2024
Patient-specific ascending aortic intervention criteria
Kalogerakos P, Zafar M, Li Y, Ellauzi H, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Patient-specific ascending aortic intervention criteria. European Journal Of Cardio-Thoracic Surgery 2024, 65: ezae162. PMID: 38632077, DOI: 10.1093/ejcts/ezae162.Peer-Reviewed Original ResearchAdverse aortic eventsRisk of adverse eventsAortic eventsAortic rootAneurysm patientsAscending aortaAdverse eventsIncreased risk of adverse eventsThoracic aortic aneurysm patientsAscending aortic aneurysmHigher risk of adverse eventsAortic aneurysm patientsAscending thoracic aortic aneurysm patientsBody surface areaGeneral populationPersonalized risk stratificationAortic diameterAneurysm locationRisk stratificationAortic aneurysmIncreased riskAscending diameterPatientsHigh riskZ-score
2023
“Big Data” Analyses Underlie Clinical Discoveries at the Aortic Institute
Zafar M, Ziganshin B, Li Y, Ostberg N, Rizzo J, Tranquilli M, Mukherjee S, Elefteriades J. “Big Data” Analyses Underlie Clinical Discoveries at the Aortic Institute. The Yale Journal Of Biology And Medicine 2023, 96: 427-440. PMID: 37780996, PMCID: PMC10524815, DOI: 10.59249/lndz2964.Peer-Reviewed Original ResearchConceptsBig dataArtificial intelligenceThoracic aortic aneurysmArtificial intelligence techniquesData setsAortic aneurysmLarge clinical data setsIntelligence techniquesAdvanced machineYale-New Haven HospitalClinical data setsAortic aneurysm patientsAortic root dilatationBicuspid aortic valveProspective clinical databaseNew Haven HospitalLarge genetic data setsIntelligenceSequencing filesThoracoabdominal aortaAortic dilatationMale patientsRisk prognosticationRoot dilatationSurgical treatmentBicuspid Aortopathy does NOT Require Earlier Surgical Intervention
Zafar M, Wu J, Vinholo T, Li Y, Papanikolaou D, Ellauzi H, Ostberg N, Kalyanasundaram A, Kalogerakos P, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Bicuspid Aortopathy does NOT Require Earlier Surgical Intervention. Journal Of Thoracic And Cardiovascular Surgery 2023 PMID: 37088130, DOI: 10.1016/j.jtcvs.2023.04.017.Peer-Reviewed Original ResearchBicuspid aortic valveAdverse aortic eventsEvent-free survivalAortic eventsAortic sizeAortic diameterAortic growth rateEarly surgical interventionLong-term complicationsRisk of complicationsThoracic aortic aneurysmAortic deathComplication rateSurgical repairOperative repairProphylactic surgerySurgical interventionAortic aneurysmAortic valveSurgical correctionBicuspid aortopathyRelative riskExpert centersTAV-ATAAPatientsFate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University
Wu J, Zafar M, Liu Y, Chen J, Li Y, Ziganshin B, Ellauzi H, Mukherjee S, Rizzo J, Elefteriades J. Fate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University. European Heart Journal 2023, 44: 4579-4588. PMID: 36994934, DOI: 10.1093/eurheartj/ehad148.Peer-Reviewed Original ResearchConceptsAdverse aortic eventsThoracic aortic aneurysmAortic sizeAortic aneurysmCox regressionAortic growthRisk factorsSignificant independent risk factorsMultivariable Cox regressionIndependent risk factorCohort of patientsUnivariable Cox regressionSignificant protective factorAortic deathATAA patientsAortic eventsPrimary endpointSurgical interventionThree-decade experienceNatural historyYearly riskProtective factorsAneurysmsPatientsIntervention criteria
2022
A machine learning approach for predicting complications in descending and thoracoabdominal aortic aneurysms
