Scholars@Duke
George Charles Hughes IV

George Charles Hughes IV

Professor of Surgery
Surgery, Cardiovascular and Thoracic Surgery
Box 3051 Med Ctr, Durham, NC 27710
3580 White Zone, Duke South, Durham, NC 27710

Selected Publications

Neurocognitive Dysfunction After Short (<20 Minutes) Duration Hypothermic Circulatory Arrest.

Journal Article Ann Thorac Surg · September 23, 2024 BACKGROUND: It has long been held that the safe duration of hypothermic circulatory arrest (HCA) is at least 25 to 30 minutes. However, this belief is based primarily on clinical outcomes research and has not been systematically investigated using more sen ... Full text Link to item Cite

Impact of nondiameter aortic indices on surgical eligibility: Results from the Treatment in Thoracic Aortic Aneurysm: Surgery Versus Surveillance (TITAN: SvS) randomized controlled trial.

Journal Article J Thorac Cardiovasc Surg · April 29, 2024 OBJECTIVES: Traditional criterion for intervention on an asymptomatic ascending aortic aneurysm has been a maximal aortic diameter of 5.5 cm or more. The 2022 American College of Cardiology/American Heart Association aortic guidelines adopted cross-section ... Full text Link to item Cite

Real-World Outcomes for the Fifth-Generation Balloon Expandable Transcatheter Heart Valve in the United States.

Journal Article JACC Cardiovasc Interv · April 22, 2024 BACKGROUND: The fifth-generation SAPIEN 3 Ultra Resilia valve (S3UR) incorporates several design changes as compared with its predecessors, the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) valves, including bovine leaflets treated with a novel process intended t ... Full text Link to item Cite

Long-term outcomes for hybrid aortic arch repair.

Journal Article J Vasc Surg · April 2024 OBJECTIVE: Since its inception in the early 2000s, hybrid arch repair (HAR) has evolved from novel approach to well-established treatment modality for aortic arch pathology in appropriately selected patients. Despite this nearly 20-year history of use, lon ... Full text Link to item Cite

Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes After Aortic Arch Surgery.

Journal Article Circulation · February 27, 2024 BACKGROUND: Deep hypothermia has been the standard for hypothermic circulatory arrest (HCA) during aortic arch surgery. However, centers worldwide have shifted toward lesser hypothermia with antegrade cerebral perfusion. This has been supported by retrospe ... Full text Link to item Cite

Mid-term outcomes of aortic valve repair using an anatomically shaped internal annuloplasty ring.

Journal Article Eur J Cardiothorac Surg · December 1, 2023 OBJECTIVES: The Hemispherical Aortic Annuloplasty Reconstructive Technology (HAART) ring is a rigid, internal and geometric device. The objective of this article is to assess the mid-term outcomes of aortic valve repair (AVr) using this prosthesis. METHODS ... Full text Link to item Cite

Tailored approach and outcomes of aortic arch reconstruction after acute type A dissection repair.

Journal Article J Thorac Cardiovasc Surg · October 2023 OBJECTIVE: After limited root/ascending with or without hemiarch repair for acute type A aortic dissection (ATAAD), 20% to 30% of patients require distal reintervention, frequently for arch pathology. In this report, we describe an institutional algorithm ... Full text Link to item Cite

3-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis.

Journal Article J Am Coll Cardiol · May 2, 2023 BACKGROUND: Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as par ... Full text Link to item Cite

Failing To See the Forest for the Trees.

Journal Article Eur J Vasc Endovasc Surg · April 2023 Full text Link to item Cite

Long-term outcomes of aortic root operations in the United States among Medicare beneficiaries.

Journal Article J Thorac Cardiovasc Surg · February 2023 OBJECTIVE: The best method of aortic root repair in older patients remains unknown given a lack of comparative effectiveness of long-term outcomes data. The objective of this study was to compare long-term outcomes of different surgical approaches for aort ... Full text Link to item Cite

Selective Sinus Replacement for Aortic Root Aneurysm: Durable Approach in Selected Patients.

Journal Article Ann Thorac Surg · February 2023 BACKGROUND: Selective sinus replacement (SSR) allows a tailored repair approach in patients with sinus of Valsalva or asymmetric aortic root aneurysm. SSR avoids the need for coronary reimplantation for nondiseased sinuses and shortens operative time, alth ... Full text Link to item Cite

It Depends What the Definition of "Safe" Is.

Journal Article Ann Thorac Surg · February 2023 Full text Link to item Cite

Association Between Device Type and Type IIIb Endoleaks Following Thoracic Endovascular Aortic Repair.

Journal Article Eur J Vasc Endovasc Surg · January 2023 OBJECTIVE: Endoleaks following thoracic endovascular aortic repair (TEVAR) can lead to the need for re-intervention and aortic rupture. Given the recent recall of a specific thoracic stent graft type due to concerns about type IIIb endoleak (T3bE), in whic ... Full text Link to item Cite

ANTIBIOTIC PROPHYLAXIS ADHERENCE AFTER VALVE REPLACEMENT SURGERY

Conference JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · 2023 Cite

Retrograde Cerebral Perfusion May Decrease Stroke Risk During Elective Aortic Arch Surgery.

Journal Article Innovations (Phila) · 2023 OBJECTIVE: Controversy remains regarding the optimal neuroprotection strategy for elective hemiarch replacement (HEMI). This study sought to compare outcomes in patients who underwent HEMI utilizing the 2 most common contemporary methods of cerebral protec ... Full text Link to item Cite

Reply: Does the Solution Only Lie in the Size of the Aorta?

Journal Article J Am Coll Cardiol · October 18, 2022 Full text Link to item Cite

Stent Graft-induced Aortic Wall Injury: Incidence, Risk Factors, and Outcomes.

Journal Article Ann Thorac Surg · September 2022 BACKGROUND: Stent graft-induced new entry has been described in thoracic endovascular aortic repair for aortic dissection. The incidence of stent graft-induced aortic wall injury (SAWI) related to iatrogenic injury in nondissections is incompletely describ ... Full text Link to item Cite

Mechanisms of Death in Low-Risk Patients After Transcatheter or Surgical Aortic Valve Replacement.

