2017
Concomitant antegrade stent grafting of the descending thoracic aorta during transverse hemiarch reconstruction for acute DeBakey I aortic dissection repair improves aortic remodeling
Sultan I, Wallen TJ, Habertheuer A, Siki M, Arnaoutakis GJ, Bavaria J, Szeto WY, Milewski R, Vallabhajosyula P. Concomitant antegrade stent grafting of the descending thoracic aorta during transverse hemiarch reconstruction for acute DeBakey I aortic dissection repair improves aortic remodeling. Journal Of Cardiac Surgery 2017, 32: 581-592. PMID: 28795434, DOI: 10.1111/jocs.13192.Peer-Reviewed Original ResearchConceptsTrue lumen diameterTEVAR groupTrue lumenThoracic aortaLumen diameterHemiarch reconstructionAortic remodelingStent graftingOpen repairAortic diameterAcute DeBakey I aortic dissectionDeBakey I aortic dissectionFalse lumen thrombosis rateThree-dimensional computed tomography scansAortic dissection repairDeBakey I dissectionsDistal aortic remodelingTotal aortic diameterFalse lumen thrombosisAbdominal aortic diameterEndovascular stent graftingEndovascular aortic repairComputed tomography scanArch tearDeBakey IOutcomes of Elective Aortic Hemiarch Reconstruction for Aneurysmal Disease in the Elderly
Kilic A, Arnaoutakis GJ, Bavaria JE, Sultan I, Desai ND, Vallabhajosyula P, Williams ML, Milewski RK, Szeto WY. Outcomes of Elective Aortic Hemiarch Reconstruction for Aneurysmal Disease in the Elderly. The Annals Of Thoracic Surgery 2017, 104: 1522-1530. PMID: 28648536, DOI: 10.1016/j.athoracsur.2017.03.067.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationCirculatory Arrest, Deep Hypothermia InducedCohort StudiesElective Surgical ProceduresFemaleGeriatric AssessmentHospital MortalityHumansMaleMiddle AgedPlastic Surgery ProceduresPostoperative CarePostoperative ComplicationsPrognosisPropensity ScoreRegistriesRetrospective StudiesRisk AssessmentSex FactorsSurvival AnalysisTreatment OutcomeConceptsModerate hypothermic circulatory arrestAntegrade cerebral perfusionHypothermic circulatory arrestHemiarch reconstructionElderly patientsAneurysmal diseaseOperative mortalityCerebral perfusionCirculatory arrestConcomitant aortic valve replacementRisk-adjusted operative mortalityCoronary artery bypassOperative mortality rateAortic valve replacementGreater comorbidity burdenLow operative mortalityOverall stroke rateSafe strategyIntensive care unitComorbidity burdenArtery bypassHospital stayRoot replacementValve replacementCare unit
2015
Direct innominate artery cannulation: An alternate technique for antegrade cerebral perfusion during aortic hemiarch reconstruction
Jassar AS, Vallabhajosyula P, Bavaria JE, Gutsche J, Desai ND, Williams ML, Milewski RK, Hargrove WC, Szeto WY. Direct innominate artery cannulation: An alternate technique for antegrade cerebral perfusion during aortic hemiarch reconstruction. Journal Of Thoracic And Cardiovascular Surgery 2015, 151: 1073-1078. PMID: 26725716, DOI: 10.1016/j.jtcvs.2015.11.027.Peer-Reviewed Original ResearchMeSH KeywordsAgedAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationBrachiocephalic TrunkCatheterization, PeripheralCerebrovascular CirculationFemaleHeart Arrest, InducedHospital MortalityHumansHypothermia, InducedMaleMiddle AgedPerfusionPostoperative ComplicationsRegional Blood FlowReoperationTime FactorsTreatment OutcomeConceptsAntegrade cerebral perfusionModerate hypothermic circulatory arrestHypothermic circulatory arrestHemiarch reconstructionInnominate arteryCerebral perfusionCirculatory arrestReversible ischemic neurologic deficitExcellent cerebral protectionInnominate artery cannulationIschemic neurologic deficitAortic valve replacementRenal failure rateProximal aortic aneurysmIncidence of injuryACP timeAscending aorticCrossclamp timeArtery cannulationCerebral protectionCentral cannulationNeurologic deficitsPatient ageRoot replacementValve replacementHemiarch replacement with concomitant antegrade stent grafting of the descending thoracic aorta versus total arch replacement for treatment of acute DeBakey I aortic dissection with arch tear†
