2023
Evidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease
Waldron C, Zafar M, Ziganshin B, Weininger G, Grewal N, Elefteriades J. Evidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease. International Journal Of Molecular Sciences 2023, 24: 15640. PMID: 37958625, PMCID: PMC10650782, DOI: 10.3390/ijms242115640.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic aneurysmCarotid intima-media thicknessLow-density lipoprotein levelsIntima-media thicknessDevelopment of atherosclerosisMatrix metalloproteinase proteinsAscending aneurysmAortic calcificationAtherosclerotic diseaseLipoprotein levelsMyocardial infarctionLeading causeAneurysmsMetalloproteinase proteinsGrowth factorProtective relationshipDiseasePossible mechanismCurrent understandingMorbidityInfarctionAtherosclerosisPatientsPathophysiology“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 treatmentGenetic Overlap of Spontaneous Dissection of Either the Thoracic Aorta or the Coronary Arteries
Jeoffrey S, Kalyanasundaram A, Zafar M, Ziganshin B, Elefteriades J. Genetic Overlap of Spontaneous Dissection of Either the Thoracic Aorta or the Coronary Arteries. The American Journal Of Cardiology 2023, 205: 69-74. PMID: 37591066, DOI: 10.1016/j.amjcard.2023.07.046.Peer-Reviewed Original ResearchConceptsCorresponding molecular pathwaysSpontaneous coronary artery dissectionGenetic overlapMolecular pathwaysGenome-wide association studiesGenetic commonalityGenetic variantsThoracic aortic dissectionIndependent genesGenetic pathwaysSmooth muscle cell functionGenetic methodsAortic dissectionMuscle cell functionAssociation studiesGenetic studiesSudden deathConnective tissue genesGenesTGFβ pathwayCausative genesCoronary artery dissectionTissue genesEarly-onset myocardial infarctionBiologic processesNatural 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 ResearchAortic Size at the Time of Type A and Type B Dissections
Perez Z, Zafar M, Velasco J, Sonsino A, Ellauzi H, John C, Kalyanasundaram A, Ziganshin B, Elefteriades J. Aortic Size at the Time of Type A and Type B Dissections. The Annals Of Thoracic Surgery 2023, 116: 262-268. PMID: 37062339, DOI: 10.1016/j.athoracsur.2023.03.037.Peer-Reviewed Original ResearchConceptsType B dissectionTime of dissectionB dissectionAortic sizeAortic diameterBicuspid aortic valveThoracic aortic aneurysmAortic interventionAortic dissectionSurgical interventionAortic aneurysmFemale sexAortic valveThoracic aortaProphylactic repairUnadjusted regressionLeft shiftLogistic regressionDissectionNew guidelinesType ASize criteriaOddsInterventionTime of typesExtended law of laplace for measurement of the cloverleaf anatomy of the aortic root
Ban E, Kalogerakos P, Khosravi R, Ziganshin B, Ellauzi H, Ramachandra A, Zafar M, Humphrey J, Elefteriades J. Extended law of laplace for measurement of the cloverleaf anatomy of the aortic root. The International Journal Of Cardiovascular Imaging 2023, 39: 1345-1356. PMID: 37046157, PMCID: PMC10250276, DOI: 10.1007/s10554-023-02847-5.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 criteriaKIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection
Velasco J, Li Y, Ziganshin B, Zafar M, Rizzo J, Ma D, Zang H, Kalyanasundaram A, Elefteriades J. KIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection. Genes 2023, 14: 252. PMID: 36833179, PMCID: PMC9956195, DOI: 10.3390/genes14020252.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic dissectionOdds ratioVariant statusArg allele carriersThoracic aortic dissectionOccurrence of ADAortic sizeArg alleleMarked adverse impactTAA patientsAortic aneurysmClinical assessmentSurgical decisionAllele carriersIncrease riskVariant patientsArg carriersPilot studyDissectionImportant intracellular functionsConfirmatory findingsPatientsAneurysmsPresent study
2022
Current status of adult cardiac surgery–part 2
Hirji S, Percy E, Trager L, Dewan K, Seese L, Saeyeldin A, Hubbard J, Zafar M, Rinewalt D, Alnajar A, Newell P, Kaneko T, Aranki S, Shekar P. Current status of adult cardiac surgery–part 2. Current Problems In Surgery 2022, 60: 101245. PMID: 36642488, DOI: 10.1016/j.cpsurg.2022.101245.Peer-Reviewed Original ResearchCurrent status of adult cardiac surgery—Part 1
Hirji S, Percy E, Trager L, Dewan K, Seese L, Saeyeldin A, Hubbard J, Zafar M, Rinewalt D, Alnajar A, Newell P, Kaneko T, Aranki S, Shekar P. Current status of adult cardiac surgery—Part 1. Current Problems In Surgery 2022, 59: 101246. PMID: 36496252, DOI: 10.1016/j.cpsurg.2022.101246.Peer-Reviewed Original ResearchLong‐term risk of arch complications in Loeys Dietz syndrome patients undergoing proximal ascending aortic replacement
Weininger G, Zafar M, Ziganshin BA, Mori M, Papanikolaou D, Sekar RB, Amabile A, Degife E, O'Marr J, Geirsson A, Elefteriades JA, Assi R, Vallabhajosyula P. Long‐term risk of arch complications in Loeys Dietz syndrome patients undergoing proximal ascending aortic replacement. Journal Of Cardiac Surgery 2022, 37: 3688-3692. PMID: 35989525, DOI: 10.1111/jocs.16855.Peer-Reviewed Original ResearchConceptsLoeys-Dietz syndromeProximal aortic replacementAortic replacementLDS patientsLong-term riskLoeys-Dietz syndrome patientsPathogenic variantsUnknown significanceLower long-term riskRare connective tissue disorderAscending Aortic ReplacementTotal arch replacementAortic valve replacementRecords of patientsConnective tissue disordersWhole-exome genetic testingArch replacementMedian followLatest followValve replacementOperative coursePatient chartsAortic diameterAortic dimensionsAortic archAscending aneurysmectomy: Should we shift to the left? ∗
Elefteriades J, Rizzo J, Zafar M, Ziganshin B. Ascending aneurysmectomy: Should we shift to the left? ∗. Journal Of Thoracic And Cardiovascular Surgery 2022, 166: 435-441. PMID: 36109210, DOI: 10.1016/j.jtcvs.2022.07.033.Peer-Reviewed Original ResearchBovine Aortic Arch: A Result of Chance or Mandate of Inheritance?
