2018
Functional Outcomes of Type I Bicuspid Aortic Valve Repair With Annular Stabilization: Subcommissural Annuloplasty Versus External Subannular Aortic Ring
Ko H, Bavaria JE, Habertheuer A, Augoustides JG, Siki MA, Freas M, Komlo C, Milewski K, Desai ND, Szeto WY, Vallabhajosyula P. Functional Outcomes of Type I Bicuspid Aortic Valve Repair With Annular Stabilization: Subcommissural Annuloplasty Versus External Subannular Aortic Ring. The Annals Of Thoracic Surgery 2018, 107: 68-75. PMID: 30086284, DOI: 10.1016/j.athoracsur.2018.06.056.Peer-Reviewed Original ResearchConceptsSubcommissural annuloplastyAortic insufficiencyAortic valve repairTransvalvular gradientValve repairAortic ringsLeaflet prolapseAnnular stabilizationVentricular outflow tract diameterBicuspid aortic valve patientsBicuspid aortic valve repairOutflow tract diameterSevere aortic insufficiencyMean transvalvular gradientIntraoperative transesophageal echocardiographyAortic valve patientsLV outflow tractAortic root complexPostprocedure outcomesValve patientsTract diameterFunctional outcomeLV dimensionsTransesophageal echocardiographyOutflow tractPredictors of Recurrent Aortic Insufficiency in Type I Bicuspid Aortic Valve Repair
Habertheuer A, Milewski RK, Bavaria JE, Siki M, Freas M, Desai N, Szeto W, Ram C, Hu R, Vallabhajosyula P. Predictors of Recurrent Aortic Insufficiency in Type I Bicuspid Aortic Valve Repair. The Annals Of Thoracic Surgery 2018, 106: 1316-1324. PMID: 30055138, DOI: 10.1016/j.athoracsur.2018.06.026.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedAortic ValveAortic Valve InsufficiencyBicuspid Aortic Valve DiseaseCardiac Valve AnnuloplastyDatabases, FactualFemaleFollow-Up StudiesHeart Valve DiseasesHeart Valve ProsthesisHumansLogistic ModelsMaleMiddle AgedPredictive Value of TestsRecurrenceReoperationRetrospective StudiesRisk AssessmentSurvival RateTreatment OutcomeTricuspid valve endocarditis in the era of the opioid epidemic
Wallen TJ, Szeto W, Williams M, Atluri P, Arnaoutakis G, Fults M, Sultan I, Desai N, Acker M, Vallabhajosyula P. Tricuspid valve endocarditis in the era of the opioid epidemic. Journal Of Cardiac Surgery 2018, 33: 260-264. PMID: 29663522, DOI: 10.1111/jocs.13600.Peer-Reviewed Original ResearchConceptsTricuspid valve endocarditisOpioid epidemicTricuspid endocarditisValve endocarditisRight heart endocarditisThirty-day mortalityTricuspid valve replacementCommon causative agentIndex hospitalizationRenal failureValve replacementSurgical volumeInstitutional experienceCommon isolatesExclusion criteriaEndocarditisAverage agePatientsStudy periodCausative agentStaphylococcus aureusEpidemicFivefold increaseReoperationHospitalizationOutcome After Operation for Aortic Dissection Type A in Morbidly Obese Patients
Kreibich M, Rylski B, Bavaria JE, Branchetti E, Dohle D, Moeller P, Vallabhajosyula P, Szeto WY, Desai ND. Outcome After Operation for Aortic Dissection Type A in Morbidly Obese Patients. The Annals Of Thoracic Surgery 2018, 106: 491-497. PMID: 29673638, DOI: 10.1016/j.athoracsur.2018.03.035.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAortic AneurysmAortic DissectionBody Mass IndexBody WeightCohort StudiesComorbidityFemaleHospital MortalityHumansLogistic ModelsMaleMiddle AgedObesity, MorbidOdds RatioPostoperative ComplicationsPrognosisReference ValuesRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment OutcomeConceptsAortic dissection type AMorbidly obese patientsNormal weight patientsObese patientsSurgical repairWeight patientsDistal aortic repairImmediate surgical approachMore obese patientsCalculated blood volumeBody mass indexIntensive care unitLength of stayType AHospital mortalityHospital stayPostoperative complicationsAortic repairPostoperative outcomesCare unitClinical featuresClinical presentationMass indexNormal weightAdverse outcomes
