2018
Management of Patients With Coronary Artery Malperfusion Secondary to Type A Aortic Dissection
Kreibich M, Bavaria JE, Branchetti E, Brown CR, Chen Z, Khurshan F, Siki M, Vallabhajosyula P, Szeto WY, Desai ND. Management of Patients With Coronary Artery Malperfusion Secondary to Type A Aortic Dissection. The Annals Of Thoracic Surgery 2018, 107: 1174-1180. PMID: 30444990, DOI: 10.1016/j.athoracsur.2018.09.065.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationCohort StudiesCoronary Artery BypassCoronary Artery DiseaseCoronary CirculationFemaleGermanyHeart Arrest, InducedHospital MortalityHospitals, UniversityHumansKaplan-Meier EstimateLength of StayMaleMiddle AgedPostoperative ComplicationsPrognosisRetrospective StudiesRisk AssessmentStatistics, NonparametricSurvival AnalysisTreatment OutcomeConceptsCoronary artery malperfusionType B patientsType C patientsAntegrade cardioplegiaC patientsB patientsAortic dissectionCoronary ostiumDissection flapCA diseaseA Aortic DissectionType C lesionsManagement of patientsType B lesionsLong-term survivalCA bypassBypass GraftingPerioperative mortalityC lesionsComplete avulsionB lesionsLandmark analysisMalperfusionSuture repairPatients
2017
Fate of remnant sinuses of Valsalva in patients with bicuspid and trileaflet valves undergoing aortic valve, ascending aorta, and aortic arch replacement
Milewski RK, Habertheuer A, Bavaria JE, Siki M, Szeto WY, Krause E, Korutla V, Desai ND, Vallabhajosyula P. Fate of remnant sinuses of Valsalva in patients with bicuspid and trileaflet valves undergoing aortic valve, ascending aorta, and aortic arch replacement. Journal Of Thoracic And Cardiovascular Surgery 2017, 154: 421-432. PMID: 28599977, DOI: 10.1016/j.jtcvs.2017.03.150.Peer-Reviewed Original ResearchConceptsAortic valve replacementBicuspid aortic valveAorta replacementTricuspid aortic valveValve replacementAortic valveValsalva dimensionsPreoperative sinusSinus segmentValvular morphologyValvular pathologyElective aortic valve replacementMultivariable Cox regression modelsAortic arch replacementKaplan-Meier analysisAortic valve morphologyCox regression modelAortic valvulopathyArch replacementSurgical managementAortic aneurysmAortic rootLongitudinal sinusValsalva groupPatients
2016
Valve Selection in End-Stage Renal Disease: Should It Always Be Biological?
Williams ML, Bavaria JE, Acker MA, Desai ND, Vallabhajosyula P, Hargrove WC, Atluri P, Szeto WY. Valve Selection in End-Stage Renal Disease: Should It Always Be Biological? The Annals Of Thoracic Surgery 2016, 102: 1531-1535. PMID: 27544289, DOI: 10.1016/j.athoracsur.2016.04.092.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAnticoagulantsAortic ValveBioprosthesisCalcinosisContraindicationsEndocarditisHeart Valve DiseasesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHumansKaplan-Meier EstimateKidney Failure, ChronicMiddle AgedMitral ValvePostoperative ComplicationsProportional Hazards ModelsProsthesis-Related InfectionsRenal DialysisRetrospective StudiesThrombophiliaConceptsEnd-stage renal diseaseValve replacementProportional hazards modelESRD patientsMechanical valvesRenal diseaseHazards modelImproved long-term survivalCox proportional hazards modelAortic valve replacementMechanical valve replacementMitral valve replacementKaplan-Meier methodLong-term survivalValve selectionESRD populationPatient ageUnadjusted survivalImproved survivalPatient populationPatientsSurvivalDiseaseMinimal differencesYearsAt the Root of the Repair Debate: Outcomes After Elective Aortic Root Replacements for Aortic Insufficiency With Aneurysm
McCarthy FH, Bavaria JE, McDermott KM, Moeller P, Spragan D, Hoedt A, Dibble T, Savino D, Williams ML, Vallabhajosyula P, Szeto WY, Desai ND. At the Root of the Repair Debate: Outcomes After Elective Aortic Root Replacements for Aortic Insufficiency With Aneurysm. The Annals Of Thoracic Surgery 2016, 102: 1199-1205. PMID: 27261085, DOI: 10.1016/j.athoracsur.2016.03.071.Peer-Reviewed Original ResearchMeSH KeywordsAdultAortic Aneurysm, ThoracicAortic Valve InsufficiencyBlood Vessel Prosthesis ImplantationCause of DeathDatabases, FactualElective Surgical ProceduresFemaleFollow-Up StudiesHeart Valve Prosthesis ImplantationHospital MortalityHumansKaplan-Meier EstimateMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment OutcomeConceptsModerate aortic insufficiencySevere aortic insufficiencyAortic insufficiencyLong-term survivalRoot replacementWorse survivalAI patientsDecreased long-term survivalElective aortic root replacementWorse long-term survivalPreoperative aortic insufficiencyPreoperative renal failureAortic root replacementAppropriate therapeutic strategiesGreater aortic insufficiencyTiming of interventionUnited States populationRenal failureYounger patientsMultivariable predictorsSimilar patientsAortic aneurysmSingle institutionInclusion criteriaSimilar survival
2015
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†
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 presentationAortic Annulus Diameter Affects Durability of the Repaired Bicuspid Aortic Valve.
