2015
Urine Biomarkers and Perioperative Acute Kidney Injury: The Impact of Preoperative Estimated GFR
Koyner JL, Coca SG, Thiessen-Philbrook H, Patel UD, Shlipak MG, Garg AX, Parikh CR, Consortium T, Raman J, Jeevanandam V, Akhter S, Devarajan P, Bennett M, Ma Q, Griffiths R, Edelstein C, Passik C, Nagy J, Swaminathan M, Chu M, Goldbach M, Guo L, McKenzie N, Myers M, Novick R, Quantz M, Schumann V, Webster L, Zappitelli M, Palijan A, Dewar M, Darr U, Hashim S, Elefteriades J, Geirsson A, Garwood S, Kemp R, Butrymowicz I. Urine Biomarkers and Perioperative Acute Kidney Injury: The Impact of Preoperative Estimated GFR. American Journal Of Kidney Diseases 2015, 66: 1006-1014. PMID: 26386737, PMCID: PMC4658239, DOI: 10.1053/j.ajkd.2015.07.027.Peer-Reviewed Original ResearchConceptsAcute kidney injurySevere acute kidney injuryPost-operative dialysisBaseline eGFRKidney injuryInterleukin-18Urinary biomarkersDevelopment of AKIAKI Network stage 1Clinical acute kidney injuryPerioperative acute kidney injuryKidney injury molecule-1Liver-type fatty acid binding proteinBaseline kidney functionImpact of PreoperativeSerum creatinine levelsHours of surgeryInjury molecule-1Prospective cohort studyGlomerular filtration rateNumber of patientsPerformance of biomarkersFatty acid binding proteinAdjusted RRsPreoperative eGFR
2013
Preoperative angiotensin-converting enzyme inhibitors and angiotensin receptor blocker use and acute kidney injury in patients undergoing cardiac surgery
Coca SG, Garg AX, Swaminathan M, Garwood S, Hong K, Thiessen-Philbrook H, Passik C, Koyner JL, Parikh CR, Consortium O, Jai R, Jeevanandam V, Akhter S, Devarajan P, Bennett M, Edelsteinm C, Patel U, Chu M, Goldbach M, Guo L, McKenzie N, Myers M, Novick R, Quantz M, Zappitelli M, Dewar M, Darr U, Hashim S, Elefteriades J, Geirsson A. Preoperative angiotensin-converting enzyme inhibitors and angiotensin receptor blocker use and acute kidney injury in patients undergoing cardiac surgery. Nephrology Dialysis Transplantation 2013, 28: 2787-2799. PMID: 24081864, PMCID: PMC3811062, DOI: 10.1093/ndt/gft405.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAdultAgedAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiomarkersCardiac Surgical ProceduresCoronary Artery DiseaseFemaleHumansIncidenceKidney Function TestsMaleMiddle AgedPreoperative CarePrognosisProspective StudiesReceptors, AngiotensinUnited StatesConceptsStructural acute kidney injuryAcute kidney injuryAngiotensin-converting enzyme inhibitorAngiotensin receptor blockersACEI/angiotensin receptor blockerACEI/ARB exposureKidney injurySerum creatinineARB exposureCardiac surgeryUrinary biomarkersEnzyme inhibitorsPreoperative angiotensin-converting enzyme inhibitorACEI/ARB usageAngiotensin receptor blocker useFunctional acute kidney injuryPostoperative acute kidney injuryACEI/ARB useAKI stage 1New urinary biomarkersMorning of surgeryReceptor blocker useCo-primary outcomesProspective cohort studyARB usage
2009
Deep Hypothermic Circulatory Arrest in Patients With High Cognitive Needs: Full Preservation of Cognitive Abilities
Percy A, Widman S, Rizzo JA, Tranquilli M, Elefteriades JA. Deep Hypothermic Circulatory Arrest in Patients With High Cognitive Needs: Full Preservation of Cognitive Abilities. The Annals Of Thoracic Surgery 2009, 87: 117-123. PMID: 19101283, DOI: 10.1016/j.athoracsur.2008.10.025.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationCase-Control StudiesCirculatory Arrest, Deep Hypothermia InducedCognitionCognition DisordersFemaleFollow-Up StudiesHumansMaleMiddle AgedPatient SatisfactionPostoperative CarePreoperative CareProbabilityPsychometricsRadiographyReference ValuesRetrospective StudiesRisk AssessmentSurveys and QuestionnairesTreatment OutcomeVascular Surgical ProceduresConceptsDeep hypothermic circulatory arrestHypothermic circulatory arrestAortic surgeryCirculatory arrestStudy groupStraight deep hypothermic circulatory arrestYale-New Haven HospitalOpen distal anastomosisThoracic aortic surgeryTotal arch replacementArch replacementCerebral protectionPreoperative statusDistal anastomosisSuch patientsFunctional outcomeControl subjectsPatientsSurgeryControl groupAdverse effectsSignificant differencesCognitive changesDaily activitiesOverall score
2008
Unilateral diaphragm paralysis: etiology, impact, and natural history.
