2025
Midterm Outcomes of thoracic endovascular aortic repair versus Optimal Medical Therapy for Uncomplicated Acute Type B Dissection
Hu K, Ma W, Pupovac S, Hameed I, Fereydooni S, Li E, Larson H, Zafar M, Tonnessen B, Cardella J, Aboian E, Guzman R, Chaar C, Strosberg D, Williams M, Nassiri N, Assi R, Vallabhajosyula P. Midterm Outcomes of thoracic endovascular aortic repair versus Optimal Medical Therapy for Uncomplicated Acute Type B Dissection. JTCVS Open 2025 DOI: 10.1016/j.xjon.2024.12.013.Peer-Reviewed Original ResearchThoracic endovascular aortic repairThoracic endovascular aortic repair groupOptimal medical therapyOptimal medical therapy groupMidterm outcomes of thoracic endovascular aortic repairOutcomes of thoracic endovascular aortic repairUncomplicated acute type B aortic dissectionEndovascular aortic repairAcute kidney injuryAortic repairMidterm outcomesMedical therapyUncomplicated acute type B dissectionAcute type B aortic dissectionAcute type B dissectionAssociated with improved survivalType B aortic dissectionThirty-day ratesType B dissectionB aortic dissectionPost-operative dataMidterm follow-upIn-hospital/30-day mortalityKaplan-Meier survivalB dissectionSex-Differences in the Patterns of Cardiovascular Referral in Patients with Marfan, Ehlers-Danlos, and Loeys-Dietz Syndromes
Waldron C, Nasir A, Wang K, Chou A, Erez E, Vallabhajosyula P, Assi R. Sex-Differences in the Patterns of Cardiovascular Referral in Patients with Marfan, Ehlers-Danlos, and Loeys-Dietz Syndromes. JTCVS Open 2025 DOI: 10.1016/j.xjon.2025.01.002.Peer-Reviewed Original ResearchCardiothoracic surgeryConnective tissue diseaseFemale patientsEhlers-DanlosAortic pathologyLoeys-DietzCardiovascular medicineMale patientsTissue diseaseRetrospective review of patientsReview of patientsLoeys-Dietz syndromeDiagnosis of MFSReferral ratesSex differencesMFS patientsRetrospective reviewAortic diseaseRate of referralSurgeryPatientsMedical recordsClinical diagnosisElectronic medical recordsObjective diagnosis
2024
Clinical Effectiveness of Genetic Testing Guidelines in Patients with Thoracic Aortic Aneurysms
Erez E, Acuna Higaki A, Cupo M, Phu T, Verma S, Assi R, Vallabhajosyula P. Clinical Effectiveness of Genetic Testing Guidelines in Patients with Thoracic Aortic Aneurysms. Journal Of Thoracic And Cardiovascular Surgery 2024 PMID: 39321868, DOI: 10.1016/j.jtcvs.2024.09.026.Peer-Reviewed Original ResearchFeatures of connective tissue diseaseThoracic aortic diseaseConnective tissue diseaseThoracic aortic aneurysmGenetic testing guidelinesSyndromic featuresMutation rateFamily historyVUS rateAortic aneurysmPrimary genesGenetic testingAssociated with thoracic aortic diseaseThoracic aorta diameterTesting guidelinesAorta diameterPathogen mutation rateAortic diseaseRisk stratificationSecondary genesPathogenic mutationsTissue diseaseClinical effectsVUSGenesHeterogeneous Cardiac- and Neural Crest-Derived Aortic Smooth Muscle Cells have Similar Transcriptional Changes after TGFβ Signaling Disruption.
Ren P, Jiang B, Hassab A, Li G, Li W, Assi R, Tellides G. Heterogeneous Cardiac- and Neural Crest-Derived Aortic Smooth Muscle Cells have Similar Transcriptional Changes after TGFβ Signaling Disruption. BioRxiv 2024 PMID: 38746256, DOI: 10.1101/2024.04.28.591539.Peer-Reviewed Original ResearchShort-Term Disruption of TGFβ Signaling in Adult Mice Renders the Aorta Vulnerable to Hypertension-Induced Dissection.
