2022
mTOR inhibition prevents angiotensin II–induced aortic rupture and pseudoaneurysm but promotes dissection in Apoe-deficient mice
He C, Jiang B, Wang M, Ren P, Murtada SI, Caulk AW, Li G, Qin L, Assi R, Lovoulos CJ, Schwartz MA, Humphrey JD, Tellides G. mTOR inhibition prevents angiotensin II–induced aortic rupture and pseudoaneurysm but promotes dissection in Apoe-deficient mice. JCI Insight 2022, 7: e155815. PMID: 35132962, PMCID: PMC8855820, DOI: 10.1172/jci.insight.155815.Peer-Reviewed Original ResearchConceptsApoE-deficient miceAngiotensin IIVascular wall cellsAortic tearAortic ruptureMTOR inhibitionSmooth muscle cell hypertrophyMatricellular proteinWall cellsSuprarenal abdominal aortaMuscle cell hypertrophyExtracellular matrix accumulationInhibition of mTORRole of mTORSubadventitial hematomaFree ruptureAortic dissectionAortic diseaseAortic aneurysmSignificant dissectionAbdominal aortaHemorrhagic lesionsExtensive dissectionMetalloproteinase expressionCell hypertrophyGrowth rate of ascending thoracic aortic aneurysms in a non-referral-based population
Weininger G, Mori M, Yousef S, Hur DJ, Assi R, Geirsson A, Vallabhajosyula P. Growth rate of ascending thoracic aortic aneurysms in a non-referral-based population. Journal Of Cardiothoracic Surgery 2022, 17: 14. PMID: 35109884, PMCID: PMC8812194, DOI: 10.1186/s13019-022-01761-6.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAortaAortic AneurysmAortic Aneurysm, ThoracicFemaleHumansMiddle AgedReferral and ConsultationTomography, X-Ray ComputedConceptsAneurysm growth rateAortic dilatationAortic aneurysmStudy populationCT scanInitial aneurysm sizeTrue natural historyPatients age 50High-risk patientsMedian time intervalLarge institutional databaseThoracic aortic aneurysmComputed tomography scanAortic aneurysm diseaseRisk patientsAortic sizeInstitutional databaseTomography scanAneurysm diseaseRadiologic diagnosisAneurysm sizeBackgroundPrior studiesAge 50PatientsNatural history
2021
Socioeconomic disparities in surveillance and follow‐up of patients with thoracic aortic aneurysm
Shang M, Weininger G, Mori M, Kahler‐Quesada A, Degife E, Brooks C, Yousef S, Williams M, Assi R, Geirsson A, Vallabhajosyula P. Socioeconomic disparities in surveillance and follow‐up of patients with thoracic aortic aneurysm. Journal Of Cardiac Surgery 2021, 37: 831-839. PMID: 34873754, DOI: 10.1111/jocs.16173.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicFollow-Up StudiesHumansRetrospective StudiesRisk FactorsSocioeconomic FactorsTomography, X-Ray ComputedConceptsAortic aneurysmArea Deprivation IndexCardiovascular specialistsSocioeconomic statusSurgical interventionAneurysm sizeReferral of patientsRisk of deathSignificant risk factorsThoracic aortic aneurysmComputed tomography scanLowest socioeconomic quartileLow socioeconomic statusLower Socioeconomic StatusADI quartileAortic surveillanceAortic dissectionConsecutive patientsPrimary outcomeSpecialist referralSurgical repairTimely followSurveillance imagingRisk regressionRisk factorsDevelopment and Validation of a Predictive Model to Identify Patients With an Ascending Thoracic Aortic Aneurysm
Mori M, Gan G, Deng Y, Yousef S, Weininger G, Daggula KR, Agarwal R, Shang M, Assi R, Geirsson A, Vallabhajosyula P. Development and Validation of a Predictive Model to Identify Patients With an Ascending Thoracic Aortic Aneurysm. Journal Of The American Heart Association 2021, 10: e022102. PMID: 34743563, PMCID: PMC8751931, DOI: 10.1161/jaha.121.022102.Peer-Reviewed Original ResearchMeSH KeywordsAortaAorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionAortic ValveCross-Sectional StudiesFemaleHumansConceptsThoracic aortic aneurysmAortic aneurysmPatient riskTomography scanHigher body surface areaTertiary care centerAortic valve diseaseHistory of arrhythmiaAvailable clinical informationBody surface areaScreening of patientsCross-sectional studyRisk prediction algorithmAscending Thoracic Aortic AneurysmsLogistic regression modelsClinical characteristicsAortic dissectionUnique patientsValve diseaseC-statisticFemale sexThoracic aortaCare centerComorbidity variablesMultivariable modelQuantitative not qualitative histology differentiates aneurysmal from nondilated ascending aortas and reveals a net gain of medial components
