2018
Tricuspid 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 increaseReoperationHospitalization
2017
Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement
Hyman MC, Vemulapalli S, Szeto WY, Stebbins A, Patel PA, Matsouaka RA, Herrmann HC, Anwaruddin S, Kobayashi T, Desai ND, Vallabhajosyula P, McCarthy FH, Li R, Bavaria JE, Giri J. Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement. Circulation 2017, 136: 2132-2140. PMID: 28864443, DOI: 10.1161/circulationaha.116.026656.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnesthesia, GeneralAortic Valve StenosisComparative Effectiveness ResearchConscious SedationFemaleHospital MortalityHumansIntention to Treat AnalysisLength of StayMalePatient DischargePractice Patterns, Physicians'RegistriesRisk AssessmentRisk FactorsTime FactorsTranscatheter Aortic Valve ReplacementTreatment OutcomeUnited StatesConceptsTranscatheter aortic valve replacementAortic valve replacementConscious sedationIntensive care unitGeneral anesthesiaHospital lengthValve replacementProcedural successCare unitEnd-point analysisPercutaneous transfemoral transcatheter aortic valve replacementConscious Sedation Versus General AnesthesiaTransfemoral transcatheter aortic valve replacementCardiology Transcatheter Valve Therapy RegistryThoracic Surgeons/American CollegeDeath/stroke ratePacemaker/defibrillator implantationTranscatheter Valve Therapy RegistryInverse probabilityConscious sedation groupDeath/strokeTreatment-weighted adjustmentTreatment-weighted analysisLower procedural successComparative effectiveness analysisLong-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
Bicuspid 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 procedureLower-extremity complications with femoral extracorporeal life support
Vallabhajosyula P, Kramer M, Lazar S, McCarthy F, Rame E, Wald J, Szeto W, Williams M, Atluri P, Desai N, Acker M. Lower-extremity complications with femoral extracorporeal life support. Journal Of Thoracic And Cardiovascular Surgery 2016, 151: 1738-1744. PMID: 27207130, DOI: 10.1016/j.jtcvs.2015.11.044.Peer-Reviewed Original ResearchConceptsFemoral artery groupLower extremity complicationsExtracorporeal life supportSuperficial femoral arteryFemoral artery cannulationArtery groupFemoral arteryArtery cannulationLife supportMultiorgan failureComplication rateMean agePerfusion strategyFemoral artery repairLower extremity perfusionFemoral artery approachPatients' mean ageEmergency thromboembolectomyHospital mortalityAngiographic confirmationArtery approachArtery repairKnee amputationPercutaneous cannulationRetrospective review
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 replacementMonitoring of Allogeneic Islet Grafts in Nonhuman Primates Using MRI
Wang P, Schuetz C, Vallabhajosyula P, Medarova Z, Tena A, Wei L, Yamada K, Deng S, Markmann JF, Sachs DH, Moore A. Monitoring of Allogeneic Islet Grafts in Nonhuman Primates Using MRI. Transplantation 2015, 99: 1574-1581. PMID: 25806407, PMCID: PMC4551574, DOI: 10.1097/tp.0000000000000682.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAnimalsBiomarkersBlood GlucoseContrast MediaDextransDisease Models, AnimalGraft RejectionImmunosuppressive AgentsIslets of LangerhansIslets of Langerhans TransplantationMagnetic Resonance ImagingMagnetite NanoparticlesMaleOrgan SizePapio hamadryasPredictive Value of TestsStreptozocinTime FactorsTransplantation, HomologousConceptsGraft volumeIslet graftsBlood glucosePancreatic isletsNonhuman primatesAcute graft lossAllogeneic immune rejectionAllogeneic islet graftsWithdrawal of immunosuppressionPancreatic islet graftsVivo MRIGraft lossAllogeneic isletsGraft monitoringTreatment optionsIslet lossIslet transplantationRenal capsuleAllogeneic modelAutologous modelImmune rejectionMRISecondary damageImmunosuppressionIsletsAortic 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 transcatheter aortic valve replacement in patients with chronic liver disease
