2024
Patient-specific ascending aortic intervention criteria
Kalogerakos P, Zafar M, Li Y, Ellauzi H, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Patient-specific ascending aortic intervention criteria. European Journal Of Cardio-Thoracic Surgery 2024, 65: ezae162. PMID: 38632077, DOI: 10.1093/ejcts/ezae162.Peer-Reviewed Original ResearchAdverse aortic eventsRisk of adverse eventsAortic eventsAortic rootAneurysm patientsAscending aortaAdverse eventsIncreased risk of adverse eventsThoracic aortic aneurysm patientsAscending aortic aneurysmHigher risk of adverse eventsAortic aneurysm patientsAscending thoracic aortic aneurysm patientsBody surface areaGeneral populationPersonalized risk stratificationAortic diameterAneurysm locationRisk stratificationAortic aneurysmIncreased riskAscending diameterPatientsHigh riskZ-score
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 ResearchConceptsBig 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 treatmentBicuspid aortopathy does not require earlier surgical intervention
Zafar M, Wu J, Vinholo T, Li Y, Papanikolaou D, Ellauzi H, Ostberg N, Kalyanasundaram A, Kalogerakos P, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Bicuspid aortopathy does not require earlier surgical intervention. Journal Of Thoracic And Cardiovascular Surgery 2023, 168: 760-769.e4. PMID: 37088130, DOI: 10.1016/j.jtcvs.2023.04.017.Peer-Reviewed Original ResearchBicuspid aortic valveAdverse aortic eventsEvent-free survivalAortic eventsAortic sizeAortic diameterAortic growth rateEarly surgical interventionLong-term complicationsRisk of complicationsThoracic aortic aneurysmAortic deathComplication rateSurgical repairOperative repairProphylactic surgerySurgical interventionAortic aneurysmAortic valveSurgical correctionBicuspid aortopathyRelative riskExpert centersTAV-ATAAPatientsFate 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 ResearchConceptsAdverse 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
A machine learning approach for predicting complications in descending and thoracoabdominal aortic aneurysms
Ostberg NP, Zafar MA, Mukherjee SK, Ziganshin BA, Elefteriades JA. A machine learning approach for predicting complications in descending and thoracoabdominal aortic aneurysms. Journal Of Thoracic And Cardiovascular Surgery 2022, 166: 1011-1020.e3. PMID: 35120761, DOI: 10.1016/j.jtcvs.2021.12.045.Peer-Reviewed Original ResearchConceptsType B dissectionThoracoabdominal aortic aneurysmsB dissectionCause mortalityAortic aneurysmReceiver operator curveAortic diameterOperator curveInitial patient encounterOccurrence of dissectionSurgical intervention criteriaMean followPatient sexMyocardial infarctionPatient encountersRetrospective dataEnd pointPatientsAneurysmsDissectionMortalityRisk predictionComplicationsIntervention criteriaRupturePhenotyping Zebrafish Mutant Models to Assess Candidate Genes Associated with Aortic Aneurysm
Prendergast A, Ziganshin BA, Papanikolaou D, Zafar MA, Nicoli S, Mukherjee S, Elefteriades JA. Phenotyping Zebrafish Mutant Models to Assess Candidate Genes Associated with Aortic Aneurysm. Genes 2022, 13: 123. PMID: 35052463, PMCID: PMC8775119, DOI: 10.3390/genes13010123.Peer-Reviewed Original ResearchConceptsAortic aneurysmSkeletal abnormalitiesThoracic aortic aneurysmWhole-exome sequencingDirect microscopic assessmentSilico genetic analysisVisualized abnormalitiesTAA patientsClinical managementGeneral populationClinical practiceRoutine assessmentClinical testingCell countEvidence-based decisionsUnknown significanceUncertain significanceExperimental modelPilot studyExome sequencingAbnormalitiesMicroscopic assessmentPatientsPositive controlAneurysms