Ostberg NP, Zafar MA, Mukherjee SK, Ziganshin BA, Elefteriades JA. A machine learning approach for predicting complications in descending and thoracoabdominal aortic aneurysms. Journal Of Thoracic And Cardiovascular Surgery 2022, 166: 1011-1020.e3. PMID: 35120761, DOI: 10.1016/j.jtcvs.2021.12.045.Peer-Reviewed Original ResearchConceptsType B dissectionThoracoabdominal aortic aneurysmsB dissectionCause mortalityAortic aneurysmReceiver operator curveAortic diameterOperator curveInitial patient encounterOccurrence of dissectionSurgical intervention criteriaMean followPatient sexMyocardial infarctionPatient encountersRetrospective dataEnd pointPatientsAneurysmsDissectionMortalityRisk predictionComplicationsIntervention criteriaRupturePhenotyping Zebrafish Mutant Models to Assess Candidate Genes Associated with Aortic Aneurysm
Prendergast A, Ziganshin BA, Papanikolaou D, Zafar MA, Nicoli S, Mukherjee S, Elefteriades JA. Phenotyping Zebrafish Mutant Models to Assess Candidate Genes Associated with Aortic Aneurysm. Genes 2022, 13: 123. PMID: 35052463, PMCID: PMC8775119, DOI: 10.3390/genes13010123.Peer-Reviewed Original ResearchConceptsAortic aneurysmSkeletal abnormalitiesThoracic aortic aneurysmWhole-exome sequencingDirect microscopic assessmentSilico genetic analysisVisualized abnormalitiesTAA patientsClinical managementGeneral populationClinical practiceRoutine assessmentClinical testingCell countEvidence-based decisionsUnknown significanceUncertain significanceExperimental modelPilot studyExome sequencingAbnormalitiesMicroscopic assessmentPatientsPositive controlAneurysms
2021
Root Dilatation Is More Malignant Than Ascending Aortic Dilation
Kalogerakos PD, Zafar MA, Li Y, Mukherjee SK, Ziganshin BA, Rizzo JA, Elefteriades JA. Root Dilatation Is More Malignant Than Ascending Aortic Dilation. Journal Of The American Heart Association 2021, 10: e020645. PMID: 34238012, PMCID: PMC8483477, DOI: 10.1161/jaha.120.020645.Peer-Reviewed Original ResearchConceptsMid-ascending aortaAortic rootAdverse eventsRoot dilatationNatural historyAcute aortic dissectionLong-term complicationsAortic root dilatationSignificant higher riskThoracic aortic aneurysmSerious risk factorAortic interventionAortic dilatationAortic dilationAortic dissectionAortic aneurysmInternational registryRisk factorsAortic segmentsGuideline criteriaHigh riskExpert centersAortaShort statureResult diametersAortic Delamination—A Possible Precursor of Impending Catastrophe
Saeyeldin A, Zafar MA, Baldassarre LA, Mojibian H, Ziganshin BA, Mukherjee SK, Elefteriades JA. Aortic Delamination—A Possible Precursor of Impending Catastrophe. International Journal Of Angiology 2021, 30: 160-164. PMID: 34054275, PMCID: PMC8159620, DOI: 10.1055/s-0040-1718546.Peer-Reviewed Original ResearchAortic wall thicknessAdverse aortic eventsAortic eventsChest painDeep hypothermic circulatory arrestHypothermic circulatory arrestAortic repairAortic ruptureCirculatory arrestOpen repairAortic catastropheAortic diameterSurgical pathologyLimited evidencePowerful predictorPainPatientsDissectionSurgical videosRepairWall thicknessPathologyInterstage mortality in two‐stage elephant trunk surgery
Saeyeldin A, Gryaznov AA, Zafar MA, Wu J, Mukherjee S, Vallabhajosyula P, Ziganshin BA, Elefteriades JA. Interstage mortality in two‐stage elephant trunk surgery. Journal Of Cardiac Surgery 2021, 36: 1882-1891. PMID: 33634489, DOI: 10.1111/jocs.15441.Peer-Reviewed Original ResearchConceptsExtensive thoracic aortic aneurysmThoracic aortic aneurysmInterstage intervalStage IIET procedureStage II procedureHospital mortalityInterstage mortalityMega aortaTrunk surgeryAortic ruptureOverall mortalitySingle surgeonAortic diseasePatient groupAortic aneurysmPatientsStage IMortalityCumulative mortalityI procedureInterval periodRupturePrior studiesSafetyIs Aortic Z-score an Appropriate Index of Beneficial Drug Effect in Clinical Trials in Aortic Aneurysm Disease?
