2023
Natural History and Intervention Thresholds for Ascending Thoracic Aortic Aneurysm—Not an Easy Nut to Crack
Zafar M, Elefteriades J. Natural History and Intervention Thresholds for Ascending Thoracic Aortic Aneurysm—Not an Easy Nut to Crack. JAMA Cardiology 2023, 8: 512-512. PMID: 36920367, DOI: 10.1001/jamacardio.2023.0153.Peer-Reviewed Original ResearchThe natural history of aortic root aneurysms
Ziganshin B, Kargin N, Zafar M, Elefteriades J. The natural history of aortic root aneurysms. Annals Of Cardiothoracic Surgery 2023, 12: 21324-21224. PMID: 37304695, PMCID: PMC10248916, DOI: 10.21037/acs-2023-avs1-20.Peer-Reviewed Original ResearchFate 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
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 diameters
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 differencesThoracic aortic aneurysm gene dictionary
Rohde S, Zafar MA, Ziganshin BA, Elefteriades JA. Thoracic aortic aneurysm gene dictionary. Asian Cardiovascular And Thoracic Annals 2020, 29: 682-696. PMID: 32689806, DOI: 10.1177/0218492320943800.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic aneurysmRisk of dissectionSpecific causative mutationSmaller aortic sizeSystemic manifestationsAortic sizeDissection patientsLethal complicationGenetic predispositionProgressive enlargementAneurysmsNatural historyPersonalized careAneurysm growthPatientsFamilial casesClinical realityDissectionNon-syndromic thoracic aortic aneurysmsSubstantial proportionGenetic sequencingDisease phenotypeCausative genesHigh rateThe Genetics of Thoracic Aortic Aneurysms and Dissection: A Clinical Perspective
Ostberg NP, Zafar MA, Ziganshin BA, Elefteriades JA. The Genetics of Thoracic Aortic Aneurysms and Dissection: A Clinical Perspective. Biomolecules 2020, 10: 182. PMID: 31991693, PMCID: PMC7072177, DOI: 10.3390/biom10020182.Peer-Reviewed Original ResearchConceptsAortic aneurysmThoracic aortic aneurysmHigh mortality rateGenetic screening testsClinical manifestationsSurgical interventionNon-syndromic TAADHigh riskMortality rateClear genetic basisScreening testNatural historyClinical perspectiveTAADDegenerative diseasesDissectionCellular mechanismsBiomechanical stressPatientsAneurysmsDiseaseAortaExtensive investigation
2019
Natural history and management of Kommerell's diverticulum in a single tertiary referral center
Erben Y, Brownstein AJ, Velasquez CA, Li Y, Rizzo JA, Mojibian H, Tanweer M, Zafar MA, Ziganshin BA, Elefteriades JA. Natural history and management of Kommerell's diverticulum in a single tertiary referral center. Journal Of Vascular Surgery 2019, 71: 2004-2011. PMID: 31708305, DOI: 10.1016/j.jvs.2019.08.260.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAortaAortic RuptureAortographyCardiovascular AbnormalitiesComputed Tomography AngiographyConnecticutDatabases, FactualDisease ProgressionDiverticulumFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsSex FactorsSubclavian ArteryTertiary Care CentersTreatment OutcomeVascular MalformationsVascular Surgical ProceduresYoung AdultConceptsAberrant subclavian arteryKommerell's diverticulumNatural historyOperative interventionBack painCT scanChest/back painLeft aberrant subclavian arteryRight aberrant subclavian arterySingle tertiary referral centerRight-sided aortaSingle-center experienceTertiary referral centerDeep vein thrombosisSerial CT scansComputed tomography scanMultivariable regression analysisRare developmental abnormalityAsymptomatic patientsHemorrhagic transformationDistal emboliEndovascular repairIschemic strokeMost patientsReferral centerAscending 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 informationRiskPatientsNonsyndromic Thoracic Aortic Aneurysms and Dissections—Is Screening Possible?
