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 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 treatmentGenetic 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 ResearchMeSH KeywordsAorta, ThoracicAortic DissectionCoronary VesselsGenome-Wide Association StudyHumansProspective StudiesRetrospective StudiesConceptsCorresponding 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 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
Progress 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
Getting 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 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
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 differencesThoracic 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
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 ResearchNatural 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 ResearchAscending 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 informationRiskPatientsSubacute/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 symptomsNonsyndromic Thoracic Aortic Aneurysms and Dissections—Is Screening Possible?
Faggion Vinholo T, Zafar MA, Ziganshin BA, Elefteriades JA. Nonsyndromic Thoracic Aortic Aneurysms and Dissections—Is Screening Possible? Seminars In Thoracic And Cardiovascular Surgery 2019, 31: 628-634. PMID: 31212014, DOI: 10.1053/j.semtcvs.2019.05.035.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmTAAD patientsAortic aneurysmFatal natural historySerologic screening testsProphylactic surgical interventionNormal life expectancyObvious clinical signsRoutine genetic testingWhole-exome sequencingTAAD casesSurgical interventionClinical signsTimely diagnosisScreening testClinical settingNatural historyGenetic testingTAADExome sequencingDisease-causing genesGenetic mutationsLife expectancyDiagnosisPatientsCommentary: Should we routinely prescribe β-blockers after surgical repair of type A dissection?
Elefteriades JA, Zafar MA, Ziganshin BA. Commentary: Should we routinely prescribe β-blockers after surgical repair of type A dissection? Journal Of Thoracic And Cardiovascular Surgery 2019, 159: 1706-1707. PMID: 31324426, DOI: 10.1016/j.jtcvs.2019.06.006.Peer-Reviewed Original ResearchA 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 surgeryPredictability of acute aortic dissection: A dream in evolution
Zafar MA, Ziganshin BA, Elefteriades JA. Predictability of acute aortic dissection: A dream in evolution. Journal Of Thoracic And Cardiovascular Surgery 2019, 157: e324-e326. PMID: 30826100, DOI: 10.1016/j.jtcvs.2019.01.097.Peer-Reviewed Original Research
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 applicationSymptomsTotal