2017
Outcomes of Elective Aortic Hemiarch Reconstruction for Aneurysmal Disease in the Elderly
Kilic A, Arnaoutakis GJ, Bavaria JE, Sultan I, Desai ND, Vallabhajosyula P, Williams ML, Milewski RK, Szeto WY. Outcomes of Elective Aortic Hemiarch Reconstruction for Aneurysmal Disease in the Elderly. The Annals Of Thoracic Surgery 2017, 104: 1522-1530. PMID: 28648536, DOI: 10.1016/j.athoracsur.2017.03.067.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationCirculatory Arrest, Deep Hypothermia InducedCohort StudiesElective Surgical ProceduresFemaleGeriatric AssessmentHospital MortalityHumansMaleMiddle AgedPlastic Surgery ProceduresPostoperative CarePostoperative ComplicationsPrognosisPropensity ScoreRegistriesRetrospective StudiesRisk AssessmentSex FactorsSurvival AnalysisTreatment OutcomeConceptsModerate hypothermic circulatory arrestAntegrade cerebral perfusionHypothermic circulatory arrestHemiarch reconstructionElderly patientsAneurysmal diseaseOperative mortalityCerebral perfusionCirculatory arrestConcomitant aortic valve replacementRisk-adjusted operative mortalityCoronary artery bypassOperative mortality rateAortic valve replacementGreater comorbidity burdenLow operative mortalityOverall stroke rateSafe strategyIntensive care unitComorbidity burdenArtery bypassHospital stayRoot replacementValve replacementCare unit
2016
At 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
Direct innominate artery cannulation: An alternate technique for antegrade cerebral perfusion during aortic hemiarch reconstruction
Jassar AS, Vallabhajosyula P, Bavaria JE, Gutsche J, Desai ND, Williams ML, Milewski RK, Hargrove WC, Szeto WY. Direct innominate artery cannulation: An alternate technique for antegrade cerebral perfusion during aortic hemiarch reconstruction. Journal Of Thoracic And Cardiovascular Surgery 2015, 151: 1073-1078. PMID: 26725716, DOI: 10.1016/j.jtcvs.2015.11.027.Peer-Reviewed Original ResearchMeSH KeywordsAgedAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel Prosthesis ImplantationBrachiocephalic TrunkCatheterization, PeripheralCerebrovascular CirculationFemaleHeart Arrest, InducedHospital MortalityHumansHypothermia, InducedMaleMiddle AgedPerfusionPostoperative ComplicationsRegional Blood FlowReoperationTime FactorsTreatment OutcomeConceptsAntegrade cerebral perfusionModerate hypothermic circulatory arrestHypothermic circulatory arrestHemiarch reconstructionInnominate arteryCerebral perfusionCirculatory arrestReversible ischemic neurologic deficitExcellent cerebral protectionInnominate artery cannulationIschemic neurologic deficitAortic valve replacementRenal failure rateProximal aortic aneurysmIncidence of injuryACP timeAscending aorticCrossclamp timeArtery cannulationCerebral protectionCentral cannulationNeurologic deficitsPatient ageRoot replacementValve replacementModerate Versus Deep Hypothermic Circulatory Arrest for Elective Aortic Transverse Hemiarch Reconstruction
Vallabhajosyula P, Jassar AS, Menon RS, Komlo C, Gutsche J, Desai ND, Hargrove WC, Bavaria JE, Szeto WY. Moderate Versus Deep Hypothermic Circulatory Arrest for Elective Aortic Transverse Hemiarch Reconstruction. The Annals Of Thoracic Surgery 2015, 99: 1511-1517. PMID: 25825200, DOI: 10.1016/j.athoracsur.2014.12.067.Peer-Reviewed Original ResearchConceptsModerate hypothermic circulatory arrestDeep hypothermic circulatory arrestHypothermic circulatory arrestDirect innominate artery cannulationAntegrade cerebral perfusionInnominate artery cannulationCerebral perfusionCirculatory arrestHemiarch reconstructionTransfusion requirementsArtery cannulationMHCA groupCerebral perfusion strategyCerebral protection strategiesConcomitant root replacementRetrograde cerebral perfusionAortic valve replacementFresh frozen plasmaAortic aneurysm diseaseHemodialysis rateAortic reconstructionNeurologic complicationsGroup patientsPostoperative outcomesRoot replacementOutcomes 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