2021
Root 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 diametersAortic Delamination—A Possible Precursor of Impending Catastrophe
Saeyeldin A, Zafar MA, Baldassarre LA, Mojibian H, Ziganshin BA, Mukherjee SK, Elefteriades JA. Aortic Delamination—A Possible Precursor of Impending Catastrophe. International Journal Of Angiology 2021, 30: 160-164. PMID: 34054275, PMCID: PMC8159620, DOI: 10.1055/s-0040-1718546.Peer-Reviewed Original ResearchAortic wall thicknessAdverse aortic eventsAortic eventsChest painDeep hypothermic circulatory arrestHypothermic circulatory arrestAortic repairAortic ruptureCirculatory arrestOpen repairAortic catastropheAortic diameterSurgical pathologyLimited evidencePowerful predictorPainPatientsDissectionSurgical videosRepairWall thicknessPathologyInterstage mortality in two‐stage elephant trunk surgery
Saeyeldin A, Gryaznov AA, Zafar MA, Wu J, Mukherjee S, Vallabhajosyula P, Ziganshin BA, Elefteriades JA. Interstage mortality in two‐stage elephant trunk surgery. Journal Of Cardiac Surgery 2021, 36: 1882-1891. PMID: 33634489, DOI: 10.1111/jocs.15441.Peer-Reviewed Original ResearchConceptsExtensive thoracic aortic aneurysmThoracic aortic aneurysmInterstage intervalStage IIET procedureStage II procedureHospital mortalityInterstage mortalityMega aortaTrunk surgeryAortic ruptureOverall mortalitySingle surgeonAortic diseasePatient groupAortic aneurysmPatientsStage IMortalityCumulative mortalityI procedureInterval periodRupturePrior studiesSafetyIs Aortic Z-score an Appropriate Index of Beneficial Drug Effect in Clinical Trials in Aortic Aneurysm Disease?
Elkinany S, Weismann C, Curtis A, Smith T, Zafar MA, Breen T, Li Y, Tranquilli M, Rizzo JA, Mukherjee SK, Ziganshin BA, Elefteriades JA. Is Aortic Z-score an Appropriate Index of Beneficial Drug Effect in Clinical Trials in Aortic Aneurysm Disease? The American Journal Of Cardiology 2021, 143: 145-153. PMID: 33352210, DOI: 10.1016/j.amjcard.2020.12.025.Peer-Reviewed Original ResearchConceptsBody mass indexAortic Z-scoresZ-score decreaseBeneficial drug effectsZ-scoreMarfan patientsClinical trialsAneurysm diseaseDrug effectsChild's ageEcho examAortic dilation rateDecreased Z-scoreConnective tissue diseaseBody surface areaEffects of medicationAortic aneurysm diseaseClinical drug trialsMass indexTissue diseaseAortic diseaseAneurysmal pathologyDrug trialsInvestigational drugsSpontaneous decrease
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 differencesDiscrepancies in Measurement of the Thoracic Aorta JACC Review Topic of the Week
Elefteriades JA, Mukherjee SK, Mojibian H. Discrepancies in Measurement of the Thoracic Aorta JACC Review Topic of the Week. Journal Of The American College Of Cardiology 2020, 76: 201-217. PMID: 32646571, DOI: 10.1016/j.jacc.2020.03.084.Peer-Reviewed Original Research
2019
Ascending 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 informationRiskPatientsCross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory
Olson K, Sinsky C, Rinne ST, Long T, Vender R, Mukherjee S, Bennick M, Linzer M. Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory. Stress And Health 2019, 35: 157-175. PMID: 30467949, DOI: 10.1002/smi.2849.Peer-Reviewed Original ResearchConceptsMaslach Burnout InventoryPhysician burnoutPrivate practitionersAcademic health systemCross-sectional surveyPrevalence of burnoutBurnout InventoryOdds of burnoutHealth systemAdverse effectsDocumentation timePoor controlPredictors of burnoutBurnout metricMore burnoutWorkplace stressorsValid methodStressorsAcademic facultyHospitalCliniciansPrevalencePhysiciansBurnoutInformation Technology Strategies to Help Mitigate Physician Burnout: “Less Time Typing, More Time Caring”