Journal Article Cardiovasc Revasc Med · September 2022 BACKGROUND: Death in high- and intermediate-risk patients after self-expanding transcatheter (TAVR) and surgical aortic valve replacement (surgery) differed in mechanisms and timing. In both risk groups, 1-year all-cause mortality was lower in TAVR than in ... Full text Link to item Cite

Open arch surgery in the redo setting: contemporary outcomes.

Journal Article J Cardiovasc Surg (Torino) · August 2022 BACKGROUND: Aortic arch reconstruction after prior cardiac surgery is technically complex, especially after proximal aortic surgery. While multiple surgical adaptations in the redo setting have been described, traditional open reconstruction remains the mo ... Full text Link to item Cite

Feasibility study of a novel digital health platform for patients undergoing transcatheter aortic valve replacement.

Journal Article J Card Surg · July 2022 INTRODUCTION: Despite abundant evidence indicating that digital health solutions improve outcomes in chronic medical conditions, there are few validated solutions for acute surgical episodes. Transcatheter aortic valve replacement (TAVR) is a less invasive ... Full text Link to item Cite

Location of Aortic Enlargement and Risk of Type A Dissection at Smaller Diameters.

Journal Article J Am Coll Cardiol · May 17, 2022 BACKGROUND: Previous work has demonstrated that more than one-half of acute type A aortic dissections (ATADs) occur at a maximal aortic diameter (MAD) of <5.5 cm. However, no analysis has investigated whether ATAD risk at smaller MADs is more common with m ... Full text Link to item Cite

Early Outcomes of Patients Undergoing Neoaortic Valve Repair Incorporating Geometric Ring Annuloplasty.

Journal Article World J Pediatr Congenit Heart Surg · May 2022 OBJECTIVES: During congenital heart surgery, the pulmonary valve and root may be placed into the systemic position, yielding a "neoaortic" valve. With the stress of systemic pressure, the pulmonary roots can dilate, creating aneurysms and/or neoaortic insu ... Full text Link to item Cite

Five-year outcomes of endovascular repair of complicated acute type B aortic dissections.

Journal Article J Thorac Cardiovasc Surg · February 2022 OBJECTIVE: Thoracic endovascular aortic repair is the standard of care for acute complicated type B aortic dissections, but long-term single-device outcomes are limited. METHODS: Fifty patients were treated with the Valiant Captivia thoracic stent graft (M ... Full text Link to item Cite

Surgical Sutureless and Sutured Aortic Valve Replacement in Low-risk Patients.

Journal Article Ann Thorac Surg · February 2022 BACKGROUND: Randomized clinical trials have shown that transcatheter aortic valve replacement is noninferior to surgery in low surgical risk patients. We compared outcomes in patients treated with a sutured (stented or stentless) or sutureless surgical val ... Full text Link to item Cite

Evaluation of U-Net Based Architectures for Automatic Aortic Dissection Segmentation

Journal Article ACM Transactions on Computing for Healthcare · January 1, 2022 Segmentation and reconstruction of arteries is important for a variety of medical and engineering fields, such as surgical planning and physiological modeling. However, manual methods can be laborious and subject to a high degree of human variability. In t ... Full text Cite

Management of chronic type B aortic dissection

Journal Article Vessel Plus · January 1, 2022 The standard of care first-line therapy for uncomplicated acute type B aortic dissection is medical therapy. As a result, many of these dissections progress to become chronic type B aortic dissections (CTBAD). In the following manuscript, we will outline t ... Full text Cite

Complex Repair of a Completely Fused Nullicuspid Aortic Valve Late in Adolescence.

Journal Article World J Pediatr Congenit Heart Surg · November 2021 We report a case of an 18-year-old female who presented with severe aortic stenosis and insufficiency, eight years following resection of a subaortic membrane. On echocardiography, she was found to have a completely fused or nullicuspid valve, with three e ... Full text Link to item Cite

Current state of hybrid solutions for aortic arch aneurysms.

Journal Article Ann Cardiothorac Surg · November 2021 Since its inception in the early 2000s, hybrid arch repair (HAR) has evolved from a novel approach to a well-established treatment modality for aortic arch pathology in appropriately selected patients. HAR procedures have been proposed as a means to circum ... Full text Link to item Cite

National trends in repair for type B aortic dissection.

Journal Article Clin Cardiol · August 2021 BACKGROUND: Thoracic endovascular aortic repair (TEVAR) first gained in popularity for repair of type B aortic dissections (TBADs) in the early 2000's. We aimed to describe patients undergoing open repair, TEVAR, and no repair and analyze factors associate ... Full text Link to item Cite

Does deeper hypothermia reduce the risk of acute kidney injury after circulatory arrest for aortic arch surgery?

Conference Eur J Cardiothorac Surg · July 30, 2021 OBJECTIVES: The impact of hypothermic circulatory arrest (HCA) temperature on postoperative acute kidney injury (AKI) has not been evaluated. This study examined the association between circulatory arrest temperatures and AKI in patients undergoing proxima ... Full text Link to item Cite

When to Consider Deferral of Surgery in Acute Type A Aortic Dissection: A Review.

Journal Article Ann Thorac Surg · June 2021 BACKGROUND: Acute type A aortic dissection (ATAAD) is a surgical emergency with an operative mortality of up to 30%, a rate that has not changed meaningfully in more than 2 decades. A growing body of research has highlighted several comorbidities and prese ... Full text Link to item Cite

Long-term outcomes of aortic root replacement for endocarditis.