Outcomes of Surgery for Chronic Type A Aortic Dissection
Rylski B, Milewski RK, Bavaria JE, Branchetti E, Vallabhajosyula P, Szeto WY, Desai ND. Outcomes of Surgery for Chronic Type A Aortic Dissection. The Annals Of Thoracic Surgery 2014, 99: 88-93. PMID: 25442993, DOI: 10.1016/j.athoracsur.2014.07.032.Peer-Reviewed Original ResearchConceptsOutcome of surgeryChronic dissectionAortic dissectionChronic groupDissection patientsAortic tissueChronic Type A Aortic DissectionBicuspid aortic valve syndromeType A Aortic DissectionAcute dissection patientsChronic dissection patientsChronic Stanford typeNative ascending aortaA Aortic DissectionPrevious cardiac surgeryAortic root replacementMajority of patientsLong-term resultsHospital mortalityAcute typePrimary surgeryOverall survivalRoot replacementStanford typeCardiac surgeryAortic Valve Morphology Determines the Presentation and Surgical Approach to Acute Type A Aortic Dissection
Rylski B, Desai ND, Bavaria JE, Vallabhajosyula P, Moser W, Pochettino A, Szeto WY, Milewski RK. Aortic Valve Morphology Determines the Presentation and Surgical Approach to Acute Type A Aortic Dissection. The Annals Of Thoracic Surgery 2014, 97: 1991-1997. PMID: 24786861, DOI: 10.1016/j.athoracsur.2013.12.090.Peer-Reviewed Original ResearchConceptsTricuspid aortic valveBAV patientsAortic valve morphologyHospital mortalityAortic dissectionTAV patientsAcute Type A Aortic DissectionBicuspid aortic valve syndromeType A Aortic DissectionValve morphologyA Aortic DissectionSevere aortic insufficiencyTotal arch replacementAortic root replacementAortic root repairMedian followProximal reoperationAcute typeArch replacementCardiogenic shockAortic insufficiencyRoot replacementAortic diameterAorta diameterSurgical approachType 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 type
2013
Moderate mitral regurgitation in aortic root replacement surgery: Comparing mitral repair with no mitral repair
McCarthy FH, Desai ND, Fox Z, George J, Moeller P, Vallabhajosyula P, Szeto WY, Bavaria JE. Moderate mitral regurgitation in aortic root replacement surgery: Comparing mitral repair with no mitral repair. Journal Of Thoracic And Cardiovascular Surgery 2013, 147: 938-941. PMID: 24035374, DOI: 10.1016/j.jtcvs.2013.07.056.Peer-Reviewed Original ResearchMeSH KeywordsAortic Valve InsufficiencyAortic Valve StenosisComorbidityHeart FailureHeart Valve Prosthesis ImplantationHumansIncidenceMitral Valve InsufficiencyPatient SelectionPennsylvaniaPostoperative ComplicationsRetrospective StudiesRisk FactorsSeverity of Illness IndexTime FactorsTreatment OutcomeConceptsAortic root replacement surgeryModerate mitral regurgitationMitral repair groupAortic root replacementMitral regurgitationMitral repairReplacement surgeryRoot replacementRepair groupNew York Heart Association III/IVAcceptable operative riskGreater mitral regurgitationPreoperative mitral regurgitationPostoperative renal failureMitral valve pathologyMitral valve repairLong-term survivalBenefits of interventionsCrossclamp timeMitral reinterventionOperative riskRenal failureHeart failureValve pathologyValve repair