Vallabhajosyula P, Komlo CM, Szeto WY, Rhode T, Menon R, Desai ND, Bavaria JE. Aortic Annulus Diameter Affects Durability of the Repaired Bicuspid Aortic Valve. The Journal Of Heart Valve Disease 2015, 24: 412-9. PMID: 26897808.Peer-Reviewed Original ResearchMeSH KeywordsAdultAortic ValveAortic Valve InsufficiencyBicuspid Aortic Valve DiseaseCardiac Valve AnnuloplastyChi-Square DistributionDisease-Free SurvivalFemaleHeart Valve DiseasesHumansKaplan-Meier EstimateMaleMiddle AgedOdds RatioRecurrenceReplantationRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeConceptsValve-sparing root reimplantationFive-year freedomSubcommissural annuloplastyAnnular diameterSCA groupAI gradeSCA subgroupsBicuspid aortic valve repairAortic insufficiency gradeAortic annular diameterBicuspid aortic valveAortic annulus diameterAortic valve repairBAV repairVSRR groupVSRR patientsMidterm outcomesBAV patientsAortic annulusRetrospective reviewRoot reimplantationValve repairAortic valveUnivariate analysisAnnulus diameter
2014
Impact of timing on major complications after thoracic endovascular aortic repair for acute type B aortic dissection
Desai ND, Gottret JP, Szeto WY, McCarthy F, Moeller P, Menon R, Jackson B, Vallabhajosyula P, Wang GJ, Fairman R, Bavaria JE. Impact of timing on major complications after thoracic endovascular aortic repair for acute type B aortic dissection. Journal Of Thoracic And Cardiovascular Surgery 2014, 149: s151-s156. PMID: 25466855, DOI: 10.1016/j.jtcvs.2014.10.105.Peer-Reviewed Original ResearchConceptsType B dissectionEndovascular aortic repairB dissectionImpact of timingAortic repairAortic dissectionMedical therapyAcute type B aortic dissectionComplicated type B dissectionType B aortic dissectionB aortic dissectionHours of presentationOnset of symptomsRisk of complicationsWeeks of presentationOverall survivalSevere complicationsSurvival benefitMajor complicationsSuch patientsAcute patientsOpen surgeryRetrograde typeClinical registryTEVARValve-sparing root reimplantation and leaflet repair in a bicuspid aortic valve: Comparison with the 3-cusp David procedure
Bavaria JE, Desai N, Szeto WY, Komlo C, Rhode T, Wallen T, Vallabhajosyula P. Valve-sparing root reimplantation and leaflet repair in a bicuspid aortic valve: Comparison with the 3-cusp David procedure. Journal Of Thoracic And Cardiovascular Surgery 2014, 149: s22-s28. PMID: 25500099, DOI: 10.1016/j.jtcvs.2014.10.103.Peer-Reviewed Original ResearchMeSH KeywordsAdultAortic AneurysmAortic ValveAortic Valve InsufficiencyBicuspid Aortic Valve DiseaseBlood Vessel Prosthesis ImplantationCardiac Surgical ProceduresDisease-Free SurvivalFemaleHeart Valve DiseasesHemodynamicsHumansKaplan-Meier EstimateMaleMiddle AgedReoperationReplantationRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeConceptsValve-sparing root reimplantationAortic valve patientsBAV patientsAI gradeMidterm outcomesAortic insufficiencyTransvalvular gradientValve patientsRoot reimplantationLeaflet repairEntire cohortBicuspid aortic valve patientsTricuspid aortic valve patientsAortic valve reoperationPrimary valve repairBicuspid aortic valveExcellent midterm outcomesActuarial freedomPostoperative freedomPostoperative mortalityValve reoperationBAV groupGroup patientsPacemaker requirementRetrospective reviewLong-term results of aggressive hemiarch replacement in 534 patients with type A aortic dissection
