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
Midterm follow-up of composite graft replacement of the aortic root (30-year experience)—remarkably safe, effective, and durable
Jeoffrey S, Zafar M, Velasco J, Khattak A, Ellauzi H, Nasir A, Kalyanasundaram A, Ziganshin B, Elefteriades J. Midterm follow-up of composite graft replacement of the aortic root (30-year experience)—remarkably safe, effective, and durable. JTCVS Open 2023, 17: 1-13. PMID: 38420531, PMCID: PMC10897671, DOI: 10.1016/j.xjon.2023.11.007.Peer-Reviewed Original ResearchAortic root replacementOperative mortalityTerm outcomesDistal aortic segmentsLong-term bleedingAortic root diseaseComposite graft replacementType A DissectionFirst-time operationsAge/genderARR patientsConcomitant CABGLate reoperationAcute typeRoot replacementAdverse eventsGraft failureGraft replacementRedo proceduresCabrol procedureUrgent operationAortic rootAortic segmentsPatientsOperative choiceEvidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease
Waldron C, Zafar M, Ziganshin B, Weininger G, Grewal N, Elefteriades J. Evidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease. International Journal Of Molecular Sciences 2023, 24: 15640. PMID: 37958625, PMCID: PMC10650782, DOI: 10.3390/ijms242115640.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic aneurysmCarotid intima-media thicknessLow-density lipoprotein levelsIntima-media thicknessDevelopment of atherosclerosisMatrix metalloproteinase proteinsAscending aneurysmAortic calcificationAtherosclerotic diseaseLipoprotein levelsMyocardial infarctionLeading causeAneurysmsMetalloproteinase proteinsGrowth factorProtective relationshipDiseasePossible mechanismCurrent understandingMorbidityInfarctionAtherosclerosisPatientsPathophysiologyBicuspid 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 criteriaFull calcium jacket: Conservative management of a traumatic aortic injury
Tripathi R, Ellauzi H, Zafar M, Ziganshin B, Elefteriades J. Full calcium jacket: Conservative management of a traumatic aortic injury. Journal Of Vascular Surgery Cases And Innovative Techniques 2023, 9: 101132. PMID: 37139352, PMCID: PMC10149390, DOI: 10.1016/j.jvscit.2023.101132.Peer-Reviewed Original ResearchKIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection
Velasco J, Li Y, Ziganshin B, Zafar M, Rizzo J, Ma D, Zang H, Kalyanasundaram A, Elefteriades J. KIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection. Genes 2023, 14: 252. PMID: 36833179, PMCID: PMC9956195, DOI: 10.3390/genes14020252.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic dissectionOdds ratioVariant statusArg allele carriersThoracic aortic dissectionOccurrence of ADAortic sizeArg alleleMarked adverse impactTAA patientsAortic aneurysmClinical assessmentSurgical decisionAllele carriersIncrease riskVariant patientsArg carriersPilot studyDissectionImportant intracellular functionsConfirmatory findingsPatientsAneurysmsPresent study
2022
Rapid growth of thoracic aortic aneurysm: Reality or myth?
Sonsino A, Ellauzi H, Ziganshin BA, Zafar MA, Elefteriades JA. Rapid growth of thoracic aortic aneurysm: Reality or myth? Journal Of Thoracic And Cardiovascular Surgery 2022, 167: 1206-1213. PMID: 36028356, DOI: 10.1016/j.jtcvs.2022.06.021.Peer-Reviewed Original ResearchRapid aortic growthAortic growthAortic growth rateProphylactic surgical interventionThoracic aortic aneurysmPrompt surgeryInoperable patientsAortic diseaseSurgical interventionAortic measurementsAortic aneurysmPositivity ratePatientsAortaExperienced cliniciansGenetic findingsAortic imagesAneurysmsAmerican AssociationPotential sourceSurgeryAscendingCliniciansDiseaseSurvivorsClinical Experience with “Stand-Alone” Elephant Trunk Procedure for Descending Aortic Aneurysms
Kumbasar U, Zafar MA, Ziganshin BA, Elefteriades JA. Clinical Experience with “Stand-Alone” Elephant Trunk Procedure for Descending Aortic Aneurysms. Aorta 2022, 10: 52-56. PMID: 35933985, PMCID: PMC9357495, DOI: 10.1055/s-0042-1743535.Peer-Reviewed Original ResearchElephant trunk procedureAortic replacementElephant trunkAortic aneurysmLanding zoneDeep hypothermic circulatory arrestHypothermic circulatory arrestProximal landing zoneThoracic aortic aneurysmStage 1Subclavian levelCardiac causesCirculatory arrestEndovascular approachSubclavian arteryEndovascular treatmentLeft carotidSuitable landing zoneClinical experiencePatientsAneurysmsProximal foundationAortaStrokeMortalityBovine Aortic Arch: A Result of Chance or Mandate of Inheritance?
