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 repairPatientsOutcome After Operation for Aortic Dissection Type A in Morbidly Obese Patients
Kreibich M, Rylski B, Bavaria JE, Branchetti E, Dohle D, Moeller P, Vallabhajosyula P, Szeto WY, Desai ND. Outcome After Operation for Aortic Dissection Type A in Morbidly Obese Patients. The Annals Of Thoracic Surgery 2018, 106: 491-497. PMID: 29673638, DOI: 10.1016/j.athoracsur.2018.03.035.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAortic AneurysmAortic DissectionBody Mass IndexBody WeightCohort StudiesComorbidityFemaleHospital MortalityHumansLogistic ModelsMaleMiddle AgedObesity, MorbidOdds RatioPostoperative ComplicationsPrognosisReference ValuesRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment OutcomeConceptsAortic dissection type AMorbidly obese patientsNormal weight patientsObese patientsSurgical repairWeight patientsDistal aortic repairImmediate surgical approachMore obese patientsCalculated blood volumeBody mass indexIntensive care unitLength of stayType AHospital mortalityHospital stayPostoperative complicationsAortic repairPostoperative outcomesCare unitClinical featuresClinical presentationMass indexNormal weightAdverse outcomesPredicting 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
The role of extracorporeal membrane oxygenator therapy in the setting of Type A aortic dissection
Sultan I, Habertheuer A, Wallen T, Siki M, Szeto W, Bavaria JE, Williams M, Vallabhajosyula P. The role of extracorporeal membrane oxygenator therapy in the setting of Type A aortic dissection. Journal Of Cardiac Surgery 2017, 32: 822-825. PMID: 29216679, DOI: 10.1111/jocs.13245.Peer-Reviewed Original ResearchConceptsPost-operative dayAortic dissectionTAAD repairECMO supportPennsylvania Health Care Cost Containment Council databaseDiagnosis/procedure codesType A Aortic DissectionFirst post-operative dayAcute cardiopulmonary failurePost-cardiotomy shockSame hospital visitA Aortic DissectionAcute aortic dissectionSame dayWide clinical spectrumSalvage therapyTAAD surgeryECMO implantationCardiopulmonary failureHemodynamic stabilityCardiovascular collapseOpen repairOverall mortalityMedian timeClinical spectrumConcomitant 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 repairAortic Regurgitation in Acute Type-A Aortic Dissection: A Clinical Classification for the Perioperative Echocardiographer in the Era of the Functional Aortic Annulus
Patel PA, Bavaria JE, Ghadimi K, Gutsche JT, Vallabhajosyula P, Ko HA, Desai ND, Mackay E, Weiss SJ, Augoustides JGT. Aortic Regurgitation in Acute Type-A Aortic Dissection: A Clinical Classification for the Perioperative Echocardiographer in the Era of the Functional Aortic Annulus. Journal Of Cardiothoracic And Vascular Anesthesia 2017, 32: 586-597. PMID: 28927697, DOI: 10.1053/j.jvca.2017.06.014.Peer-Reviewed Educational MaterialsConceptsFunctional aortic annulusAortic annulusAortic regurgitationSurgical therapyAcute Type A Aortic DissectionType A Aortic DissectionPerioperative echocardiographerAcute aortic syndromeCoronary artery involvementAortic syndromeArtery involvementAortic dissectionTransesophageal echocardiographyRoot dissectionAortic rootPatient presentationClinical classificationSurgical experienceAnatomic considerationsClinical approachRegurgitationTherapyEchocardiographersDissectionLatest literature
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 repair
2015
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†
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 presentationNearly Missed: Postpartum Type B Aortic Dissection
Ahluwalia M, Parmacek MS, Sayani FA, Vallabhajosyula P. Nearly Missed: Postpartum Type B Aortic Dissection. The American Journal Of Medicine 2015, 128: 1188-1190. PMID: 26264721, DOI: 10.1016/j.amjmed.2015.07.023.Peer-Reviewed Original Research
2014
Distal aortic reintervention after surgery for acute DeBakey type I or II aortic dissection: open versus endovascular repair†
Rylski B, Beyersdorf F, Desai ND, Euringer W, Siepe M, Kari FA, Vallabhajosyula P, Szeto WY, Milewski RK, Bavaria JE. Distal aortic reintervention after surgery for acute DeBakey type I or II aortic dissection: open versus endovascular repair†. European Journal Of Cardio-Thoracic Surgery 2014, 48: 258-263. PMID: 25527171, DOI: 10.1093/ejcts/ezu488.Peer-Reviewed Original ResearchConceptsDeBakey type IDistal reinterventionAortic reinterventionDissection repairEndovascular groupHospital mortalityAortic pathologyAcute aortic dissection repairAcute DeBakey type IType IAortic dissection repairDistal aortic pathologyDistal aortic reinterventionOpen repair patientsEndovascular patientsLate reinterventionSpinal ischaemiaAcute dissectionEndovascular repairAortic dissectionConsecutive patientsEndovascular approachSurgical repairTertiary centerMedian timeOutcomes 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 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 registryTEVAREndovascular 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 ResearchModeling of predissection aortic size in acute type A dissection: More than 90% fail to meet the guidelines for elective ascending replacement
Rylski B, Branchetti E, Bavaria JE, Vallabhajosyula P, Szeto WY, Milewski RK, Desai ND. Modeling of predissection aortic size in acute type A dissection: More than 90% fail to meet the guidelines for elective ascending replacement. Journal Of Thoracic And Cardiovascular Surgery 2014, 148: 944-948.e1. PMID: 24998700, DOI: 10.1016/j.jtcvs.2014.05.050.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAortic AneurysmAortic DissectionAortographyBlood Vessel Prosthesis ImplantationEchocardiography, TransesophagealElective Surgical ProceduresFemaleGermanyGuideline AdherenceHumansIncidenceMaleMiddle AgedPatient SelectionPractice Guidelines as TopicPredictive Value of TestsRetrospective StudiesRisk FactorsTomography, X-Ray ComputedConceptsDissection onsetAcute typeAortic dissectionAorta diameterAortic diameterAscending aortaPreoperative computed tomography angiogramsComputed tomography angiogramAortic dissection onsetAcute dissectionAortic replacementAortic dilatationAortic sizeTomography angiogramBiochemical predictorsCurrent guidelinesPatientsDiameter increase ratePredissectionDissectionAortaMarfanOnsetWomenAdditional 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
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 outcomes