Journal Article J Card Surg · June 2021 BACKGROUND: Infective endocarditis (IE) involving the aortic valve and root is associated with high risk requiring thoughtful surgical decision-making. The impact of valve and conduit choices and patient factors on long-term outcomes in this patient popula ... Full text Link to item Cite

Aortic Valve Repair Using Geometric Ring Annuloplasty

Journal Article Operative Techniques in Thoracic and Cardiovascular Surgery · June 1, 2021 Reparative operations for insufficient cardiac valves constitute the surgical procedures of choice when pathoanatomies permit. At present, mitral and tricuspid repair techniques are well-established, but recent data also suggest that reconstruction of insu ... Full text Cite

Commentary: Branched Endograft Repair of Thoracoabdominal Aortic Aneurysm–Finally Ready for Prime Time

Journal Article Operative Techniques in Thoracic and Cardiovascular Surgery · March 1, 2021 Full text Cite

Midterm outcomes in patients undergoing endovascular repair of thoracic aortic aneurysms and penetrating atherosclerotic ulcers using the RelayPlus stent graft.

Journal Article J Vasc Surg · February 2021 BACKGROUND: The Relay Thoracic Stent-Graft with Plus Delivery System (RelayPlus; Terumo Aortic, Sunrise, Fla) was designed to handle the curvature and tortuosity of the thoracic aorta. It was approved by the Food and Drug Administration in 2012; the postap ... Full text Link to item Cite

Algorithmic Approach to Treatment of Aortic Coarctation in Adults

Conference JOURNAL OF VASCULAR SURGERY · 2021 Cite

Acute Type A Aortic Dissection: When Not to Operate

Chapter · January 1, 2021 Acute type A aortic dissection (ATAAD) is a surgical emergency which carries an operative mortality of 10–30% in multiple series, a rate which has not decreased meaningfully over the past 15 years. This lack of improvement in outcomes over time has prompte ... Full text Cite

Permissive Hypertension and Collateral Revascularization May Allow Avoidance of Cerebrospinal Fluid Drainage in Thoracic Endovascular Aortic Repair.

Journal Article Ann Thorac Surg · November 2020 BACKGROUND: The utility of cerebrospinal fluid drainage (CSFD) for prevention of spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) remains unclear. We previously published our institutional algorithm restricting preoperative CSFD ... Full text Link to item Cite

Geographic Access to Transcatheter Aortic Valve Replacement Centers in the United States: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal Article JAMA Cardiol · September 1, 2020 IMPORTANCE: Geographic access to transcatheter aortic replacement (TAVR) centers varies in the United States as a result of controlled expansion through minimum volume requirements. OBJECTIVE: To describe the current geographic access to TAVR centers in th ... Full text Link to item Cite

Impact of dual energy cardiac CT for metal artefact reduction post aortic valve replacement.

Journal Article Eur J Radiol · August 2020 PURPOSE: Assess image quality of dual-energy (DE) and single-energy (SE) cardiac multi-detector computed tomographic (MDCT) post aortic valve replacement (AVR) on a dual source MDCT scanner. METHODS: Eighty patients with cardiac MDCT acquisitions (ECG gate ... Full text Link to item Cite

INVITED COMMENTARY.

Journal Article Ann Thorac Surg · July 2020 Full text Link to item Cite

Geographic Access to Transcatheter Aortic Valve Replacement Centers in the United States: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal Article JAMA Cardiol · June 10, 2020 Importance: Geographic access to transcatheter aortic replacement (TAVR) centers varies in the United States as a result of controlled expansion through minimum volume requirements. Objective: To describe the current geographic access to TAVR centers in th ... Full text Link to item Cite

Aortic valve repair with a newly approved geometric annuloplasty ring in patients undergoing proximal aortic repair: early results from a single-centre experience.

Journal Article Eur J Cardiothorac Surg · June 1, 2020 OBJECTIVES: Aortic insufficiency (AI) is common in patients with proximal aortic disease, but limited options exist to facilitate aortic valve repair (AVr) in this population. This study reports 'real-world' early results of AVr using newly FDA-approved tr ... Full text Link to item Cite

Transcatheter aortic valve replacement for patients with severe bicuspid aortic stenosis.

Journal Article Am Heart J · June 2020 BACKGROUND: Patients with bicuspid aortic valve stenosis (BAV) were excluded from all the trileaflet aortic valve stenosis (TAV) pivotal trials, and therefore, their outcomes are not clearly defined. The aim of the study was to evaluate the outcomes of tra ... Full text Link to item Cite

Valve-in-Ring Transcatheter Aortic Valve Replacement After Left Ventricular Assist Device Therapy.

Journal Article Ann Thorac Surg · March 2020 Aortic regurgitation after left ventricular assist device (LVAD) implantation is a well-described problem that decreases the clinical effectiveness of LVAD therapy and may eventually prompt consideration of aortic valve replacement once the regurgitation b ... Full text Link to item Cite

Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) Reporting Standards for Type B Aortic Dissections.

Journal Article Ann Thorac Surg · March 2020 This Society for Vascular Surgery/Society of Thoracic Surgeons (SVS/STS) document illustrates and defines the overall nomenclature associated with type B aortic dissection. The contents describe a new classification system for practical use and reporting t ... Full text Link to item Cite

Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections.

Journal Article J Vasc Surg · March 2020 This Society for Vascular Surgery/Society of Thoracic Surgeons (SVS/STS) document illustrates and defines the overall nomenclature associated with type B aortic dissection. The contents describe a new classification system for practical use and reporting t ... Full text Link to item Cite

Invited Commentary.

Journal Article Ann Thorac Surg · January 2020 Full text Link to item Cite

Acute Type B Aortic Dissection

Chapter · January 1, 2020 Acute type B aortic dissection (identified within 2 weeks of symptom onset), as described using the Stanford classification, involves the aorta distal to the left subclavian artery and accounts for 25-40% of all aortic dissections. The traditional treatmen ... Full text Cite

Factors Associated With and Outcomes of Aborted Procedures During Elective Transcatheter Aortic Valve Replacement.

Journal Article JACC Cardiovasc Interv · September 23, 2019 OBJECTIVES: This study sought to evaluate the outcomes and factors associated with aborted procedures among patients undergoing elective transcatheter aortic valve replacement (TAVR). BACKGROUND: Elective TAVR procedures can be aborted because of device li ... Full text Link to item Cite

Relation of Postdischarge Care Fragmentation and Outcomes in Transcatheter Aortic Valve Implantation from the STS/ACC TVT Registry.