Shang M, Vinholo TF, Buntin J, Zafar MA, Ziganshin BA, Elefteriades JA. Bovine Aortic Arch: A Result of Chance or Mandate of Inheritance? The American Journal Of Cardiology 2022, 172: 115-120. PMID: 35321803, PMCID: PMC9978865, DOI: 10.1016/j.amjcard.2022.02.030.Peer-Reviewed Original ResearchConceptsBovine archThoracic aortic aneurysmAortic aneurysmThoracic aortic aneurysm diseaseAortic arch configurationAortic aneurysm diseaseSecond-degree relativesInstitutional databaseAneurysm diseaseChest imagingPatientsAneurysmsAvailable scansGenetic mutationsArch resultsArchArch configurationFamily membersSample populationProbandsScansMagnetic resonanceResult of chancePrevious studiesChestEngineering analysis of aortic wall stress and root dilatation in the V-shape surgery for treatment of ascending aortic aneurysms
Dong H, Liu M, Qin T, Liang L, Ziganshin B, Ellauzi H, Zafar M, Jang S, Elefteriades J, Sun W. Engineering analysis of aortic wall stress and root dilatation in the V-shape surgery for treatment of ascending aortic aneurysms. Interdisciplinary CardioVascular And Thoracic Surgery 2022, 34: 1124-1131. PMID: 35134955, PMCID: PMC9159430, DOI: 10.1093/icvts/ivac004.Peer-Reviewed Original ResearchConceptsRoot dilatationAortic rootAortic wall stressAortic aneurysmWall stressComputed tomography imagesTime pointsAortic root diameterTomography imagesSignificant reductionPost-surgery statesWhole aortaAortic wallSurgeryDilatationClinical cardiacPatientsAverage dilatationStudy objectiveAneurysmsAortaBiomechanical analysisTreatmentA 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
Ascending Aneurysms in Heart Transplant Patients A Rare Opportunity to Assess Heredity Versus Biological Environment
Anis O, Kopf G, Ziganshin B, Zafar M, Tranquilli M, Sieller R, Elefteriades J. Ascending Aneurysms in Heart Transplant Patients A Rare Opportunity to Assess Heredity Versus Biological Environment. JACC Case Reports 2021, 3: 1685-1689. PMID: 34766019, PMCID: PMC8571777, DOI: 10.1016/j.jaccas.2021.07.010.Peer-Reviewed Original ResearchDelayed Surgery for Acute Aortic Dissection
Pinkhasova P, Zafar M, Ziganshin B, Elefteriades J. Delayed Surgery for Acute Aortic Dissection. 2021, 535-551. DOI: 10.1007/978-3-030-66668-2_37.Peer-Reviewed Original ResearchLipid profiles help to explain protection from systemic atherosclerosis in patients with ascending aortic aneurysm
Weininger G, Ostberg N, Shang M, Zafar M, Ziganshin BA, Liu S, Erben Y, Elefteriades JA. Lipid profiles help to explain protection from systemic atherosclerosis in patients with ascending aortic aneurysm. Journal Of Thoracic And Cardiovascular Surgery 2021, 163: e129-e132. PMID: 34635315, DOI: 10.1016/j.jtcvs.2021.09.031.Peer-Reviewed Original ResearchSimple Hepatic Cysts as Markers of Thoracic Aortic Disease
C K, BA Z, MA Z, J B, J E. Simple Hepatic Cysts as Markers of Thoracic Aortic Disease. Journal Of Disease Markers 2021, 6 DOI: 10.26420/jdismarkers.2021.1043.Peer-Reviewed Original ResearchThoracic aortic diseaseSimple hepatic cystsBovine aortic archBicuspid aortic valveSimple renal cystsPositive family historyMost patientsAortic diseaseHepatic cystsRetrospective studyAortic aneurysmAortic archAortic valveClinical markersHospital patientsFamily historyRenal cystsTAD patientsControl groupPatientsAneurysmsPrevalenceCystsDiseaseAccuracy of the “Thumb-Palm Test” for Detection of Ascending Aortic Aneurysm
Blumel R, Patel K, Rizzo JA, Mok S, Barrett A, Wu J, Zafar MA, Ziganshin BA, Elefteriades JA. Accuracy of the “Thumb-Palm Test” for Detection of Ascending Aortic Aneurysm. The American Journal Of Cardiology 2021, 150: 114-116. PMID: 34020772, DOI: 10.1016/j.amjcard.2021.03.041.Peer-Reviewed Original ResearchConceptsAscending aortic diameterAortic aneurysmTransesophageal echocardiographyPalm testAortic diameterIntra-operative transesophageal echocardiographyAscending Aortic AneurysmThoracic aortic aneurysmStandard physical examinationThousands of patientsVariety of disordersAscending aneurysmCardiac surgeryAneurysm patientsPhysical examinationPositive testPatientsNegative testAneurysmsHigher likelihoodNegative resultsAscAASubstantial likelihoodSignsEchocardiographyAortic 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 studiesSafety