Rylski B, Milewski RK, Bavaria JE, Vallabhajosyula P, Moser W, Szeto WY, Desai ND. Long-term results of aggressive hemiarch replacement in 534 patients with type A aortic dissection. Journal Of Thoracic And Cardiovascular Surgery 2014, 148: 2981-2985. PMID: 25112930, DOI: 10.1016/j.jtcvs.2014.05.093.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationFemaleHospital MortalityHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPostoperative ComplicationsReoperationRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeConceptsDeBakey type IDistal aortic reinterventionHemiarch replacementAcute typeAortic reinterventionAortic dissectionDeBakey type I dissectionAdverse aortic eventsType I dissectionAortic arch aneurysmLong-term resultsType IAortic wall tissueDistal reinterventionHospital mortalityAortic eventsReoperation rateTotal archArch aneurysmIndependent predictorsReinterventionStudy populationMarfan syndromePatientsLower mortalityType A Aortic Dissection After Previous Cardiac Surgery: Results of an Integrated Surgical Approach
Rylski B, Desai ND, Bavaria JE, Moser W, Vallabhajosyula P, Pochettino A, Szeto WY, Milewski RK. Type A Aortic Dissection After Previous Cardiac Surgery: Results of an Integrated Surgical Approach. The Annals Of Thoracic Surgery 2014, 97: 1582-1589. PMID: 24629304, DOI: 10.1016/j.athoracsur.2013.12.064.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationCardiac Surgical ProceduresCause of DeathCohort StudiesFemaleFollow-Up StudiesHospital MortalityHumansKaplan-Meier EstimateLength of StayMaleMiddle AgedPatient SafetyPostoperative ComplicationsRadiographyReoperationRetrospective StudiesRisk AssessmentSeverity of Illness IndexStatistics, NonparametricSurvival AnalysisTime FactorsTreatment OutcomeConceptsPrevious cardiac surgeryPCS patientsAortic dissectionCardiac surgeryAcute typeCardiac tamponadeHospital mortality risk factorsAcceptable postoperative mortalityPostoperative stroke ratePrior myocardial revascularizationA Aortic DissectionHospital mortality rateCoronary artery diseaseMortality risk factorsCoronary malperfusionHospital mortalityPostoperative mortalityAortic repairMyocardial revascularizationStanford typeArtery diseaseSurgical repairSurgical approachRisk factorsStroke rate
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
2012
Hybrid approaches in the treatment of aortic arch aneurysms: Postoperative and midterm outcomes
Bavaria J, Vallabhajosyula P, Moeller P, Szeto W, Desai N, Pochettino A. Hybrid approaches in the treatment of aortic arch aneurysms: Postoperative and midterm outcomes. Journal Of Thoracic And Cardiovascular Surgery 2012, 145: s85-s90. PMID: 23260461, DOI: 10.1016/j.jtcvs.2012.11.044.Peer-Reviewed Original ResearchMeSH KeywordsAgedAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationCardiopulmonary BypassEndoleakEndovascular ProceduresFemaleHeart Arrest, InducedHospital MortalityHumansKaplan-Meier EstimateMaleMiddle AgedParaplegiaPhiladelphiaReoperationRisk FactorsStentsSternotomyStrokeTime FactorsTreatment OutcomeConceptsAortic arch aneurysmThoracic endovascular repairArch vessel debranchingArch aneurysmMidterm outcomesAverage cardiopulmonary bypass timeType 1Aortic arch surgeryAortic reoperation ratesCardiopulmonary bypass timeGreater comorbid burdenHybrid arch repairSafe treatment modalityAscending Aortic AneurysmCirculatory arrest timeMedian sternotomy approachGood midterm resultsPercent of casesType III repairType II repairArch surgeryComorbid burdenCrossclamp timeParaplegia ratePostoperative endoleaks