Journal Article Am J Cardiol · September 15, 2019 Fragmented care following elective surgery has been associated with poor outcomes. The association between fragmented care and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. We examined patients who underwent TAV ... Full text Link to item Cite

Trends and Outcomes of Alternative-Access Transcatheter Aortic Valve Replacement.

Journal Article J Invasive Cardiol · July 2019 BACKGROUND: Alternative access (AA) is still required for a significant proportion of patients undergoing transcatheter aortic valve replacement (TAVR). We sought to compare the clinical outcomes of patients undergoing AA vs transfemoral (TF) access. METHO ... Link to item Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Elective Aortic Root Replacement in North America: Analysis of STS Adult Cardiac Surgery Database.

Journal Article Ann Thorac Surg · May 2019 BACKGROUND: Unlike coronary artery bypass and aortic and mitral valve procedures, there is no predictive risk model for aortic root replacement procedures. As a first step toward development of a risk model, this study analyzed The Society of Thoracic Surg ... Full text Link to item Cite

Back stabber: ladder fall causing traumatic aortic transection.

Journal Article Asian Cardiovasc Thorac Ann · May 2019 A 68-year-old man presented with back pain after falling from a ladder and was found to have anterolisthesis of thoracic vertebrae T11-12 with secondary focal aortic injury and disruption of the aortic wall. This was successfully repaired using thoracic en ... Full text Link to item Cite

Valvular Disease in Marfan Syndrome: Surgical Considerations and Management.

Journal Article Curr Cardiol Rep · March 4, 2019 PURPOSE OF REVIEW: Detail the current strategies for the management of valve dysfunction in Marfan syndrome (MFS), understand the limitations of surgical interventions, and delineate the likely direction of future innovations. RECENT FINDINGS: Significant ... Full text Link to item Cite

Outcomes of carotid-subclavian bypass performed in the setting of thoracic endovascular aortic repair.

Journal Article J Vasc Surg · March 2019 BACKGROUND: Subclavian artery revascularization is frequently performed in the setting of thoracic endovascular aortic repair (TEVAR). However, there is little information on the short- and long-term outcomes of patients undergoing carotid to subclavian ar ... Full text Link to item Cite

Risk Prediction Model for Major Adverse Outcome in Proximal Thoracic Aortic Surgery.

Journal Article Ann Thorac Surg · March 2019 BACKGROUND: Proximal thoracic aortic surgery utilizing hypothermic circulatory arrest carries risks of mortality and major morbidity; however, these risks are not the same for every patient. The goal of the current study was to establish a risk prediction ... Full text Link to item Cite

Acute aortic dissections with entry tear in the arch: A report from the International Registry of Acute Aortic Dissection.

Journal Article J Thorac Cardiovasc Surg · January 2019 OBJECTIVE: To analyze presentation, management, and outcomes of acute aortic dissections with proximal entry tear in the arch. METHODS: Patients enrolled in the International Registry of Acute Aortic Dissection and entry tear in the arch were classified in ... Full text Link to item Cite

ROBO4 variants predispose individuals to bicuspid aortic valve and thoracic aortic aneurysm.

Journal Article Nat Genet · January 2019 Bicuspid aortic valve (BAV) is a common congenital heart defect (population incidence, 1-2%)1-3 that frequently presents with ascending aortic aneurysm (AscAA)4. BAV/AscAA shows autosomal dominant inheritance with incomplete penetrance and male predominanc ... Full text Link to item Cite

Stent graft-induced new entry tear (SINE): Intentional and NOT.

Journal Article J Thorac Cardiovasc Surg · January 2019 Full text Link to item Cite

5-Year Outcomes of Self-Expanding Transcatheter Versus Surgical Aortic Valve Replacement in High-Risk Patients.

Journal Article J Am Coll Cardiol · December 4, 2018 BACKGROUND: The CoreValve U.S. Pivotal High Risk Trial was the first randomized trial to show superior 1-year mortality of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (SAVR) among high operative mortality-r ... Full text Link to item Cite

Outcomes of Planned Two-Stage Hybrid Aortic Repair With Dacron-Replaced Proximal Landing Zone.

Journal Article Ann Thorac Surg · October 2018 BACKGROUND: Results of hybrid arch repair (HAR) using the native zone 0 proximal landing zone (PLZ) have been unsatisfactory in many series, especially in the setting of ascending aortic dilation (>4.0 cm). This study reports early and late outcomes of pla ... Full text Link to item Cite

Incidence, Management, and Associated Clinical Outcomes of New-Onset Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: An Analysis From the STS/ACC TVT Registry.

Journal Article JACC Cardiovasc Interv · September 10, 2018 OBJECTIVES: The aim of this study was to evaluate incidence, care patterns, and clinical outcomes in patients developing new-onset atrial fibrillation (AF) following transcatheter aortic valve replacement (TAVR). BACKGROUND: Pre-procedural AF has been asso ... Full text Link to item Cite

Anticoagulation and Antiplatelet Strategies After On-X Mechanical Aortic Valve Replacement.

Journal Article J Am Coll Cardiol · June 19, 2018 BACKGROUND: The burden oral anticoagulation is a limitation of mechanical valve prostheses. OBJECTIVES: The aim of this study was to test whether patients could be safely managed with dual-antiplatelet therapy (DAPT) (aspirin 325 mg and clopidogrel 75 mg) ... Full text Link to item Cite

Stroke and Cardiovascular Outcomes in Patients With Carotid Disease Undergoing Transcatheter Aortic Valve Replacement.

Journal Article Circ Cardiovasc Interv · June 2018 BACKGROUND: Stroke is a serious complication of both transcatheter aortic valve replacement (TAVR) and carotid artery disease (CD). The implications of CD in patients undergoing TAVR are unclear. METHODS AND RESULTS: The Society of Thoracic Surgeons and Am ... Full text Link to item Cite

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery.

