2023
One-Year Results of a Low-Profile Endograft in Acute, Complicated Type B Aortic Dissection
Rossi P, Desai N, Malaisrie S, Lyden S, Nassiri N, Reece T, Adams J, Moanie S, Shults C, Investigators R, Vallabhajosyula P, Panneton J, Kumins N, Sharafuddin M, Toursavadkohi S, Ullery B, Duwayri Y, Han S, Rahimi S, Meisner R, Dryjski M, Starnes B, Fukuhara S, Cheema M. One-Year Results of a Low-Profile Endograft in Acute, Complicated Type B Aortic Dissection. The Annals Of Thoracic Surgery 2023, 117: 336-343. PMID: 37769702, DOI: 10.1016/j.athoracsur.2023.08.035.Peer-Reviewed Original ResearchConceptsType B aortic dissectionComplicated type B aortic dissectionMajor adverse eventsB aortic dissectionAdverse eventsCause mortalityAortic dissectionTechnical successEnd pointAortic diameter growthFalse lumen perfusionPrimary end pointSecondary end pointsKaplan-Meier analysisOne-year resultsParaplegia/paraparesisLong-term outcomesUnited States CentersMedian hospitalizationAortic expansionPatency lossRenal failurePivotal trialsRetrograde dissectionIliac artery
2018
Management of Patients With Coronary Artery Malperfusion Secondary to Type A Aortic Dissection
Kreibich M, Bavaria JE, Branchetti E, Brown CR, Chen Z, Khurshan F, Siki M, Vallabhajosyula P, Szeto WY, Desai ND. Management of Patients With Coronary Artery Malperfusion Secondary to Type A Aortic Dissection. The Annals Of Thoracic Surgery 2018, 107: 1174-1180. PMID: 30444990, DOI: 10.1016/j.athoracsur.2018.09.065.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationCohort StudiesCoronary Artery BypassCoronary Artery DiseaseCoronary CirculationFemaleGermanyHeart Arrest, InducedHospital MortalityHospitals, UniversityHumansKaplan-Meier EstimateLength of StayMaleMiddle AgedPostoperative ComplicationsPrognosisRetrospective StudiesRisk AssessmentStatistics, NonparametricSurvival AnalysisTreatment OutcomeConceptsCoronary artery malperfusionType B patientsType C patientsAntegrade cardioplegiaC patientsB patientsAortic dissectionCoronary ostiumDissection flapCA diseaseA Aortic DissectionType C lesionsManagement of patientsType B lesionsLong-term survivalCA bypassBypass GraftingPerioperative mortalityC lesionsComplete avulsionB lesionsLandmark analysisMalperfusionSuture repairPatientsHybrid arch surgery challenges other forms of arch treatment
Wallen TJ, Bavaria JE, Vallabhajosyula P. Hybrid arch surgery challenges other forms of arch treatment. The Journal Of Cardiovascular Surgery 2018, 59: 554-558. PMID: 29687970, DOI: 10.23736/s0021-9509.18.10516-7.Peer-Reviewed Original ResearchMeSH KeywordsAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel ProsthesisEndovascular ProceduresHumansConceptsHybrid arch proceduresHigh-risk patientsArch proceduresArch replacementRisk patientsTotal arch replacement procedureAcceptable postoperative outcomesSignificant comorbid burdenSignificant operative riskAortic arch replacementProspective randomized trialsTotal arch replacementAortic arch pathologiesOptimal surgical managementHybrid procedureArch surgeryComorbid burdenPostoperative mortalityAortic remodelingArch pathologiesOperative riskPostoperative outcomesSignificant comorbiditiesCirculatory arrestCase seriesPredicting Distal Aortic Remodeling After Endovascular Repair for Chronic DeBakey III Aortic Dissection
Sultan I, Siki MA, Bavaria JE, Dibble TR, Savino DC, Kilic A, Szeto W, Vallabhajosyula P, Fairman RM, Jackson BM, Wang GJ, Desai ND. Predicting Distal Aortic Remodeling After Endovascular Repair for Chronic DeBakey III Aortic Dissection. The Annals Of Thoracic Surgery 2018, 105: 1691-1696. PMID: 29391144, DOI: 10.1016/j.athoracsur.2018.01.006.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationChronic DiseaseCohort StudiesComputed Tomography AngiographyFemaleHospitals, UniversityHumansImaging, Three-DimensionalLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex FactorsSurvival RateTreatment OutcomeConceptsDeBakey III aortic dissectionAortic remodelingAortic dissectionVisceral vesselsTotal thrombosisGreater curveExact testDistal aortic remodelingOpen aortic reconstructionPositive aortic remodelingMultivariable logistic regressionNegative predictorFisher's exact testMultivariate logistic modelTomography angiography scansWilcoxon rank sumEndovascular aortic graftingAortic centersChronic dissectionAortic reconstructionCeliac axisAortic graftingEndovascular repairPrimary tearAortic size
2017
Central 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 repairOutcomes 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