Shah AM, Ogbara J, Herrmann HC, Fox Z, Kadakia M, Anwaruddin S, Bavaria JE, Desai ND, Jagasia D, Szeto WY, Li RH, Vallabhajosyula P, Giri J. Outcomes of transcatheter aortic valve replacement in patients with chronic liver disease. Catheterization And Cardiovascular Interventions 2015, 86: 888-894. PMID: 25963625, DOI: 10.1002/ccd.25994.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAortic ValveAortic Valve StenosisBioprosthesisBiopsyCardiac CatheterizationChronic DiseaseFeasibility StudiesFemaleFemoral ArteryHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHospital MortalityHumansLiver DiseasesMaleMiddle AgedPatient SelectionRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTreatment OutcomeConceptsTranscatheter aortic valve replacementChronic liver diseaseValve Academic Research ConsortiumAcute kidney injuryAortic valve replacementLiver diseaseLate deathsKidney injuryValve replacementUnknown causeTransapical (TA) TAVRRole of TAVRTA TAVRSevere symptomatic aortic valve stenosisModerate chronic liver diseaseSymptomatic aortic valve stenosisAdvanced liver diseaseMajor bleeding complicationsNon-cardiac causesOutcomes of patientsTransient ischemic attackAcademic Research ConsortiumHigh-risk surgeryAortic valve stenosisLong-term follow
2014
Impact of timing on major complications after thoracic endovascular aortic repair for acute type B aortic dissection
Desai ND, Gottret JP, Szeto WY, McCarthy F, Moeller P, Menon R, Jackson B, Vallabhajosyula P, Wang GJ, Fairman R, Bavaria JE. Impact of timing on major complications after thoracic endovascular aortic repair for acute type B aortic dissection. Journal Of Thoracic And Cardiovascular Surgery 2014, 149: s151-s156. PMID: 25466855, DOI: 10.1016/j.jtcvs.2014.10.105.Peer-Reviewed Original ResearchConceptsType B dissectionEndovascular aortic repairB dissectionImpact of timingAortic repairAortic dissectionMedical therapyAcute type B aortic dissectionComplicated type B dissectionType B aortic dissectionB aortic dissectionHours of presentationOnset of symptomsRisk of complicationsWeeks of presentationOverall survivalSevere complicationsSurvival benefitMajor complicationsSuch patientsAcute patientsOpen surgeryRetrograde typeClinical registryTEVARValve-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 reviewEndovascular 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 technologyLong-term results of aggressive hemiarch replacement in 534 patients with type A aortic dissection
Rylski B, Milewski RK, Bavaria JE, Vallabhajosyula P, Moser W, Szeto WY, Desai ND. Long-term results of aggressive hemiarch replacement in 534 patients with type A aortic dissection. Journal Of Thoracic And Cardiovascular Surgery 2014, 148: 2981-2985. PMID: 25112930, DOI: 10.1016/j.jtcvs.2014.05.093.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationFemaleHospital MortalityHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPostoperative ComplicationsReoperationRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeConceptsDeBakey type IDistal aortic reinterventionHemiarch replacementAcute typeAortic reinterventionAortic dissectionDeBakey type I dissectionAdverse aortic eventsType I dissectionAortic arch aneurysmLong-term resultsType IAortic wall tissueDistal reinterventionHospital mortalityAortic eventsReoperation rateTotal archArch aneurysmIndependent predictorsReinterventionStudy populationMarfan syndromePatientsLower mortalityLong-Term Results of Neomedia Sinus Valsalva Repair in 489 Patients With Type A Aortic Dissection
