2018
Hybrid 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 seriesManagement of the moderately dilated sinus of Valsalva: To cut or not to cut?
Milewski RK, Habertheuer A, Bavaria JE, Vallabhajosyula P. Management of the moderately dilated sinus of Valsalva: To cut or not to cut? Journal Of Thoracic And Cardiovascular Surgery 2018, 155: 526-527. PMID: 29415375, DOI: 10.1016/j.jtcvs.2017.10.002.Peer-Reviewed Original Research
2017
Concomitant antegrade stent grafting of the descending thoracic aorta during transverse hemiarch reconstruction for acute DeBakey I aortic dissection repair improves aortic remodeling
Sultan I, Wallen TJ, Habertheuer A, Siki M, Arnaoutakis GJ, Bavaria J, Szeto WY, Milewski R, Vallabhajosyula P. Concomitant antegrade stent grafting of the descending thoracic aorta during transverse hemiarch reconstruction for acute DeBakey I aortic dissection repair improves aortic remodeling. Journal Of Cardiac Surgery 2017, 32: 581-592. PMID: 28795434, DOI: 10.1111/jocs.13192.Peer-Reviewed Original ResearchConceptsTrue lumen diameterTEVAR groupTrue lumenThoracic aortaLumen diameterHemiarch reconstructionAortic remodelingStent graftingOpen repairAortic diameterAcute DeBakey I aortic dissectionDeBakey I aortic dissectionFalse lumen thrombosis rateThree-dimensional computed tomography scansAortic dissection repairDeBakey I dissectionsDistal aortic remodelingTotal aortic diameterFalse lumen thrombosisAbdominal aortic diameterEndovascular stent graftingEndovascular aortic repairComputed tomography scanArch tearDeBakey ICentral 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 unitFate of remnant sinuses of Valsalva in patients with bicuspid and trileaflet valves undergoing aortic valve, ascending aorta, and aortic arch replacement
Milewski RK, Habertheuer A, Bavaria JE, Siki M, Szeto WY, Krause E, Korutla V, Desai ND, Vallabhajosyula P. Fate of remnant sinuses of Valsalva in patients with bicuspid and trileaflet valves undergoing aortic valve, ascending aorta, and aortic arch replacement. Journal Of Thoracic And Cardiovascular Surgery 2017, 154: 421-432. PMID: 28599977, DOI: 10.1016/j.jtcvs.2017.03.150.Peer-Reviewed Original ResearchConceptsAortic valve replacementBicuspid aortic valveAorta replacementTricuspid aortic valveValve replacementAortic valveValsalva dimensionsPreoperative sinusSinus segmentValvular morphologyValvular pathologyElective aortic valve replacementMultivariable Cox regression modelsAortic arch replacementKaplan-Meier analysisAortic valve morphologyCox regression modelAortic valvulopathyArch replacementSurgical managementAortic aneurysmAortic rootLongitudinal sinusValsalva groupPatients
2016
Concomitant 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 protectionBicuspid 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 replacementHemiarch replacement with concomitant antegrade stent grafting of the descending thoracic aorta versus total arch replacement for treatment of acute DeBakey I aortic dissection with arch tear†
Vallabhajosyula P, Gottret JP, Robb JD, Szeto WY, Desai ND, Pochettino A, Bavaria JE. Hemiarch replacement with concomitant antegrade stent grafting of the descending thoracic aorta versus total arch replacement for treatment of acute DeBakey I aortic dissection with arch tear†. European Journal Of Cardio-Thoracic Surgery 2015, 49: 1256-1261. PMID: 26516196, DOI: 10.1093/ejcts/ezv374.Peer-Reviewed Original ResearchConceptsThoracic endovascular aortic repairDeBakey I aortic dissectionTotal arch replacementAcute DeBakey I aortic dissectionConventional total arch replacementArch tearMid-term outcomesAortic dissectionTEVAR groupArch replacementHemiarch reconstructionHemiarch replacementTear repairFalse lumen thrombosisEndovascular aortic repairHospital/30-day mortalityAortic dissection patientsActuarial survivalTEVAR patientsCardiogenic shockStent graftingAortic repairDistal reconstructionCardiopulmonary bypassClinical presentationCurrent paradigms in aortic arch repair: Striking the balance between open surgery and endovascular repair
Vallabhajosyula P, Szeto WY. Current paradigms in aortic arch repair: Striking the balance between open surgery and endovascular repair. Journal Of Thoracic And Cardiovascular Surgery 2015, 150: 1399-1400. PMID: 26573344, DOI: 10.1016/j.jtcvs.2015.09.040.Peer-Reviewed Original ResearchManagement of the aortic arch and descending thoracic aorta for acute type A dissection: Moving away from the “less is more” paradigm
Vallabhajosyula P, Szeto WY. Management of the aortic arch and descending thoracic aorta for acute type A dissection: Moving away from the “less is more” paradigm. Journal Of Thoracic And Cardiovascular Surgery 2015, 150: 106-107. PMID: 25982293, DOI: 10.1016/j.jtcvs.2015.04.003.Peer-Reviewed Original ResearchMeSH KeywordsAorta, ThoracicAortic DiseasesBlood Vessel Prosthesis ImplantationFemaleHumansMaleStents
2014
Type 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
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 endoleaksTwo-stage surgical strategy for aortoesophageal fistula: Emergent thoracic endovascular aortic repair followed by definitive open aortic and esophageal reconstruction
Vallabhajosyula P, Komlo C, Wallen T, Szeto WY. Two-stage surgical strategy for aortoesophageal fistula: Emergent thoracic endovascular aortic repair followed by definitive open aortic and esophageal reconstruction. Journal Of Thoracic And Cardiovascular Surgery 2012, 144: 1266-1268. PMID: 22982036, DOI: 10.1016/j.jtcvs.2012.07.084.Peer-Reviewed Original ResearchMeSH KeywordsAneurysm, FalseAnti-Bacterial AgentsAorta, ThoracicAortic Aneurysm, ThoracicBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationDrainageEndovascular ProceduresEsophageal FistulaFemaleFistulaFundoplicationHumansMiddle AgedRadiographyStentsThoracic Surgery, Video-AssistedTreatment Outcome