Vallabhajosyula P, Gottret JP, Robb JD, Szeto WY, Desai ND, Pochettino A, Bavaria JE. Hemiarch replacement with concomitant antegrade stent grafting of the descending thoracic aorta versus total arch replacement for treatment of acute DeBakey I aortic dissection with arch tear†. European Journal Of Cardio-Thoracic Surgery 2015, 49: 1256-1261. PMID: 26516196, DOI: 10.1093/ejcts/ezv374.Peer-Reviewed Original ResearchConceptsThoracic endovascular aortic repairDeBakey I aortic dissectionTotal arch replacementAcute DeBakey I aortic dissectionConventional total arch replacementArch tearMid-term outcomesAortic dissectionTEVAR groupArch replacementHemiarch reconstructionHemiarch replacementTear repairFalse lumen thrombosisEndovascular aortic repairHospital/30-day mortalityAortic dissection patientsActuarial survivalTEVAR patientsCardiogenic shockStent graftingAortic repairDistal reconstructionCardiopulmonary bypassClinical presentationModerate Versus Deep Hypothermic Circulatory Arrest for Elective Aortic Transverse Hemiarch Reconstruction
Vallabhajosyula P, Jassar AS, Menon RS, Komlo C, Gutsche J, Desai ND, Hargrove WC, Bavaria JE, Szeto WY. Moderate Versus Deep Hypothermic Circulatory Arrest for Elective Aortic Transverse Hemiarch Reconstruction. The Annals Of Thoracic Surgery 2015, 99: 1511-1517. PMID: 25825200, DOI: 10.1016/j.athoracsur.2014.12.067.Peer-Reviewed Original ResearchConceptsModerate hypothermic circulatory arrestDeep hypothermic circulatory arrestHypothermic circulatory arrestDirect innominate artery cannulationAntegrade cerebral perfusionInnominate artery cannulationCerebral perfusionCirculatory arrestHemiarch reconstructionTransfusion requirementsArtery cannulationMHCA groupCerebral perfusion strategyCerebral protection strategiesConcomitant root replacementRetrograde cerebral perfusionAortic valve replacementFresh frozen plasmaAortic aneurysm diseaseHemodialysis rateAortic reconstructionNeurologic complicationsGroup patientsPostoperative outcomesRoot replacement
2013
Antegrade thoracic stent grafting during repair of acute Debakey type I dissection promotes distal aortic remodeling and reduces late open distal reoperation rate
Vallabhajosyula P, Szeto WY, Pulsipher A, Desai N, Menon R, Moeller P, Musthaq S, Pochettino A, Bavaria JE. Antegrade thoracic stent grafting during repair of acute Debakey type I dissection promotes distal aortic remodeling and reduces late open distal reoperation rate. Journal Of Thoracic And Cardiovascular Surgery 2013, 147: 942-950. PMID: 24332104, DOI: 10.1016/j.jtcvs.2013.10.047.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdultAgedAortic Aneurysm, ThoracicAortic DissectionBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationEndovascular ProceduresFemaleHospital MortalityHumansKaplan-Meier EstimateMaleMiddle AgedPlastic Surgery ProceduresPostoperative ComplicationsReoperationRetrospective StudiesStentsTime FactorsTreatment OutcomeConceptsDistal aortic remodelingStandard open repairOpen repairAortic remodelingStented groupDissection repairReoperation rateAcute DeBakey type IDeBakey type I dissectionStandard groupAntegrade cerebral perfusionAortic reintervention ratesAortic reoperation ratesDeBakey type IDistal aortic reoperationFalse lumen obliterationType I dissectionCirculatory arrest timeHospital/30-day mortalityStent-graft deploymentActuarial survivalAortic reoperationHemiarch reconstructionMidterm mortalityMidterm outcomes