Journal Article Anesthesiology · April 2018 BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patie ... Full text Link to item Cite

Long-term results of endovascular repair for descending thoracic aortic aneurysms.

Conference J Vasc Surg · February 2018 OBJECTIVE: Since thoracic endovascular aortic repair (TEVAR) received U.S. Food and Drug Administration approval for the treatment of descending thoracic aneurysms in March 2005, excellent 30-day and midterm outcomes have been described. However, data on l ... Full text Link to item Cite

Subclavian/Axillary Access for Self-Expanding Transcatheter Aortic Valve Replacement Renders Equivalent Outcomes as Transfemoral.

Journal Article Ann Thorac Surg · February 2018 BACKGROUND: Iliofemoral arterial disease can preclude transfemoral (TF) transcatheter aortic valve replacement (TF-TAVR). Transthoracic access by direct aortic or a transapical approach imparts a greater risk of complications and death than TF access. We h ... Full text Link to item Cite

Safety of Moderate Hypothermia With Antegrade Cerebral Perfusion in Total Aortic Arch Replacement.

Journal Article Ann Thorac Surg · January 2018 BACKGROUND: Total aortic arch replacement (TOTAL) is a complicated operation and has traditionally required deep hypothermic circulatory arrest. In this study, the impact of moderate hypothermic circulatory arrest (MHCA) and antegrade cerebral perfusion (A ... Full text Link to item Cite

Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database.

Journal Article J Card Surg · January 2018 PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between ... Full text Link to item Cite

Thoracic endovascular aortic repair for the ascending aorta: experience and pitfalls.

Journal Article J Vis Surg · 2018 Thoracic endovascular aortic repair (TEVAR) of the ascending aorta is a developing alternative treatment strategy, which currently is specifically aimed at patients who are too high risk for open surgery. TEVAR has been applied to patients with a variety o ... Full text Link to item Cite

The Modified Ross Procedure with Prosthetic Graft Wrap Does Not Prevent Autograft Failure.

Journal Article J Heart Valve Dis · November 2017 The modified Ross procedure, which involves replacement of the aortic valve with a pulmonary autograft root supported within a Dacron tube graft, was developed with the goal of preventing late autograft dilatation and associated aortic insufficiency. The c ... Link to item Cite

Outcomes of Reoperation After Acute Type A Aortic Dissection: Implications for Index Repair Strategy.

Conference J Am Heart Assoc · October 3, 2017 BACKGROUND: The optimal surgical approach for management of acute type A aortic dissection remains controversial. This study aimed to assess outcomes of reoperation after acute type A dissection repair to help guide decision making around index operative s ... Full text Link to item Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal Article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Peripheral Artery Disease and Transcatheter Aortic Valve Replacement Outcomes: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Therapy Registry.

Journal Article Circ Cardiovasc Interv · October 2017 BACKGROUND: Peripheral artery disease (PAD) is associated with increased cardiovascular mortality, and PAD risk factors overlap with those for aortic stenosis. The prevalence and outcomes associated with PAD in a population undergoing transcatheter aortic ... Full text Link to item Cite

Hypothermia and cerebral protection strategies in aortic arch surgery: a comparative effectiveness analysis from the STS Adult Cardiac Surgery Database.

Journal Article Eur J Cardiothorac Surg · September 1, 2017 OBJECTIVES: Hypothermic circulatory arrest is essential to aortic arch surgery, although consensus regarding optimal cerebral protection strategy remains lacking. We evaluated the current use and comparative effectiveness of hypothermia/cerebral perfusion ... Full text Link to item Cite

Imaging Surveillance After Proximal Aortic Operations: Is it Necessary?

Journal Article Ann Thorac Surg · March 2017 BACKGROUND: Current guidelines for imaging surveillance after proximal aortic repair are not evidence based. This study sought to characterize the incidence and causes of reintervention after proximal aortic operations to provide data to guide the frequenc ... Full text Link to item Cite

PREDICTORS OF MORTALITY AFTER TAVR IN A “REAL WORLD” SETTING

Conference Journal of the American College of Cardiology · March 2017 Full text Cite

Early Clinical Outcomes After Transcatheter Aortic Valve Replacement Using a Novel Self-Expanding Bioprosthesis in Patients With Severe Aortic Stenosis Who Are Suboptimal for Surgery: Results of the Evolut R U.S. Study.

Journal Article JACC Cardiovasc Interv · February 13, 2017 OBJECTIVES: This study sought to evaluate this transcatheter aortic valve (TAV) bioprosthesis in patients who are poorly suitable for surgical aortic valve (AV) replacement. BACKGROUND: A novel self-expandable TAV bioprosthesis was designed to provide a lo ... Full text Link to item Cite

Balloon Post-Dilation Following Implantation of a Self-Expanding Transcatheter Aortic Valve Bioprosthesis.

Journal Article JACC Cardiovasc Interv · January 23, 2017 OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodyna ... Full text Link to item Cite

Resolution of severe hemolysis and paravalvular aortic regurgitation employing an Amplatzer Vascular Plug 4: the importance of detailed pre-procedural planning using CT angiography.

Journal Article Cardiovasc Interv Ther · January 2017 A 76-year-old woman presented with progressive heart failure and transfusion-dependent hemolytic anemia due to severe paravalvular aortic regurgitation 4 years after bioprosthetic aortic valve replacement. She was deemed not to be a candidate for redo card ... Full text Link to item Cite

Mast cell activation and arterial hypotension during proximal aortic repair requiring hypothermic circulatory arrest.

Journal Article J Thorac Cardiovasc Surg · January 2017 OBJECTIVE: Aortic surgeries requiring hypothermic circulatory arrest evoke systemic inflammatory responses that often manifest as vasoplegia and hypotension. Because mast cells can rapidly release vasoactive and proinflammatory effectors, we investigated t ... Full text Open Access Link to item Cite

The verification of applicability of the use of embedded microwire temperature sensors in repair scenarios

Conference CAMX 2017 - Composites and Advanced Materials Expo · January 1, 2017 There is a significant need to track temperature within bondlines on composite materials during cure. The temperature history of the cured part affects the material properties of the composite and therefore part performance. Hence, the integrity of the str ... Cite

The development and evolution of an in-situ remote temperature sensing system for advanced composites manufacturing and Repa I R

Conference International SAMPE Technical Conference · January 1, 2017 Significant time, energy, and resources are spent within the composite manufacturing and repair industry focused on ensuring the quality of composite parts. Specialized technologies and processes are developed and utilized to ensure a high level of confide ... Cite

Impact of Retrograde Arch Extension in Acute Type B Aortic Dissection on Management and Outcomes.