Rylski B, Bavaria JE, Milewski RK, Vallabhajosyula P, Moser W, Kremens E, Pochettino A, Szeto WY, Desai ND. Long-Term Results of Neomedia Sinus Valsalva Repair in 489 Patients With Type A Aortic Dissection. The Annals Of Thoracic Surgery 2014, 98: 582-589. PMID: 24928674, DOI: 10.1016/j.athoracsur.2014.04.050.Peer-Reviewed Original ResearchType A Aortic Dissection After Previous Cardiac Surgery: Results of an Integrated Surgical Approach
Rylski B, Desai ND, Bavaria JE, Moser W, Vallabhajosyula P, Pochettino A, Szeto WY, Milewski RK. Type A Aortic Dissection After Previous Cardiac Surgery: Results of an Integrated Surgical Approach. The Annals Of Thoracic Surgery 2014, 97: 1582-1589. PMID: 24629304, DOI: 10.1016/j.athoracsur.2013.12.064.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationCardiac Surgical ProceduresCause of DeathCohort StudiesFemaleFollow-Up StudiesHospital MortalityHumansKaplan-Meier EstimateLength of StayMaleMiddle AgedPatient SafetyPostoperative ComplicationsRadiographyReoperationRetrospective StudiesRisk AssessmentSeverity of Illness IndexStatistics, NonparametricSurvival AnalysisTime FactorsTreatment OutcomeConceptsPrevious cardiac surgeryPCS patientsAortic dissectionCardiac surgeryAcute typeCardiac tamponadeHospital mortality risk factorsAcceptable postoperative mortalityPostoperative stroke ratePrior myocardial revascularizationA Aortic DissectionHospital mortality rateCoronary artery diseaseMortality risk factorsCoronary malperfusionHospital mortalityPostoperative mortalityAortic repairMyocardial revascularizationStanford typeArtery diseaseSurgical repairSurgical approachRisk factorsStroke rateRoot Stabilization of the Repaired Bicuspid Aortic Valve: Subcommissural Annuloplasty Versus Root Reimplantation
Vallabhajosyula P, Komlo C, Szeto WY, Wallen TJ, Desai N, Bavaria JE. Root Stabilization of the Repaired Bicuspid Aortic Valve: Subcommissural Annuloplasty Versus Root Reimplantation. The Annals Of Thoracic Surgery 2014, 97: 1227-1234. PMID: 24418204, DOI: 10.1016/j.athoracsur.2013.10.071.Peer-Reviewed Original ResearchConceptsAortic insufficiencyReimplantation groupRoot reimplantationSubcommissural annuloplastyAnnular stabilizationRepair groupBicuspid aortic valve patientsPrimary valve repairSurgical reconstructive strategiesAortic valve patientsBicuspid aortic valveAortic root pathologyAortic reoperationValve mobilityPreoperative characteristicsOverall survivalPostoperative peakValve patientsPacemaker requirementRetrospective reviewReimplantation techniqueValve repairRoot pathologyAortic valveValve preservation
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 outcomesModerate 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
2012
Hybrid approaches in the treatment of aortic arch aneurysms: Postoperative and midterm outcomes
Bavaria J, Vallabhajosyula P, Moeller P, Szeto W, Desai N, Pochettino A. Hybrid approaches in the treatment of aortic arch aneurysms: Postoperative and midterm outcomes. Journal Of Thoracic And Cardiovascular Surgery 2012, 145: s85-s90. PMID: 23260461, DOI: 10.1016/j.jtcvs.2012.11.044.Peer-Reviewed Original ResearchMeSH KeywordsAgedAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationCardiopulmonary BypassEndoleakEndovascular ProceduresFemaleHeart Arrest, InducedHospital MortalityHumansKaplan-Meier EstimateMaleMiddle AgedParaplegiaPhiladelphiaReoperationRisk FactorsStentsSternotomyStrokeTime FactorsTreatment OutcomeConceptsAortic arch aneurysmThoracic endovascular repairArch vessel debranchingArch aneurysmMidterm outcomesAverage cardiopulmonary bypass timeType 1Aortic arch surgeryAortic reoperation ratesCardiopulmonary bypass timeGreater comorbid burdenHybrid arch repairSafe treatment modalityAscending Aortic AneurysmCirculatory arrest timeMedian sternotomy approachGood midterm resultsPercent of casesType III repairType II repairArch surgeryComorbid burdenCrossclamp timeParaplegia ratePostoperative endoleaks