2017
The role of extracorporeal membrane oxygenator therapy in the setting of Type A aortic dissection
Sultan I, Habertheuer A, Wallen T, Siki M, Szeto W, Bavaria JE, Williams M, Vallabhajosyula P. The role of extracorporeal membrane oxygenator therapy in the setting of Type A aortic dissection. Journal Of Cardiac Surgery 2017, 32: 822-825. PMID: 29216679, DOI: 10.1111/jocs.13245.Peer-Reviewed Original ResearchConceptsPost-operative dayAortic dissectionTAAD repairECMO supportPennsylvania Health Care Cost Containment Council databaseDiagnosis/procedure codesType A Aortic DissectionFirst post-operative dayAcute cardiopulmonary failurePost-cardiotomy shockSame hospital visitA Aortic DissectionAcute aortic dissectionSame dayWide clinical spectrumSalvage therapyTAAD surgeryECMO implantationCardiopulmonary failureHemodynamic stabilityCardiovascular collapseOpen repairOverall mortalityMedian timeClinical spectrumCentral cannulation strategy for extent I thoracoabdominal aneurysm repair of chronic type B aortic dissection
Hobbs RD, Wallen TJ, Komlo CM, Moeller PJ, Pochettino A, Bavaria JE, Vallabhajosyula P. Central cannulation strategy for extent I thoracoabdominal aneurysm repair of chronic type B aortic dissection. Journal Of Cardiac Surgery 2017, 32: 494-499. PMID: 28691213, DOI: 10.1111/jocs.13171.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionCardiopulmonary BypassCatheterization, Central VenousChronic DiseaseCirculatory Arrest, Deep Hypothermia InducedEchocardiographyFemaleFemoral ArteryHumansMaleMiddle AgedSafetySurgery, Computer-AssistedThoracotomyTreatment OutcomeVascular Surgical ProceduresConceptsChronic type B dissectionThoracoabdominal aortic aneurysmsType B dissectionExtent I thoracoabdominal aortic aneurysmLeft thoracotomy incisionCannulation strategyB dissectionGroup IIGroup IThoracotomy incisionFemoral vesselsChronic type B aortic dissectionDeep hypothermic circulatory arrestType B aortic dissectionAlternative cannulation siteCentral aortic cannulationProximal aortic reconstructionThoracoabdominal aneurysm repairB aortic dissectionCirculatory arrest timeHypothermic circulatory arrestActuarial survivalCPB timeGroin incisionTAAA repairLong-term outcome of surgical cryoablation for refractory ventricular tachycardia in patients with non-ischemic cardiomyopathy
Liang JJ, Betensky BP, Muser D, Zado ES, Anter E, Desai ND, Callans DJ, Deo R, Frankel DS, Hutchinson MD, Lin D, Riley MP, Schaller RD, Supple GE, Santangeli P, Acker MA, Bavaria JE, Szeto WY, Vallabhajosyula P, Marchlinski FE, Dixit S. Long-term outcome of surgical cryoablation for refractory ventricular tachycardia in patients with non-ischemic cardiomyopathy. EP Europace 2017, 20: e30-e41. PMID: 28402404, DOI: 10.1093/europace/eux029.Peer-Reviewed Original ResearchConceptsNon-ischemic cardiomyopathyRadiofrequency catheter ablationLong-term outcomesSurgical ablationVT refractoryElectrophysiology labSocial Security Death IndexArrhythmia-related deathMapping/ablationPrimary surgical ablationRefractory ventricular tachycardiaVentricular tachycardia refractoryVT-free survivalLong-term survivalSurgical cryoablationICD interrogationConsecutive patientsEntire followCatheter ablationICD shocksTachycardia refractoryVT recurrenceOffice visitsTherapeutic optionsConsecutive pts
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 differencesYearsConcomitant aortic arch reconstruction using deep hypothermic circulatory arrest during heart transplantation.