Elefteriades J, Singh M, Tang P, Siegel MD, Kenney B, Pandey A, Kopf GS. Unilateral diaphragm paralysis: etiology, impact, and natural history. The Journal Of Cardiovascular Surgery 2008, 49: 289-95. PMID: 18431352.Peer-Reviewed Original ResearchConceptsUnilateral diaphragm paralysisDiaphragm paralysisChronic obstructive pulmonary diseaseNatural historyBilateral diaphragm paralysisIntact phrenic nerveObstructive pulmonary diseaseSpirometric improvementClinical improvementExpiratory volumePulmonary infectionDiaphragm resectionLeft diaphragmOccasional patientPhrenic nervePulmonary diseaseSurgical explorationDiaphragm functionLower lobeVital capacityClinical recordsClinical spectrumMean durationNeurogenic atrophyBest therapy
2007
What Is the Optimal Management of Late-Presenting Survivors of Acute Type A Aortic Dissection?
Davies RR, Coe MP, Mandapati D, Gallo A, Botta DM, Elefteriades JA, Coady MA. What Is the Optimal Management of Late-Presenting Survivors of Acute Type A Aortic Dissection? The Annals Of Thoracic Surgery 2007, 83: 1593-1602. PMID: 17462364, DOI: 10.1016/j.athoracsur.2006.12.018.Peer-Reviewed Original ResearchConceptsLong-term survivalOperative repairAortic dissectionGroup AAcute Type A Aortic DissectionType A Aortic DissectionImproved long-term survivalOptimal managementExcellent long-term resultsA Aortic DissectionInitial medical managementCongestive heart failureCoronary artery diseaseOnset of symptomsLong-term resultsImmediate operative repairAcute typeSurgical emergencySymptom onsetArtery diseaseHeart failurePulmonary diseaseMedical managementSingle institutionGroup B
2006
Familial Thoracic Aortic Aneurysms and Dissections—Incidence, Modes of Inheritance, and Phenotypic Patterns
Albornoz G, Coady MA, Roberts M, Davies RR, Tranquilli M, Rizzo JA, Elefteriades JA. Familial Thoracic Aortic Aneurysms and Dissections—Incidence, Modes of Inheritance, and Phenotypic Patterns. The Annals Of Thoracic Surgery 2006, 82: 1400-1405. PMID: 16996941, DOI: 10.1016/j.athoracsur.2006.04.098.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAbdominal aortic aneurysmFamilial thoracic aortic aneurysmsAortic aneurysmMarfan syndromeAortic growth rateNon-Marfan patientsIncidence of hypertensionAggressive clinical entityPredominant inheritance patternSporadic groupMarfan groupStudy patientsCerebral circulationClinical entityThoracic aortaAbdominal aortaInheritance patternMFS groupMFS patientsTAA groupLarge cohortAneurysm sitePatientsAneurysms
2005
Mechanical deterioration underlies malignant behavior of aneurysmal human ascending aorta
Koullias G, Modak R, Tranquilli M, Korkolis DP, Barash P, Elefteriades JA. Mechanical deterioration underlies malignant behavior of aneurysmal human ascending aorta. Journal Of Thoracic And Cardiovascular Surgery 2005, 130: 677.e1-677.e9. PMID: 16153912, DOI: 10.1016/j.jtcvs.2005.02.052.Peer-Reviewed Original ResearchConceptsMechanical characteristicsMechanical deteriorationHuman ascending aortaAortic aneurysmAortic wall stressNormal aortaAneurysmal aortaAortic distensibilityAscending aortaMalignant behaviorAortic wallWall stressMaximal tensile strengthMechanical propertiesCoronary artery bypassTensile strengthTime of surgeryAortic wall thicknessAscending Aortic AneurysmMalignant clinical behaviorElastic modulusHuman ascending aortic aneurysmsEngineering analysisAneurysmal aortic wallMechanical substrate
2001
Stroke in surgery of the thoracic aorta: Incidence, impact, etiology, and prevention