Hsaio A, Kashyap N, Khokar B, Mukherjee S, Cofrin B, Caisse B, Christian J, Obrien W, Richter B, Sicoli P, Torre C, Travers J, Stanton G, Stump L. Information strategies technologies to help mitigate physician burnout. Healthcare Information and Management Systems Society (HIMSS). Poster. 2019.Peer-Reviewed Original Research
2018
Chapter 22 Current Status of Medical Therapy of Thoracic Aortic Aneurysm and Dissection
Percy A, Mukherjee S, Ziganshin B, Elefteriades J. Chapter 22 Current Status of Medical Therapy of Thoracic Aortic Aneurysm and Dissection. 2018, 235-249. DOI: 10.1016/b978-0-12-809979-7.00022-5.Peer-Reviewed Original ResearchThoracic aortic aneurysmAortic aneurysmMost thoracic aortic aneurysmsAngiotensin receptor blockersClasses of medicationsAortic aneurysm developmentRelevant clinical endpointsAortic aneurysm expansionAsymptomatic patientsLifestyle modificationReceptor blockersMedical therapySurgical repairAortic catastropheClinical evidencePathophysiologic pathwaysSurgical interventionPathophysiologic basisTreatment modalitiesAneurysm expansionClinical endpointsClinical trialsCurrent guidelinesAneurysm formationClinical studies
2017
Medical management of aortic disease in Marfan syndrome.
Bin Mahmood SU, Velasquez CA, Zafar MA, Saeyeldin AA, Brownstein AJ, Ziganshin BA, Elefteriades JA, Mukherjee SK. Medical management of aortic disease in Marfan syndrome. Annals Of Cardiothoracic Surgery 2017, 6: 654-661. PMID: 29270377, PMCID: PMC5721117, DOI: 10.21037/acs.2017.11.09.Peer-Reviewed Original ResearchAngiotensin receptor blockersMedical managementMarfan syndromeMFS patientsThoracic aortic aneurysm diseaseDifferent medical regimensStandard of careAortic aneurysm diseaseNumerous pathophysiological effectsAortic dilatationReceptor blockersAortic diseaseMedical regimensCurrent guidelinesAneurysm diseaseCardiovascular organsΒ-blockersCurrent evidencePathophysiological effectsHereditary disorderPatientsSyndromeDiseaseRegimensManagementChapter 22 - Current Status of Medical Therapy of Thoracic Aortic Aneurysm and Dissection
Percy, AG, Mukherjee, SK, Ziganshin, B, Elefteriades, JE. Book chapter: Current Status of Medical Therapy of Thoracic Aortic Aneurysm and Dissection. (Chapter 22; Nov 2017)BooksComparing Practice Models and Workplace Stressors to Explain Burnout.
Olson, K, Linzer, M, Rinne, S, Mukherjee, S, Bennick, M, Sinsky, C, Krumholz, H, Vender, R, Long, Comparing Practice Models and Workplace Stressors to Explain Burnout. Academy Health Annual Research Meeting. 2017.Peer-Reviewed Original Research
2015
Comparison of Quality of Life Perceived by Patients with Bioprosthetic versus Mechanical Valves after Composite Aortic Root Replacement
Repack A, Ziganshin BA, Elefteriades JA, Mukherjee SK. Comparison of Quality of Life Perceived by Patients with Bioprosthetic versus Mechanical Valves after Composite Aortic Root Replacement. Cardiology 2015, 133: 3-9. PMID: 26389590, DOI: 10.1159/000438783.Peer-Reviewed Original ResearchConceptsMechanical valve groupComposite aortic root replacementAortic root replacementMechanical valvesValve groupRoot replacementSupplemental questionsBioprosthetic valvesBioprosthetic valve groupMechanical composite graftNorm-based scoringSF-36v2 surveyComparison of qualityQoL burdenAnticoagulation therapyMean followQualifying patientsConsecutive patientsPostoperative QOLPostoperative qualityReplacement patientsBlood testingBlood thinnersQOL evaluationHealth Survey