Yousef S, Matsumoto N, Dabe I, Mori M, Landry AB, Lee SR, Kawamura Y, Yang C, Li G, Assi R, Vallabhajosyula P, Geirsson A, Moeckel G, Humphrey JD, Tellides G. Quantitative not qualitative histology differentiates aneurysmal from nondilated ascending aortas and reveals a net gain of medial components. Scientific Reports 2021, 11: 13185. PMID: 34162971, PMCID: PMC8222259, DOI: 10.1038/s41598-021-92659-1.Peer-Reviewed Original ResearchConceptsMedial degenerationAortic aneurysmSporadic thoracic aortic aneurysmMedial cell numberCommon histopathological findingThoracic aortic aneurysmSmooth muscle cellsAortic dilatationHistopathological findingsAscending aortaHistopathological criteriaAneurysmal wallLumen dilatationClinical diagnosisMuscle cellsAneurysmsAortaDegenerationDilatationMural cellsMarked overlapElastic lamellaeMedial componentCell numberMedial tissueVariants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease
Yousef S, Singh S, Alkukhun A, Alturkmani B, Mori M, Chen J, Mullan CW, Brooks CW, Assi R, Gruber PJ, Cortopassi I, Geirsson A, Vallabhajosyula P. Variants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease. Journal Of Cardiac Surgery 2021, 36: 2348-2354. PMID: 33855754, DOI: 10.1111/jocs.15563.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAneurysmAorta, ThoracicAortic Aneurysm, ThoracicCardiovascular AbnormalitiesFemaleHumansMaleMiddle AgedSubclavian ArteryConceptsAortic arch anomaliesArch anomaliesAneurysm diseaseBovine archAberrant right subclavian arteryAdult populationThoracic aortic aneurysm diseasePrevalence of TAAsRight-sided archRight subclavian arteryCharacteristics of patientsIndependent risk factorAortic valve pathologyAdult general populationGeneral adult populationAortic aneurysm diseaseLogistic regression analysisSingle health systemFisher's exact testOlder adult populationBinary logistic regressionThoracic aortopathiesSubclavian arteryCommon diagnosisThoracic aneurysm
2020
Diagnosis of Thoracic Aortic Aneurysms by Computed Tomography Without Allometric Scaling
Yousef S, Mori M, Bin Mahmood SU, Assi R, Vallabhajosyula P, Geirsson A, Tellides G. Diagnosis of Thoracic Aortic Aneurysms by Computed Tomography Without Allometric Scaling. JAMA Network Open 2020, 3: e2023689. PMID: 33141157, PMCID: PMC7610193, DOI: 10.1001/jamanetworkopen.2020.23689.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAorta, ThoracicAortic Aneurysm, ThoracicFemaleHumansMaleMiddle AgedRetrospective StudiesTertiary Care CentersTomography, X-Ray ComputedUnited StatesCommentary: Reverse elephant trunk procedure—staged by intention
Assi R, Geirsson A. Commentary: Reverse elephant trunk procedure—staged by intention. Journal Of Thoracic And Cardiovascular Surgery 2020, 163: 1266-1267. PMID: 33234250, DOI: 10.1016/j.jtcvs.2020.10.088.Commentaries, Editorials and LettersSurgical management of thoracic aortic emergency with pre‐ and postoperative COVID‐19 disease
Mori M, Geirsson A, Vallabhajosyula P, Assi R. Surgical management of thoracic aortic emergency with pre‐ and postoperative COVID‐19 disease. Journal Of Cardiac Surgery 2020, 35: 2832-2834. PMID: 32667075, PMCID: PMC7405051, DOI: 10.1111/jocs.14865.Peer-Reviewed Original ResearchMeSH KeywordsAged, 80 and overAorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionBetacoronavirusComorbidityCoronavirus InfectionsCOVID-19EmergenciesFemaleHumansMaleMiddle AgedPandemicsPneumonia, ViralPostoperative PeriodPreoperative PeriodSARS-CoV-2Tomography, X-Ray ComputedVascular Surgical Procedures
2018
Techniques and outcomes of secondary open repair for chronic dissection after acute repair of type A aortic dissection.
Assi R, Bavaria JE, Desai ND. Techniques and outcomes of secondary open repair for chronic dissection after acute repair of type A aortic dissection. The Journal Of Cardiovascular Surgery 2018, 59: 759-766. PMID: 29943963, DOI: 10.23736/s0021-9509.18.10646-x.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationDisease ProgressionEndovascular ProceduresHumansReoperationRisk FactorsTreatment OutcomeConceptsAortic dissectionSecondary open repairThoraco-abdominal aortaDistal false lumenRisk of ruptureAcute TAADChronic dissectionAcceptable morbidityAcute typeAcute repairPrimary tearDistal aortaOpen repairAneurysmal dilatationFalse lumenDistal reoperationExperienced handsIndex operationProgressive degenerationSuccessful repairAortaDissectionHybrid procedureRepairReoperation