Faggion Vinholo T, Zafar MA, Ziganshin BA, Elefteriades JA. Nonsyndromic Thoracic Aortic Aneurysms and Dissections—Is Screening Possible? Seminars In Thoracic And Cardiovascular Surgery 2019, 31: 628-634. PMID: 31212014, DOI: 10.1053/j.semtcvs.2019.05.035.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmTAAD patientsAortic aneurysmFatal natural historySerologic screening testsProphylactic surgical interventionNormal life expectancyObvious clinical signsRoutine genetic testingWhole-exome sequencingTAAD casesSurgical interventionClinical signsTimely diagnosisScreening testClinical settingNatural historyGenetic testingTAADExome sequencingDisease-causing genesGenetic mutationsLife expectancyDiagnosisPatientsGenes Associated with Thoracic Aortic Aneurysm and Dissection: 2019 Update and Clinical Implications
Vinholo T, Brownstein AJ, Ziganshin BA, Zafar MA, Kuivaniemi H, Body SC, Bale AE, Elefteriades JA. Genes Associated with Thoracic Aortic Aneurysm and Dissection: 2019 Update and Clinical Implications. Aorta 2019, 07: 099-107. PMID: 31842235, PMCID: PMC6914358, DOI: 10.1055/s-0039-3400233.Peer-Reviewed Original Research
2018
Descending threshold for ascending aortic aneurysmectomy: Is it time for a “left-shift” in guidelines?
Ziganshin BA, Zafar MA, Elefteriades JA. Descending threshold for ascending aortic aneurysmectomy: Is it time for a “left-shift” in guidelines? Journal Of Thoracic And Cardiovascular Surgery 2018, 157: 37-42. PMID: 30557953, DOI: 10.1016/j.jtcvs.2018.07.114.Peer-Reviewed Original ResearchConceptsAortic sizeSmaller aortic sizeThoracic aortic diseaseAortic aneurysmectomyAortic surgeryAortic dissectionAortic catastropheAortic diameterAortic diseaseAortic aneurysmCurrent guidelinesLeftward shiftNatural historyGenetic testingMore granular dataCenterline methodGenetic defectsAneurysmsFamily membersGuidelinesAneurysmectomyPatientsSurgeryAorta
2017
Thoracic aortic aneurysm: unlocking the “silent killer” secrets
Saeyeldin AA, Velasquez CA, Mahmood SUB, Brownstein AJ, Zafar MA, Ziganshin BA, Elefteriades JA. Thoracic aortic aneurysm: unlocking the “silent killer” secrets. General Thoracic And Cardiovascular Surgery 2017, 67: 1-11. PMID: 29204794, DOI: 10.1007/s11748-017-0874-x.Peer-Reviewed Original ResearchConceptsAortic aneurysmAngiotensin receptor blockersFamilial patternBicuspid aortic valveAbdominal aortic aneurysmRisk of ruptureDifferent embryologic originsReceptor blockersBeta blockersType of repairThoracic aneurysmInflammatory disordersFemale sexSerum biomarkersAortic valveWorse outcomesEmbryologic originMedical treatmentEnzyme inhibitorsAneurysmsSilent killerIntracranial aneurysmsNatural historyOnly reliable methodPattern of inheritanceNatural history of aortic root aneurysms in Marfan syndrome.
Saeyeldin A, Zafar MA, Velasquez CA, Ip K, Gryaznov A, Brownstein AJ, Li Y, Rizzo JA, Erben Y, Ziganshin BA, Elefteriades JA. Natural history of aortic root aneurysms in Marfan syndrome. Annals Of Cardiothoracic Surgery 2017, 6: 625-632. PMID: 29270374, PMCID: PMC5721101, DOI: 10.21037/acs.2017.11.10.Peer-Reviewed Original ResearchAortic root aneurysmAortic root diameterAortic dissectionRoot aneurysmMFS patientsAortic complicationsAdverse eventsAortic rootNatural historyRisk of complicationsAortic root dilatationMarfan syndrome patientsLogistic regression modelsAortic regurgitationCardiovascular complicationsHemodynamic roleDreadful complicationRoot dilatationAortic diameterLarge aneurysmsSyndrome patientsMarfan syndromeComplicationsPatientsAneurysms