Hobbs R, Gottret JP, Menon R, Komlo C, Pochettino A, Acker M, Vallabhajosyula P. Concomitant aortic arch reconstruction using deep hypothermic circulatory arrest during heart transplantation. The Journal Of Cardiovascular Surgery 2016, 57: 620-3. PMID: 27366883.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAorta, ThoracicAortic Aneurysm, ThoracicAortographyBlood Vessel Prosthesis ImplantationCirculatory Arrest, Deep Hypothermia InducedComputed Tomography AngiographyFemaleHeart FailureHeart TransplantationHumansMaleMiddle AgedPostoperative ComplicationsTreatment OutcomeYoung AdultAt 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 survivalBicuspid Aortic Insufficiency With Aortic Root Aneurysm: Root Reimplantation Versus Bentall Root Replacement
Vallabhajosyula P, Szeto WY, Habertheuer A, Komlo C, Milewski RK, McCarthy F, Desai ND, Bavaria JE. Bicuspid Aortic Insufficiency With Aortic Root Aneurysm: Root Reimplantation Versus Bentall Root Replacement. The Annals Of Thoracic Surgery 2016, 102: 1221-1228. PMID: 27261086, DOI: 10.1016/j.athoracsur.2016.03.087.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAorta, ThoracicAortic Aneurysm, ThoracicAortic ValveAortic Valve InsufficiencyBicuspid Aortic Valve DiseaseBlood Vessel Prosthesis ImplantationCombined Modality TherapyDatabases, FactualEchocardiography, TransesophagealFemaleFollow-Up StudiesHeart Valve DiseasesHeart Valve Prosthesis ImplantationHumansMaleMiddle AgedPreoperative CareRetrospective StudiesRisk AssessmentSurvival RateTime FactorsTreatment OutcomeVascular Surgical ProceduresConceptsAortic insufficiencyBicuspid aortic valveBentall groupRoot replacementRoot reimplantationAortic valveCusp repairRoot aneurysmFive-year actuarial survivalValve-sparing root reimplantationBicuspid aortic insufficiencyHospital stroke ratePermanent pacemaker rateTransient ischemic attackVentricular diastolic diameterLow ejection fractionAortic root aneurysmAortic root proceduresActuarial survivalAortic reoperationDischarge echocardiographyHospital mortalityIschemic attackVSRR groupBentall procedure
2015
Nearly Missed: Postpartum Type B Aortic Dissection
Ahluwalia M, Parmacek MS, Sayani FA, Vallabhajosyula P. Nearly Missed: Postpartum Type B Aortic Dissection. The American Journal Of Medicine 2015, 128: 1188-1190. PMID: 26264721, DOI: 10.1016/j.amjmed.2015.07.023.Peer-Reviewed Original ResearchAortic 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 diameterOutcomes of Aortic Root Replacement After Previous Aortic Root Replacement: The “True” Redo Root
Jassar AS, Desai ND, Kobrin D, Pochettino A, Vallabhajosyula P, Milewski RK, McCarthy F, Maniaci J, Szeto WY, Bavaria JE. Outcomes of Aortic Root Replacement After Previous Aortic Root Replacement: The “True” Redo Root. The Annals Of Thoracic Surgery 2015, 99: 1601-1609. PMID: 25754965, DOI: 10.1016/j.athoracsur.2014.12.038.Peer-Reviewed Original ResearchConceptsAortic root replacementDe novo groupRedo root replacementRoot replacementNovo groupRedo groupPrevious aortic root replacementRedo aortic root replacementFirst-time sternotomyFull aortic root replacementLow perioperative morbidityStructural valve deteriorationRisk of complicationsPresence of infectionAortic reoperationHospital lengthLate deathsPerioperative deathsSternal infectionUnderwent reoperationMidterm survivalPerioperative morbidityRenal failureOverall mortalityValve deterioration
2014
Valve-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 reviewExtracorporeal life support as rescue strategy for out-of-hospital and emergency department cardiac arrest