Jiang B, Ren P, He C, Wang M, Murtada SI, Chen Y, Ramachandra AB, Li G, Qin L, Assi R, Schwartz MA, Humphrey JD, Tellides G. Short-Term Disruption of TGFβ Signaling in Adult Mice Renders the Aorta Vulnerable to Hypertension-Induced Dissection. BioRxiv 2024 PMID: 38712205, DOI: 10.1101/2024.04.22.590484.Peer-Reviewed Original ResearchIntimomedial tears of the aorta heal by smooth muscle cell-mediated fibrosis without atherosclerosis
Hassab A, Hur D, Vallabhajosyula P, Tellides G, Assi R. Intimomedial tears of the aorta heal by smooth muscle cell-mediated fibrosis without atherosclerosis. JCI Insight 2024, 9: e172437. PMID: 38592807, PMCID: PMC11141924, DOI: 10.1172/jci.insight.172437.Peer-Reviewed Original ResearchConceptsDepartment of SurgerySmooth muscle cellsCellular response to injuryResponse to injuryImmunofluorescence confocal microscopyVessel wall repairPrimary lesionAscending aortaConduit functionAneurysmal diseaseDense fibrosisRadiological signsMural hematomaTear progressionMuscle cellsNon-hemorrhagicErythrocyte extravasationWall repairAortaTear completionInduce atherosclerosisHealed lesionsScattered leukocytesMinimal injuryConclusionThese findingsLiving in disadvantaged neighborhoods linked to less intervention for severe aortic stenosis
Ram C, Yousef S, Ma W, Vallabhajosyula I, Singh S, Agarwal R, Milewski R, Assi R, Patel P, Williams M, Geirsson A, Vallabhajosyula P. Living in disadvantaged neighborhoods linked to less intervention for severe aortic stenosis. Scientific Reports 2024, 14: 4952. PMID: 38418864, PMCID: PMC10902341, DOI: 10.1038/s41598-024-52660-w.Peer-Reviewed Original ResearchConceptsAortic valve replacementSevere aortic stenosisAfrican American raceArea Deprivation IndexAortic stenosisSevere ASArea deprivation index rankAortic valve replacement ratesAmerican raceAortic valve interventionPresentation of sepsisDiagnosis of ASADI groupValve replacementValve interventionDeprived neighbourhoodsAV interventionDisadvantaged neighborhoodsPatientsFemale genderDeprivation indexHigh-ADI groupLow-ADI groupStenosisRaceEffects of RBT-1 on preconditioning response biomarkers in patients undergoing coronary artery bypass graft or heart valve surgery: a multicentre, double-blind, randomised, placebo-controlled phase 2 trial.
Lamy A, Chertow GM, Jessen M, Collar A, Brown CD, Mack CA, Marzouk M, Scavo V, Washburn TB, Savage D, Smith J, Bennetts J, Assi R, Shults C, Arghami A, Butler J, Devereaux PJ, Zager R, Wang C, Snapinn S, Browne A, Rodriguez J, Ruiz S, Singh B, of START Investigators. Effects of RBT-1 on preconditioning response biomarkers in patients undergoing coronary artery bypass graft or heart valve surgery: a multicentre, double-blind, randomised, placebo-controlled phase 2 trial. EClinicalMedicine 2024, 68: 102364. PMID: 38586479, DOI: 10.1016/j.eclinm.2023.102364.Peer-Reviewed Original Research
2023
Aortic remodeling following hybrid arch repair with zone 0 to 5 thoracic endovascular aortic repairs for complex arch and descending thoracic aortic pathologies