Journal Article Ann Thorac Surg · December 2016 BACKGROUND: Optimal management of acute type B aortic dissection with retrograde arch extension is controversial. The effect of retrograde arch extension on operative and long-term mortality has not been studied and is not incorporated into clinical treatm ... Full text Link to item Cite

Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.

Journal Article J Thorac Cardiovasc Surg · December 2016 BACKGROUND: Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in aortic arch surgery has been purported to reduce coagulopathy and bleeding complications, although there are limited data supporting this claim. This study aimed to compar ... Full text Link to item Cite

Neurophysiological Intraoperative Monitoring During Aortic Arch Surgery.

Journal Article Seminars in cardiothoracic and vascular anesthesia · December 2016 Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by s ... Full text Cite

Complementary roles of open and hybrid approaches to thoracoabdominal aortic aneurysm repair.

Journal Article J Vasc Surg · November 2016 OBJECTIVE: Thoracoabdominal aortic aneurysm (TAAA) repair remains a significant challenge with considerable perioperative morbidity and mortality. A hybrid approach utilizing visceral debranching with endovascular aneurysm exclusion has been used to treat ... Full text Link to item Cite

Outcomes in the Randomized CoreValve US Pivotal High Risk Trial in Patients With a Society of Thoracic Surgeons Risk Score of 7% or Less.

Journal Article JAMA Cardiol · November 1, 2016 IMPORTANCE: Transcatheter aortic valve replacement (TAVR) is now a well-accepted alternative to surgical AVR (SAVR) for patients with symptomatic aortic stenosis at increased operative risk. There is interest in whether TAVR would benefit patients at lower ... Full text Link to item Cite

Concomitant replacement of the ascending aorta is free-for some.

Journal Article J Thorac Cardiovasc Surg · September 2016 Full text Link to item Cite

The risk and extent of neurologic events are equivalent for high-risk patients treated with transcatheter or surgical aortic valve replacement.

Journal Article J Thorac Cardiovasc Surg · July 2016 OBJECTIVES: This study was designed to characterize the incidence of new clinically detectable neurologic events, or any comparative change in indices of higher cognitive function following transcatheter aortic valve replacement (TAVR) or surgical aortic v ... Full text Link to item Cite

3-Year Outcomes in High-Risk Patients Who Underwent Surgical or Transcatheter Aortic Valve Replacement.

Journal Article J Am Coll Cardiol · June 7, 2016 BACKGROUND: In patients with severe aortic stenosis at increased risk for surgery, self-expanding transcatheter aortic valve replacement (TAVR) is associated with improved 2-year survival compared with surgery. OBJECTIVES: This study sought to determine wh ... Full text Link to item Cite

Invited Commentary.

Journal Article Ann Thorac Surg · June 2016 Full text Link to item Cite

The utility of the aortic dissection team: outcomes and insights after a decade of experience.

Journal Article Ann Cardiothorac Surg · May 2016 BACKGROUND: Mortality rates following acute type A aortic dissection (ATAAD) repair are reduced when operations are performed by a high-volume acute aortic dissection (AAD) team, leading to efforts to centralize ATAAD care. Here, we describe our experience ... Full text Link to item Cite

Invited Commentary.

Other Ann Thorac Surg · March 2016 Full text Link to item Cite

Use of human fibrinogen concentrate during proximal aortic reconstruction with deep hypothermic circulatory arrest.

Journal Article J Thorac Cardiovasc Surg · February 2016 OBJECTIVE: Human fibrinogen concentrate (HFC) is approved by the Food and Drug Administration for use at 70 mg/kg to treat congenital afibrinogenemia. We sought to determine whether this dose of HFC increases fibrinogen levels in the setting of high-risk b ... Full text Link to item Cite

Evolving practice pattern changes and outcomes in the era of hybrid aortic arch repair.

Journal Article J Vasc Surg · February 2016 OBJECTIVE: The role of hybrid repair in the management of aortic arch pathology, and long-term outcomes with these techniques, remains uncertain. We report a decade of experience with hybrid arch repair (HAR) and assess institutional practice patterns with ... Full text Link to item Cite

Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest.

Journal Article Ann Thorac Surg · February 2016 BACKGROUND: This study aimed to characterize intraoperative electroencephalography (EEG) during moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP), which has not been described previously. METHODS: This was a ... Full text Link to item Cite

Prolonged postoperative respiratory support after proximal thoracic aortic surgery: Is deep hypothermic circulatory arrest a risk factor?

Journal Article J Crit Care · February 2016 PURPOSE: In addition to the pulmonary risks associated with cardiopulmonary bypass, thoracic aortic surgery using deep hypothermic circulatory arrest (DHCA) may subject the lungs to further injury. However, this topic has received little investigation to d ... Full text Link to item Cite

Changes in Risk Profile and Outcomes of Patients Undergoing Surgical Aortic Valve Replacement From the Pre- to Post-Transcatheter Aortic Valve Replacement Eras.

Journal Article Ann Thorac Surg · January 2016 BACKGROUND: With initiation of transcatheter aortic valve replacement (TAVR) programs, centers may see changes in surgical aortic valve replacement (SAVR) populations and related outcomes because of more high-risk patients undergoing TAVR rather than SAVR. ... Full text Link to item Cite

Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting.

Journal Article Ann Thorac Surg · January 2016 BACKGROUND: Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are treatment options for aortic stenosis in patients with prior coronary artery bypass graft surgery. We assessed the major clinical outcomes of such pa ... Full text Link to item Cite

Invited Commentary.