Goldstein L, Davies R, Rizzo J, Davila J, Cooperberg M, Shaw R, Kopf G, Elefteriades J. Stroke in surgery of the thoracic aorta: Incidence, impact, etiology, and prevention. Journal Of Thoracic And Cardiovascular Surgery 2001, 122: 935-945. PMID: 11689799, DOI: 10.1067/mtc.2001.117276.Peer-Reviewed Original ResearchConceptsDeep hypothermic circulatory arrestHypothermic circulatory arrestThoracic aortaCirculatory arrestEmergency operationAge-adjusted survivalAntegrade cerebral perfusionThoracic aortic operationsPrevention of strokeIntensive care unitPostoperative stayAortic atheromaAortic manipulationAortic operationsPostoperative deathsCardiopulmonary bypassCerebral perfusionFemoral perfusionNeurologic consultationCare unitElective operationsHeart bypassThorough debridementOperative reportsLeft heartSingle-clamp technique does not protect against cerebrovascular accident in coronary artery bypass grafting⋆
Kim R, Mariconda D, Tellides G, Kopf G, Dewar M, Lin Z, Elefteriades J. Single-clamp technique does not protect against cerebrovascular accident in coronary artery bypass grafting⋆. European Journal Of Cardio-Thoracic Surgery 2001, 20: 127-132. PMID: 11423285, DOI: 10.1016/s1010-7940(01)00765-5.Peer-Reviewed Original ResearchConceptsSingle-clamp techniqueCoronary artery bypassPostoperative strokeArtery bypassStroke preventionCerebrovascular accidentSide-biting aortic clampAdverse myocardial effectsCross-clamp timePostoperative adverse eventsPerioperative myocardial infarctionCoronary bypass operationsLogistic regression analysisEmbolic consequencesHospital mortalityAdverse eventsAortic clampMyocardial effectsBypass operationMyocardial infarctionMyocardial protectionClinical practiceClamp techniqueSecond surgeonStroke
2000
Effect of left ventricular volume on results of coronary artery bypass grafting
Kim R, Ugurlu B, Tereb D, Wackers F, Tellides G, Elefteriades J. Effect of left ventricular volume on results of coronary artery bypass grafting. The American Journal Of Cardiology 2000, 86: 1261-1264. PMID: 11090805, DOI: 10.1016/s0002-9149(00)01216-9.Peer-Reviewed Original ResearchConceptsCoronary artery bypassArtery bypassSignificant left ventricular dilationLeft ventricular dilationLV chamber sizeLV ejection fractionMedium-term survivalSurgical revascularizationAngina symptomsEjection fractionIschemic cardiomyopathyLV dilationVentricular dilationVentricular sizeVentricular volumePatientsSignificant reductionBypassChamber sizeDilationRevascularizationCardiomyopathySymptomsSafety of left innominate vein division during aortic arch surgery
Sudhakar C, Elefteriades J. Safety of left innominate vein division during aortic arch surgery. The Annals Of Thoracic Surgery 2000, 70: 856-858. PMID: 11016323, DOI: 10.1016/s0003-4975(00)01498-3.Peer-Reviewed Original ResearchConceptsLeft innominate veinUpper extremity edemaExtremity edemaMediastinal tumorNeurologic symptomsSignificant long-term morbidityAortic arch surgeryDistal aortic anastomosisLong-term morbidityArch replacementArch surgeryExtent of involvementMultiorgan dysfunctionInnominate veinVein divisionEarly patientsMedian sternotomyAortic anastomosisMean ageSurgical approachAortic archMediastinal structuresArm elevationPatientsLocal anatomy
1999
Pharmacology and Biological Efficacy of a Recombinant, Humanized, Single-Chain Antibody C5 Complement Inhibitor in Patients Undergoing Coronary Artery Bypass Graft Surgery With Cardiopulmonary Bypass
Fitch J, Rollins S, Matis L, Alford B, Aranki S, Collard C, Dewar M, Elefteriades J, Hines R, Kopf G, Kraker P, Li L, O’Hara R, Rinder C, Rinder H, Shaw R, Smith B, Stahl G, Shernan S. Pharmacology and Biological Efficacy of a Recombinant, Humanized, Single-Chain Antibody C5 Complement Inhibitor in Patients Undergoing Coronary Artery Bypass Graft Surgery With Cardiopulmonary Bypass. Circulation 1999, 100: 2499-2506. PMID: 10604887, DOI: 10.1161/01.cir.100.25.2499.Peer-Reviewed Original ResearchMeSH KeywordsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedBlood Loss, SurgicalCardiopulmonary BypassCognition DisordersComplement