Johnson NJ, Acker M, Hsu CH, Desai N, Vallabhajosyula P, Lazar S, Horak J, Wald J, McCarthy F, Rame E, Gray K, Perman SM, Becker L, Cowie D, Grossestreuer A, Smith T, Gaieski DF. Extracorporeal life support as rescue strategy for out-of-hospital and emergency department cardiac arrest. Resuscitation 2014, 85: 1527-1532. PMID: 25201611, DOI: 10.1016/j.resuscitation.2014.08.028.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedCardiopulmonary ResuscitationConfidence IntervalsEmergency Service, HospitalExtracorporeal Membrane OxygenationFemaleFollow-Up StudiesHeart ArrestHospital MortalityHumansLife Support SystemsMaleMiddle AgedOut-of-Hospital Cardiac ArrestPhiladelphiaProspective StudiesRegistriesRisk AssessmentSurvival AnalysisTreatment OutcomeConceptsEmergency department cardiac arrestED cardiac arrestCardiac arrestLife supportRescue strategyUrban academic medical centerInitiation of ECLSHours of admissionInitial cardiac rhythmExtracorporeal life supportPulseless ventricular tachycardiaInitial cardiac arrestConventional cardiopulmonary resuscitationAcademic medical centerHospital dischargeIschemic eventsConsecutive patientsPrimary outcomePatient selectionInstitution experienceVentricular tachycardiaECLS cannulationVentricular fibrillationCardiopulmonary resuscitationMedical CenterEndovascular repair of the ascending aorta in patients at high risk for open repair
Vallabhajosyula P, Gottret JP, Bavaria JE, Desai ND, Szeto WY. Endovascular repair of the ascending aorta in patients at high risk for open repair. Journal Of Thoracic And Cardiovascular Surgery 2014, 149: s144-s150. PMID: 25218530, DOI: 10.1016/j.jtcvs.2014.07.063.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAneurysm, FalseAortic AneurysmAortic DissectionAortographyBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationComorbidityEndovascular ProceduresHumansLength of StayMaleMiddle AgedProsthesis DesignRetrospective StudiesRisk FactorsStentsTime FactorsTomography, X-Ray ComputedTreatment OutcomeYoung AdultConceptsEndovascular repairAortic pathologyHigh riskStent graft lengthOpen surgical treatmentThoracic aortic pathologyAmplatzer occluder deviceCommon carotid arteryCurrent endovascular technologyIntraoperative endoleaksMinor strokeProhibitive riskAortic dissectionOpen repairSurgical treatmentAortic accessOpen surgeryTechnical successZenith TX2Extensive comorbidityOccluder deviceIliac limbCarotid arteryEmergency basisEndovascular technologyType A Aortic Dissection in Marfan Syndrome
Rylski B, Bavaria JE, Beyersdorf F, Branchetti E, Desai ND, Milewski RK, Szeto WY, Vallabhajosyula P, Siepe M, Kari FA. Type A Aortic Dissection in Marfan Syndrome. Circulation 2014, 129: 1381-1386. PMID: 24594630, DOI: 10.1161/circulationaha.113.005865.Peer-Reviewed Original ResearchConceptsMarfan syndromeAortic dissectionPrimary surgeryAortic dissection type AAortic arch surgeryAortic root reoperationComposite valved graftHemi-arch replacementA Aortic DissectionAortic root replacementComplex clinical courseAortic root replacement procedureLong-term resultsValve-sparing aortic root replacement procedureRoot replacement proceduresAorta interventionAortic reinterventionArch surgeryHospital mortalityRoot reinterventionRoot reoperationArch repairEmergency surgeryRoot replacementStanford typeMinimally Invasive Mitral Valve Surgery Utilizing Heart Port Technology
Vallabhajosyula P, Wallen TJ, Solometo LP, Fox J, Vernick WJ, Hargrove WC. Minimally Invasive Mitral Valve Surgery Utilizing Heart Port Technology. Journal Of Cardiac Surgery 2014, 29: 343-348. PMID: 24495015, DOI: 10.1111/jocs.12293.Peer-Reviewed Original ResearchConceptsMitral valve surgeryInvasive mitral valve surgeryPort-access technologyPrevious cardiac operationsValve surgeryMitral regurgitationMitral stenosisGroup 1Operative outcomesCardiac operationsPrevious aortic valve surgeryPrevious mitral valve surgeryPrevious coronary artery bypassMedian hospital stayMitral valve casesAortic valve surgeryCardiac surgery patientsCoronary artery bypassSevere mitral regurgitationTrace mitral regurgitationChitwood clampFibrillatory arrestArtery bypassHospital mortalityHospital stay
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