Elkinany S, Weismann C, Curtis A, Smith T, Zafar MA, Breen T, Li Y, Tranquilli M, Rizzo JA, Mukherjee SK, Ziganshin BA, Elefteriades JA. Is Aortic Z-score an Appropriate Index of Beneficial Drug Effect in Clinical Trials in Aortic Aneurysm Disease? The American Journal Of Cardiology 2021, 143: 145-153. PMID: 33352210, DOI: 10.1016/j.amjcard.2020.12.025.Peer-Reviewed Original ResearchConceptsBody mass indexAortic Z-scoresZ-score decreaseBeneficial drug effectsZ-scoreMarfan patientsClinical trialsAneurysm diseaseDrug effectsChild's ageEcho examAortic dilation rateDecreased Z-scoreConnective tissue diseaseBody surface areaEffects of medicationAortic aneurysm diseaseClinical drug trialsMass indexTissue diseaseAortic diseaseAneurysmal pathologyDrug trialsInvestigational drugsSpontaneous decrease
2020
Increased Virulence of Descending Thoracic and Thoracoabdominal Aortic Aneurysms in Women
Chen JF, Zafar MA, Wu J, Li Y, Rizzo JA, Papanikolaou D, Kalogerakos P, Abdelbaky M, Ellauzi H, Rohde S, Vinholo TF, Charilaou P, Buntin J, Mukherjee SK, Ziganshin BA, Elefteriades JA. Increased Virulence of Descending Thoracic and Thoracoabdominal Aortic Aneurysms in Women. The Annals Of Thoracic Surgery 2020, 112: 45-52. PMID: 33075319, DOI: 10.1016/j.athoracsur.2020.08.026.Peer-Reviewed Original ResearchConceptsThoracoabdominal aortic aneurysmsAortic deathFatal complicationAortic sizeAortic aneurysmFaster aneurysm growthMean aortic diameterComplication rateComposite endpointAortic diameterSurgical interventionCurrent guidelinesAneurysm sizeSex considerationsNatural historyAneurysm growthThoracicWomenDissectionYearly rateComplicationsDeathAneurysmsHigh rateSex differences
2019
Ascending Aortic Length and Risk of Aortic Adverse Events The Neglected Dimension
Wu J, Zafar MA, Li Y, Saeyeldin A, Huang Y, Zhao R, Qiu J, Tanweer M, Abdelbaky M, Gryaznov A, Buntin J, Ziganshin BA, Mukherjee SK, Rizzo JA, Yu C, Elefteriades JA. Ascending Aortic Length and Risk of Aortic Adverse Events The Neglected Dimension. Journal Of The American College Of Cardiology 2019, 74: 1883-1894. PMID: 31526537, DOI: 10.1016/j.jacc.2019.07.078.Peer-Reviewed Original ResearchConceptsAortic height indexAortic elongationAdverse eventsAortic diameterAortic lengthAneurysmal ascending aortaThoracic aortic aneurysmLogistic regression modelsATAA patientsRisk stratificationAscending aortaAortic aneurysmNatural historyYearly riskLongitudinal changesHeight indexNovel predictive toolYearly rateIntervention criteriaAverage yearly rateDissectionRegression modelsLittle informationRiskPatients
2017
Medical management of aortic disease in Marfan syndrome.
Bin Mahmood SU, Velasquez CA, Zafar MA, Saeyeldin AA, Brownstein AJ, Ziganshin BA, Elefteriades JA, Mukherjee SK. Medical management of aortic disease in Marfan syndrome. Annals Of Cardiothoracic Surgery 2017, 6: 654-661. PMID: 29270377, PMCID: PMC5721117, DOI: 10.21037/acs.2017.11.09.Peer-Reviewed Original ResearchAngiotensin receptor blockersMedical managementMarfan syndromeMFS patientsThoracic aortic aneurysm diseaseDifferent medical regimensStandard of careAortic aneurysm diseaseNumerous pathophysiological effectsAortic dilatationReceptor blockersAortic diseaseMedical regimensCurrent guidelinesAneurysm diseaseCardiovascular organsΒ-blockersCurrent evidencePathophysiological effectsHereditary disorderPatientsSyndromeDiseaseRegimensManagement
2012
Carotid Intima-Media Thickness Provides Evidence that Ascending Aortic Aneurysm Protects against Systemic Atherosclerosis
Hung A, Zafar M, Mukherjee S, Tranquilli M, Scoutt LM, Elefteriades JA. Carotid Intima-Media Thickness Provides Evidence that Ascending Aortic Aneurysm Protects against Systemic Atherosclerosis. Cardiology 2012, 123: 71-77. PMID: 23006774, DOI: 10.1159/000341234.Peer-Reviewed Original ResearchConceptsIntima-media thicknessCarotid intima-media thicknessAortic aneurysmCalcium scoreAortic calcium scoreAverage intima-media thicknessAortic aneurysm patientsCarotid IMT valuesDegree of atherosclerosisPositive family historyAortic aneurysm developmentDevelopment of atherosclerosisCommon carotid arterySystemic atherosclerosisAneurysm patientsIMT valuesMale genderRisk factorsCarotid arteryFamily historyMultiple linear regression analysisAtherosclerosisEarly markerAneurysm developmentAneurysms