Other Ann Thorac Surg · January 2016 Full text Link to item Cite

One-year outcomes from the international multicenter study of the Zenith Alpha Thoracic Endovascular Graft for thoracic endovascular repair.

Journal Article J Vasc Surg · December 2015 OBJECTIVE: This study evaluated the safety and effectiveness of the Zenith Alpha Thoracic Endovascular Graft (Cook Medical, Bloomington, Ind) for the treatment of descending thoracic aortic aneurysms and large ulcers. METHODS: The Zenith Alpha Thoracic End ... Full text Link to item Cite

Repair of Bicuspid Aortic Valve Syndrome with Anomalous Right Coronary Artery in Osteogenesis Imperfecta.

Journal Article J Heart Valve Dis · November 2015 Osteogenesis imperfecta (OI) is an inherited connective tissue disorder caused by the defective synthesis of type I collagen. The clinical phenotype is dominated by bone fragility, but cardiovascular tissue involvement has also been reported. Here, the cas ... Link to item Cite

Intraoperative Magnesium Administration Does Not Reduce Postoperative Atrial Fibrillation After Cardiac Surgery.

Journal Article Anesth Analg · October 2015 BACKGROUND: Hypomagnesemia has been associated with an increased risk of postoperative atrial fibrillation (POAF). Although previous studies have suggested a beneficial effect of magnesium (Mg) therapy, almost all of these are limited by small sample size ... Full text Link to item Cite

Reply: To PMID 25301369.

Other Ann Thorac Surg · October 2015 Full text Link to item Cite

2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery.

Journal Article J Am Coll Cardiol · September 22, 2015 BACKGROUND: We reported favorable 1-year outcomes in patients unsuitable for surgery who underwent self-expanding transcatheter aortic valve replacement (TAVR) compared with an objective performance goal. Longer-term outcomes in these patients are not know ... Full text Link to item Cite

Outcomes of Thoracic Endovascular Aortic Repair in Acute Type B Aortic Dissection: Results From the Valiant United States Investigational Device Exemption Study.

Journal Article Ann Thorac Surg · September 2015 BACKGROUND: Acute type B aortic dissection complicated by malperfusion or rupture carries a risk of death. We report 30-day and 12-month results of endovascular treatment with the Valiant Captivia Thoracic Stent Graft (Medtronic, Santa Rosa, CA) in patient ... Full text Link to item Cite

Epigenetic profiling identifies novel genes for ascending aortic aneurysm formation with bicuspid aortic valves.

Journal Article Heart Surg Forum · August 30, 2015 BACKGROUND:   Bicuspid aortic valves predispose to ascending aortic aneurysms, but the mechanisms underlying this aortopathy remain incompletely characterized.  We sought to identify epigenetic pathways predisposing to aneurysm formation in bicuspid patien ... Full text Link to item Cite

Long-Term Survival After Bovine Pericardial Versus Porcine Stented Bioprosthetic Aortic Valve Replacement: Does Valve Choice Matter?

Journal Article Ann Thorac Surg · August 2015 BACKGROUND: Bioprosthetic options are increasingly used for surgical aortic valve replacement (AVR). However, current decision making regarding bioprosthetic valve choice is not data-driven given incomplete information on comparative long-term outcomes aft ... Full text Link to item Cite

Discussion

Other Annals of Thoracic Surgery · August 1, 2015 Full text Cite

2-Year Outcomes in Patients Undergoing Surgical or Self-Expanding Transcatheter Aortic Valve Replacement.

Journal Article J Am Coll Cardiol · July 14, 2015 BACKGROUND: The U.S. pivotal trial for the self-expanding valve found that among patients with severe aortic stenosis at increased risk for surgery, the 1-year survival rate was 4.9 percentage points higher in patients treated with a self-expanding transca ... Full text Link to item Cite

Factor VIIa for Annulus Rupture After Transcatheter Aortic Valve Replacement.

Journal Article Ann Thorac Surg · July 2015 Over the last decade, transcatheter aortic valve replacement (TAVR) has emerged as an effective treatment for inoperable and selected high surgical-risk patients with aortic stenosis. However, management of procedural complications with TAVR represents a m ... Full text Link to item Cite

Comparison of aortic annulus size by transesophageal echocardiography and computed tomography angiography with direct surgical measurement.

Journal Article Am J Cardiol · June 1, 2015 This study sought to compare the accuracy of 2-dimensional transesophageal echocardiography (TEE) and computed tomography angiography (CTA) for noninvasive aortic annular sizing as required for transcatheter aortic valve implantation (TAVI). Direct intraop ... Full text Link to item Cite

PC46. Improved Long-Term Survival of EVAR Compared to Open Repair

Conference Journal of Vascular Surgery · June 2015 Full text Cite

Immediate mechanical effects of acute left bundle branch block by speckle tracked strain.

Journal Article J Electrocardiol · 2015 INTRODUCTION: Left bundle branch block (LBBB) is a known complication of transcatheter aortic valve replacement (TAVR) and has been shown to predict worsened outcomes in TAVR patients. A regional longitudinal strain pattern, termed the "classic" pattern of ... Full text Link to item Cite

Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.

Journal Article J Thorac Cardiovasc Surg · December 2014 OBJECTIVE: The choice of cerebral perfusion strategy for aortic arch surgery has been debated, and the superiority of antegrade (ACP) or retrograde (RCP) cerebral perfusion has not been shown. We examined the early and late outcomes for ACP versus RCP in p ... Full text Link to item Cite

Root replacement surgery versus more conservative management during type A acute aortic dissection repair.

Journal Article Ann Thorac Surg · December 2014 BACKGROUND: Aortic root management in type A acute aortic dissection is controversial. This study compared outcomes of root replacement (RR) interventions versus more conservative root (CR) management. METHODS: Of 1,995 type A acute aortic dissection patie ... Full text Link to item Cite

Thoracic endovascular aortic repair for chronic DeBakey IIIb aortic dissection.