ActivationComplement C5Complement Membrane Attack ComplexCoronary Artery BypassCoronary DiseaseCreatine KinaseHumansInflammationIsoenzymesMiddle AgedMyocardial Reperfusion InjuryPostoperative ComplicationsProspective StudiesPsychological TestsSingle-Chain AntibodiesConceptsMini-Mental State ExaminationPathological complement activationCardiopulmonary bypassBlood lossMyocardial injuryC5 inhibitionTissue injuryCoronary artery bypass graft surgeryComplement inhibitorsArtery bypass graft surgeryComplement activationCognitive deficitsSingle-chain antibodyC5 complement inhibitorNew cognitive deficitsSignificant dose-dependent inhibitionBypass graft surgeryPostoperative blood lossPostoperative myocardial injurySystemic inflammatory responseComplement-mediated inflammationLeukocyte CD11b expressionNovel therapeutic strategiesComplement hemolytic activityDose-dependent fashionDEVELOPING SURGICAL INTERVENTION CRITERIA FOR THORACIC AORTIC ANEURYSMS
Coady M, Rizzo J, Elefteriades J. DEVELOPING SURGICAL INTERVENTION CRITERIA FOR THORACIC AORTIC ANEURYSMS. Cardiology Clinics 1999, 17: 827-839. PMID: 10589349, DOI: 10.1016/s0733-8651(05)70118-1.Peer-Reviewed Original ResearchConceptsSurgical interventionAcute ascending aortic dissectionAscending aortic dissectionConcomitant aortic insufficiencyIntervention criteriaLarger patient numbersAppropriate clinical careThoracic aortic aneurysmSize criteriaSurgical intervention criteriaOverall physical conditionAortic insufficiencyAdverse eventsAortic dissectionPatient ageAortic sizeOrgan compressionPatient enrollmentPatient numbersAortic aneurysmThoracic aortaSymptomatic stateClinical careClinical experienceLife expectancyPATHOLOGIC VARIANTS OF THORACIC AORTIC DISSECTIONS Penetrating Atherosclerotic Ulcers and Intramural Hematomas
Coady M, Rizzo J, Elefteriades J. PATHOLOGIC VARIANTS OF THORACIC AORTIC DISSECTIONS Penetrating Atherosclerotic Ulcers and Intramural Hematomas. Cardiology Clinics 1999, 17: 637-657. PMID: 10589337, DOI: 10.1016/s0733-8651(05)70106-5.Peer-Reviewed Original ResearchConceptsClassic aortic dissectionAcute aortic pathologyIntramural hematomaAortic dissectionAortic lumenAtherosclerotic ulcerAortic lesionsIMH patientsAortic pathologyClassic dissectionRupture rateType B aortic dissectionTypical aortic dissectionB aortic dissectionDistinct clinical entityThoracic aortic dissectionTypical patient profileMore superficial locationHigher rupture rateBranch-vessel compromiseLarger aortasMinimal arteriosclerosisTypical dissectionIschemic manifestationsThoracoabdominal aortaFailure to Improve Left Ventricular Function After Coronary Revascularization for Ischemic Cardiomyopathy Is Not Associated With Worse Outcome
Samady H, Elefteriades J, Abbott B, Mattera J, McPherson C, Wackers F. Failure to Improve Left Ventricular Function After Coronary Revascularization for Ischemic Cardiomyopathy Is Not Associated With Worse Outcome. Circulation 1999, 100: 1298-1304. PMID: 10491374, DOI: 10.1161/01.cir.100.12.1298.Peer-Reviewed Original ResearchConceptsVentricular functionIschemic cardiomyopathyGroup AHeart failure scoreLeft ventricular functionIschemic LV dysfunctionPoor patient outcomesB. Group ALack of improvementBaseline LVEFEffective revascularizationImproved LVEFCoronary revascularizationLV dysfunctionConsecutive patientsIntraoperative variablesPostoperative improvementCardiac deathLV functionPoor outcomeViable myocardiumLVEF assessmentIschemic myocardiumPatient outcomesWorse outcomesSurgical intervention criteria for thoracic aortic aneurysms: a study of growth rates and complications