Hameed I, Ahmed A, Pupovac S, Nassiri N, Assi R, Vallabhajosyula P. Aortic remodeling following hybrid arch repair with zone 0 to 5 thoracic endovascular aortic repairs for complex arch and descending thoracic aortic pathologies. JTCVS Open 2023, 17: 23-36. PMID: 38420535, PMCID: PMC10897673, DOI: 10.1016/j.xjon.2023.12.004.Peer-Reviewed Original ResearchHybrid aortic arch repairThoracic endovascular repairAortic arch repairAortic remodelingArch repairLuminal diameterZone 0Complete false lumen thrombosisLeft inferior pulmonary veinThoracic endovascular aortic repairComputed tomography angiography scansFalse lumen obliterationInferior left atriumFalse lumen thrombosisHigh-risk patientsHybrid arch repairAortic arch pathologiesCommon iliac arteryEndovascular aortic repairAdjunctive treatment strategyInferior pulmonary veinShort-term outcomesThoracic aortic pathologyTomography angiography scansAorta remodelingAortic Remodeling Following Hybrid Arch Repair for Complex Arch and Proximal Descending Thoracic Aortopathies
Hameed I, Ahmed A, Pupovac S, Komlo C, Amabile A, Nassiri N, Assi R, Vallabhajosyula P. Aortic Remodeling Following Hybrid Arch Repair for Complex Arch and Proximal Descending Thoracic Aortopathies. Journal Of Vascular Surgery 2023, 77: e255-e256. DOI: 10.1016/j.jvs.2023.03.361.Peer-Reviewed Original ResearchThoracic Endovascular Aortic Repair vs Medical Therapy Alone for Uncomplicated Acute Type B Aortic Dissection
Hu K, Pupovac S, Hameed I, Zafar M, Fereydooni S, Li E, Ma W, Williams M, Assi R, Nassiri N, Vallabhajosyula P. Thoracic Endovascular Aortic Repair vs Medical Therapy Alone for Uncomplicated Acute Type B Aortic Dissection. Journal Of Vascular Surgery 2023, 77: e270. DOI: 10.1016/j.jvs.2023.03.378.Peer-Reviewed Original ResearchTAVR explant with aortic root replacement using a homograft for an aortic rupture.
Singh S, Vallabhajosyula P, Geirsson A, Assi R. TAVR explant with aortic root replacement using a homograft for an aortic rupture. Multimedia Manual Of Cardio-Thoracic Surgery 2023, 2023 PMID: 36644957, DOI: 10.1510/mmcts.2022.101.Peer-Reviewed Original ResearchConceptsLeft coronary buttonAortic ruptureCoronary buttonsAortic rootAortic root replacementTranscatheter aortic valve prosthesisAortic valve prosthesisTAVR explantRoot replacementMale presentingCase reportTranscatheter prosthesesValve prosthesisStent frameBovine pericardiumProsthesisRuptureHaemopericardiumPseudoaneurysmHomograftsPresenting
2022
Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome
Kahler-Quesada A, Vallabhajosyula I, Yousef S, Mori M, Amabile A, Assi R, Geirsson A, Vallabhajosyula P. Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome. Scientific Reports 2022, 12: 22009. PMID: 36539583, PMCID: PMC9768129, DOI: 10.1038/s41598-022-25571-x.Peer-Reviewed Original ResearchConceptsBicuspid aortic valveTertiary care centerAortic valveCare centerCardiovascular specialistsBicuspid aortic valve syndromeAortic pathologySurveillance imagingDisease progressionPatientsBivariate analysisEchocardiogramGuide interventionDiagnosisHigher proportionValveSurveillance practicesUrgent needGuidelinesValvulopathySpecialistsSurgeryValvularSyndromeFollowDirect relationship between transvalvular velocity and cardiac dysfunction, morbidity, and mortality in patients with aortic stenosis
Yousef S, Amabile A, Ram C, Singh S, Agarwal R, Milewski R, Assi R, Patel P, Krane M, Geirsson A, Vallabhajosyula P. Direct relationship between transvalvular velocity and cardiac dysfunction, morbidity, and mortality in patients with aortic stenosis. Journal Of Cardiac Surgery 2022, 37: 5052-5062. PMID: 36378856, DOI: 10.1111/jocs.17199.Peer-Reviewed Original ResearchConceptsDegree of ASCardiac structural changesAortic stenosisSevere symptomatic aortic stenosisEnd-organ morbiditiesStructural cardiac changesSymptomatic aortic stenosisEnd-organ diseaseKaplan-Meier curvesRisk of mortalityTransvalvular flow velocityCochran-Armitage testCause mortalityPatient characteristicsCardiac changesCardiac dysfunctionPatient morbidityTransvalvular velocityCurrent guidelinesGroup BGroup ACaucasian raceHigh riskCox modelEarly interventionComprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience
Singh S, Pupovac SS, Assi R, Vallabhajosyula P. Comprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience. Frontiers In Cardiovascular Medicine 2022, 9: 991824. PMID: 36187018, PMCID: PMC9520124, DOI: 10.3389/fcvm.2022.991824.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 archConnection through cardiothoracic surgery subspecialty collaboration: Strategies for Early Faculty Peer Network Development
Lee M, Woodard G, Assi R. Connection through cardiothoracic surgery subspecialty collaboration: Strategies for Early Faculty Peer Network Development. JTCVS Open 2022, 12: 329-334. PMID: 36590730, PMCID: PMC9801233, DOI: 10.1016/j.xjon.2022.07.008.Commentaries, Editorials and LettersScreening Tool to Identify Patients with Advanced Aortic Valve Stenosis
Yousef S, Amabile A, Ram C, Huang H, Korutla V, Singh S, Agarwal R, Assi R, Milewski RK, Zhang Y, Patel PA, Krane M, Geirsson A, Vallabhajosyula P. Screening Tool to Identify Patients with Advanced Aortic Valve Stenosis. Journal Of Clinical Medicine 2022, 11: 4386. PMID: 35956007, PMCID: PMC9369431, DOI: 10.3390/jcm11154386.Peer-Reviewed Original ResearchAortic stenosisRisk prediction modelTertiary academic care centerAcademic care centerSevere aortic stenosisAortic valve stenosisBody mass indexCross-sectional analysisLogistic regression modelsLarge population cohortCardiovascular comorbiditiesEchocardiographic studyValve stenosisMass indexClinical burdenClinical variablesUnique patientsC-statisticCare centerMale genderPatient riskComorbidity variablesC-indexMultivariable modelInclusion criteriaOne and Five-Year Mortality Risk Prediction in Patients with Moderate and Severe Aortic Stenosis
Yousef S, Amabile A, Huang H, Agarwal R, Singh S, Ram C, Milewski RK, Assi R, Zhang Y, Krane M, Geirsson A, Vallabhajosyula P. One and Five-Year Mortality Risk Prediction in Patients with Moderate and Severe Aortic Stenosis. Journal Of Clinical Medicine 2022, 11: 2949. PMID: 35629075, PMCID: PMC9146915, DOI: 10.3390/jcm11102949.Peer-Reviewed Original ResearchSevere aortic stenosisAortic stenosisRisk prediction modelPatient characteristicsDegree of ASCox proportional hazards modelModerate aortic stenosisSevere AS patientsUnadjusted overall mortalityLow ejection fractionProportional hazards modelMortality risk predictionCardiac comorbiditiesEchocardiographic evidenceOnly patientsEjection fractionOverall mortalityAS patientsHigh morbidityComplex patientsC-statisticSingle institutionIndividualized riskRisk scoreHazards modelRight heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations
Khosla A, Mojibian H, Assi R, Tantawy H, Singh I, Pollak J. Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations. Pulmonary Circulation 2022, 12: e12080. PMID: 35514771, PMCID: PMC9063956, DOI: 10.1002/pul2.12080.Peer-Reviewed Original ResearchRight heart thrombusConcomitant pulmonary embolismPulmonary embolismHeart thrombusTreatment strategiesLimited clinical dataMultiple treatment strategiesMultiple medical specialtiesSystemic thrombolysisSurgical therapyExact incidenceRisk stratificationPoor outcomeUse of pointClinical dilemmaClinical dataTreatment considerationsPE managementCare ultrasoundMultiple specialtiesMedical specialtiesThrombusSpecialtiesAnticoagulationThrombolysis