Central Repair With Antegrade TEVAR for Malperfusion Syndromes in Acute Debakey I Aortic Dissection
Vallabhajosyula P, Gottret JP, Menon R, Sultan I, Abbas Z, Siki M, Kramer M, Pulsipher A, Naidu S, Pochettino A, Milewski K, Szeto WY, Bavaria JE. Central Repair With Antegrade TEVAR for Malperfusion Syndromes in Acute Debakey I Aortic Dissection. The Annals Of Thoracic Surgery 2016, 103: 748-755. PMID: 27666785, DOI: 10.1016/j.athoracsur.2016.06.097.Peer-Reviewed Original ResearchConceptsAcute DeBakey I aortic dissectionDeBakey I aortic dissectionTEVAR groupMalperfusion syndromeAortic dissectionStandard repairCirculatory arrestMortality rateHospital/30-day mortality ratePostoperative stroke rateRenal failure rateEnd-organ malperfusionStandard open repairEnd-organ systemDeBakey IParaplegia ratePreoperative comorbiditiesHemiarch replacementEmergent operationDistal repairOpen repairSurvival benefitThoracic aortaStroke rateCentral repairConcomitant 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 AdultThe Impact of Deep Versus Moderate Hypothermia on Postoperative Kidney Function After Elective Aortic Hemiarch Repair
Arnaoutakis GJ, Vallabhajosyula P, Bavaria JE, Sultan I, Siki M, Naidu S, Milewski RK, Williams ML, Hargrove WC, Desai ND, Szeto WY. The Impact of Deep Versus Moderate Hypothermia on Postoperative Kidney Function After Elective Aortic Hemiarch Repair. The Annals Of Thoracic Surgery 2016, 102: 1313-1321. PMID: 27318775, DOI: 10.1016/j.athoracsur.2016.04.007.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAorta, ThoracicAortic Aneurysm, ThoracicCause of DeathCerebrovascular CirculationCirculatory Arrest, Deep Hypothermia InducedCohort StudiesDatabases, FactualElective Surgical ProceduresFemaleFollow-Up StudiesGlomerular Filtration RateHospital MortalityHumansHypothermia, InducedLogistic ModelsMaleMiddle AgedMultivariate AnalysisPerfusionPostoperative ComplicationsRetrospective StudiesSurvival AnalysisTreatment OutcomeConceptsAntegrade cerebral perfusionRetrograde cerebral perfusionAcute kidney injuryModerate hypothermic circulatory arrestDeep hypothermic circulatory arrestHypothermic circulatory arrestGlomerular filtration rateHemiarch repairCerebral perfusionCirculatory arrestEjection fractionAneurysmal diseaseLower baseline glomerular filtration rateOccurrence of AKIAortic cross-clamp timeBaseline glomerular filtration rateHigher acute kidney injuryLonger cardiopulmonary bypass timeLow preoperative ejection fractionPostoperative acute kidney injuryAortic hemiarch replacementBaseline renal dysfunctionCerebral perfusion strategyCerebral protection strategiesDistal organ protectionAt 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
How to Perfuse: Concepts of Cerebral Protection during Arch Replacement
Habertheuer A, Wiedemann D, Kocher A, Laufer G, Vallabhajosyula P. How to Perfuse: Concepts of Cerebral Protection during Arch Replacement. BioMed Research International 2015, 2015: 981813. PMID: 26713319, PMCID: PMC4680049, DOI: 10.1155/2015/981813.Peer-Reviewed Original ResearchConceptsAntegrade cerebral perfusionCerebral protectionCerebral perfusionPerfusion strategyBilateral antegrade cerebral perfusionAvailable surgical strategiesCardiac surgery communityCerebral perfusion strategyComplex aortic pathologiesSingle-center dataDegree of hypothermiaComplete circulatory arrestArch replacementArch surgeryAortic pathologyArch reconstructionCirculatory arrestCirculatory managementEuropean multicenterHypothermic arrestIschemic insultThoracic aneurysmSurgical interventionSurgical strategySurgical approachDirect 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 replacementFour-branched graft with stent hybrid prosthesis for single-stage treatment of chronic aortic arch pathology
Vallabhajosyula P, Szeto WY. Four-branched graft with stent hybrid prosthesis for single-stage treatment of chronic aortic arch pathology. Journal Of Thoracic And Cardiovascular Surgery 2015, 150: 255-257. PMID: 25982295, DOI: 10.1016/j.jtcvs.2015.04.023.Peer-Reviewed Original ResearchModerate 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 replacement
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 ResearchMeSH KeywordsAgedAged, 80 and overAortic Aneurysm, ThoracicAortic DissectionChronic DiseaseFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeConceptsOutcome 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 surgeryImpact 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 registryTEVARLong-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 rate