Coady M, Rizzo J, Hammond G, Kopf G, Elefteriades J. Surgical intervention criteria for thoracic aortic aneurysms: a study of growth rates and complications. The Annals Of Thoracic Surgery 1999, 67: 1922-1926. PMID: 10391339, DOI: 10.1016/s0003-4975(99)00431-2.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic aneurysmDevastating complicationAortic growth rateComplications of ruptureIncidence of dissectionTime of complicationsRisk of dissectionMultivariable regression analysisMedian sizeSurgical intervention criteriaTime of dissectionAcute dissectionElective resectionPerioperative complicationsInitial presentationSurgical interventionRisk factorsThoracic aortaAneurysm sizeComplicationsTime of ruptureYale University SchoolLower mortalityAneurysmsFamilial Patterns of Thoracic Aortic Aneurysms
Coady M, Davies R, Roberts M, Goldstein L, Rogalski M, Rizzo J, Hammond G, Kopf G, Elefteriades J. Familial Patterns of Thoracic Aortic Aneurysms. JAMA Surgery 1999, 134: 361-367. PMID: 10199307, DOI: 10.1001/archsurg.134.4.361.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAortic Aneurysm, ThoracicFemaleHumansMaleMiddle AgedPedigreeRetrospective StudiesConceptsThoracic aortic aneurysmSporadic thoracic aortic aneurysmConcomitant aortic dissectionAortic dissectionAortic aneurysmMarfan syndromeAortic diseaseAutosomal recessive modeFamilial patternMean ageFamily historyRecessive modeCollagen vascular disordersTime of diagnosisThoracic aortic diseaseGenetic factorsNew risk factorsFamily pedigreeConcomitant diseasesRetrospective reviewAortic sizeUniversity HospitalRisk factorsVascular disordersAutosomal dominant modeInterval or Permanent Nonoperative Management of Acute Type A Aortic Dissection
Scholl F, Coady M, Davies R, Rizzo J, Hammond G, Kopf G, Elefteriades J. Interval or Permanent Nonoperative Management of Acute Type A Aortic Dissection. JAMA Surgery 1999, 134: 402-406. PMID: 10199313, DOI: 10.1001/archsurg.134.4.402.Peer-Reviewed Original ResearchConceptsAcute Type A Aortic DissectionType A Aortic DissectionA Aortic DissectionAortic dissectionShort-term outcomesOperative candidatesNonoperative managementMedical therapyMedical treatmentAggressive medical therapyImmediate surgical therapyInitial operative treatmentSevere aortic insufficiencyAggressive medical treatmentGroup of patientsShort-term survivalHospital mortalityAcute typeCoronary ischemiaInitial misdiagnosisNonoperative therapySignificant comorbiditiesVascular complicationsAortic insufficiencyDefinitive operation
1998
Procedures for Estimating Growth Rates in Thoracic Aortic Aneurysms
Rizzo J, Coady M, Elefteriades J. Procedures for Estimating Growth Rates in Thoracic Aortic Aneurysms. Journal Of Clinical Epidemiology 1998, 51: 747-754. PMID: 9731923, DOI: 10.1016/s0895-4356(98)00050-x.Peer-Reviewed Original ResearchConceptsTAA growth ratesStatistical problemsStatistical methodsEstimation procedureTAA growthConventional approachesMore reliable resultsInstrumental variable estimationVariable estimationMeasurement errorRate estimatesPrecise estimatesEstimationMeasured growth rateReliable estimatesEstimatesReliable resultsProblemConventional methodsApproachLethal medical conditionErrorPenetrating ulcer of the thoracic aorta: What is it? How do we recognize it? How do we manage it?
Coady M, Rizzo J, Hammond G, Pierce J, Kopf G, Elefteriades J. Penetrating ulcer of the thoracic aorta: What is it? How do we recognize it? How do we manage it? Journal Of Vascular Surgery 1998, 27: 1006-1016. PMID: 9652462, DOI: 10.1016/s0741-5214(98)70003-5.Peer-Reviewed Original ResearchConceptsAortic dissectionOptimal treatmentThoracic aortaNatural historyType AType B aortic dissectionB aortic dissectionClassic aortic dissectionLarger aortic diametersAortic ulcerAtherosclerotic ulcerAortic ruptureClinical featuresInitial diagnosisInitial presentationIntraoperative findingsRetrospective reviewSurgical managementAortic diameterRadiologic signsTomographic scanPathology reportsUlcersPatientsAorta