrovascular accidentOpen repairRetrospective reviewElective surgeryEndovascular treatmentIntraoperative descending aortic dissection during aortic root replacement: successful management
Gryaznov AA, Ma WG, Erben Y, Zafar MA, Velasquez CA, Saeyeldin A, Ziganshin BA, Elefteriades JA. Intraoperative descending aortic dissection during aortic root replacement: successful management. Journal Of Thoracic Disease 2018, 10: 3065-3069. PMID: 29997974, PMCID: PMC6006070, DOI: 10.21037/jtd.2018.05.29.Peer-Reviewed Original ResearchIntraoperative aortic dissectionAortic dissectionSurgical cardiac interventionsAortic root replacementLife-threatening complicationsRoot replacementRare complicationCardiac interventionsOptimal managementSuccessful managementDissectionCatastrophic outcomesComplicationsHigh rateClear guidelinesMorbidityMortality