Shang M, Vinholo TF, Buntin J, Zafar MA, Ziganshin BA, Elefteriades JA. Bovine Aortic Arch: A Result of Chance or Mandate of Inheritance? The American Journal Of Cardiology 2022, 172: 115-120. PMID: 35321803, PMCID: PMC9978865, DOI: 10.1016/j.amjcard.2022.02.030.Peer-Reviewed Original ResearchConceptsBovine archThoracic aortic aneurysmAortic aneurysmThoracic aortic aneurysm diseaseAortic arch configurationAortic aneurysm diseaseSecond-degree relativesInstitutional databaseAneurysm diseaseChest imagingPatientsAneurysmsAvailable scansGenetic mutationsArch resultsArchArch configurationFamily membersSample populationProbandsScansMagnetic resonanceResult of chancePrevious studiesChestEngineering analysis of aortic wall stress and root dilatation in the V-shape surgery for treatment of ascending aortic aneurysms
Dong H, Liu M, Qin T, Liang L, Ziganshin B, Ellauzi H, Zafar M, Jang S, Elefteriades J, Sun W. Engineering analysis of aortic wall stress and root dilatation in the V-shape surgery for treatment of ascending aortic aneurysms. Interdisciplinary CardioVascular And Thoracic Surgery 2022, 34: 1124-1131. PMID: 35134955, PMCID: PMC9159430, DOI: 10.1093/icvts/ivac004.Peer-Reviewed Original ResearchConceptsRoot dilatationAortic rootAortic wall stressAortic aneurysmWall stressComputed tomography imagesTime pointsAortic root diameterTomography imagesSignificant reductionPost-surgery statesWhole aortaAortic wallSurgeryDilatationClinical cardiacPatientsAverage dilatationStudy objectiveAneurysmsAortaBiomechanical analysisTreatmentA novel computational growth framework for biological tissues: Application to growth of aortic root aneurysm repaired by the V-shape surgery
Dong H, Liu M, Qin T, Liang L, Ziganshin B, Ellauzi H, Zafar M, Jang S, Elefteriades J, Sun W, Gleason RL. A novel computational growth framework for biological tissues: Application to growth of aortic root aneurysm repaired by the V-shape surgery. Journal Of The Mechanical Behavior Of Biomedical Materials 2022, 127: 105081. PMID: 35092917, DOI: 10.1016/j.jmbbm.2022.105081.Peer-Reviewed Original ResearchA 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 controlAneurysmsProgress in surgical interventions for aortic root aneurysms and dissections
Parameswaran S, Ziganshin BA, Zafar M, Elefteriades JA. Progress in surgical interventions for aortic root aneurysms and dissections. Expert Review Of Cardiovascular Therapy 2022, 20: 65-79. PMID: 35037567, DOI: 10.1080/14779072.2022.2029702.Peer-Reviewed Original ResearchConceptsAortic root aneurysmRoot aneurysmAortic root replacement surgeryAortic root surgeryAortic valve leafletsValve dysfunctionAortic dissectionAortic pathologyProgressive dilatationSurgical optionsAneurysmal diseaseSurgical interventionCoronary arteryRoot surgeryAortic rootAortic tubeReplacement surgerySurgical investigationAnatomic patternsPubMed databaseRisk profileValve leafletsSystematic searchSurgeryAneurysms
2021
Nationwide collaboration produces valuable data regarding arch and descending aorta
Elefteriades JA, Zafar MA, Ziganshin BA. Nationwide collaboration produces valuable data regarding arch and descending aorta. European Heart Journal 2021, 43: 2370-2372. PMID: 34904151, DOI: 10.1093/eurheartj/ehab854.Peer-Reviewed Original ResearchGetting to the root of aortic dissection in congenital heart disease
Zafar MA, Ziganshin BA, Elefteriades JA. Getting to the root of aortic dissection in congenital heart disease. European Journal Of Cardio-Thoracic Surgery 2021, 61: 318-319. PMID: 34718492, DOI: 10.1093/ejcts/ezab464.Peer-Reviewed Original Research