Journal Article Ann Thorac Surg · December 2014 BACKGROUND: Thoracic endovascular aortic repair (TEVAR) for chronic DeBakey IIIb dissection with associated descending aneurysm remains controversial. This study examines long-term results of TEVAR for this disorder including examination of anatomic featur ... Full text Link to item Cite

Role of cardiac evaluation before thoracic endovascular aortic repair.

Conference J Vasc Surg · November 2014 BACKGROUND: Patients with thoracic aortic disease undergoing thoracic endovascular aortic repair (TEVAR) often have concomitant coronary artery disease and are at risk for perioperative adverse cardiac events. Despite this risk, the need for and extent of ... Full text Link to item Cite

Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection.

Journal Article Am J Med · September 2014 BACKGROUND: Acute aortic dissection associated with cocaine use is rare and has been reported predominantly as single cases or in small patient cohorts. METHODS: Our study analyzed 3584 patients enrolled in the International Registry of Acute Aortic Dissec ... Full text Link to item Cite

Analysis of geographic variations in the diagnosis and treatment of patients with aortic stenosis in North Carolina.

Journal Article Am J Cardiol · June 1, 2014 Despite advances in the treatment of aortic stenosis (AS), many patients with AS remain untreated. Barriers to accessing cardiovascular surgical care may play a role in this undertreatment. We sought to examine whether there are geographic variations in th ... Full text Link to item Cite

Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery.

Journal Article J Am Coll Cardiol · May 20, 2014 OBJECTIVES: This study sought to evaluate the safety and efficacy of the CoreValve transcatheter heart valve (THV) for the treatment of severe aortic stenosis in patients at extreme risk for surgery. BACKGROUND: Untreated severe aortic stenosis is a progre ... Full text Link to item Cite

Transcatheter aortic-valve replacement with a self-expanding prosthesis.

Journal Article N Engl J Med · May 8, 2014 BACKGROUND: We compared transcatheter aortic-valve replacement (TAVR), using a self-expanding transcatheter aortic-valve bioprosthesis, with surgical aortic-valve replacement in patients with severe aortic stenosis and an increased risk of death during sur ... Full text Link to item Cite

Outcomes of acute type a dissection repair before and after implementation of a multidisciplinary thoracic aortic surgery program.

Journal Article J Am Coll Cardiol · May 6, 2014 OBJECTIVES: The purpose of this study was to compare the results of acute type A aortic dissection (ATAAD) repair before and after implementation of a multidisciplinary thoracic aortic surgery program (TASP) at our institution, with dedicated high-volume t ... Full text Link to item Cite

Insurance status is associated with acuity of presentation and outcomes for thoracic aortic operations.

Journal Article Circ Cardiovasc Qual Outcomes · May 2014 BACKGROUND: Nonelective procedure status is the greatest risk factor for postoperative morbidity and mortality in patients undergoing thoracic aortic operations. We hypothesized that uninsured patients were more likely to require nonelective thoracic aorti ... Full text Link to item Cite

Current management and outcome of chronic type B aortic dissection: results with open and endovascular repair since the advent of thoracic endografting.

Journal Article Ann Cardiothorac Surg · May 2014 BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become the preferred treatment for chronic type B aortic dissection (CTBAD) at our institution. However, it remains incapable of treating all patients with CTBAD. The present study aims to review ... Full text Link to item Cite

Reduced anticoagulation after mechanical aortic valve replacement: interim results from the prospective randomized on-X valve anticoagulation clinical trial randomized Food and Drug Administration investigational device exemption trial.

Journal Article J Thorac Cardiovasc Surg · April 2014 OBJECTIVE: Under Food and Drug Administration investigational device exemption, the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT) has been testing the safety of less aggressive anticoagulation than recommended by the American College ... Full text Link to item Cite

The ARCH Projects: design and rationale (IAASSG 001).

Journal Article Eur J Cardiothorac Surg · January 2014 OBJECTIVE: A number of factors limit the effectiveness of current aortic arch studies in assessing optimal neuroprotection strategies, including insufficient patient numbers, heterogenous definitions of clinical variables, multiple technical strategies, in ... Full text Link to item Cite

Aortic subannular left ventricular aneurysm: a rare and surgically correctable cause of angina.

Journal Article Ann Thorac Surg · January 2014 Aortic subannular left ventricular aneurysm is a rare form of cardiac pathology. We report a case, including noninvasive and intraoperative imaging, of this entity in a young woman presenting with angina. The patient underwent successful surgical repair an ... Full text Link to item Cite

Endovascular Repair of Chronic Type B Aortic Dissection With Aneurysmal Degeneration

Journal Article Operative Techniques in Thoracic and Cardiovascular Surgery · December 16, 2013 Full text Cite

Repair of Mycotic Thoracoabdominal Aortic Aneurysm Following BCG Treatment

Conference Journal of Vascular Surgery · December 2013 Full text Cite

Radiation-associated valvular heart disease.

Journal Article J Heart Valve Dis · November 2013 Therapeutic ionizing radiation, such as that used in the treatment of Hodgkin's lymphoma, can cause cardiac valvular damage that may take several years to manifest as radiation-associated valvular heart disease. Treatment can be complicated by comorbid rad ... Link to item Cite

Risk-adjusted survival after tissue versus mechanical aortic valve replacement: a 23-year assessment.

Journal Article J Heart Valve Dis · November 2013 BACKGROUND AND AIM OF THE STUDY: Detailed analyses of risk-adjusted outcomes after mitral valve surgery have documented significant survival decrements with tissue valves at any age. Several recent studies of prosthetic aortic valve replacement (AVR) also ... Link to item Cite

Transcatheter aortic valve replacement: an update.

Journal Article Curr Cardiol Rep · June 2013 Aortic stenosis affects many people worldwide with a significant impact on morbidity and mortality with uncorrected, symptomatic aortic valve stenosis carrying mortality of 50% at one year. Degenerative calcific pathology, the most common cause of aortic s ... Full text Link to item Cite

Conformable Gore® TAG® Thoracic Endoprosthesis for the treatment of thoracic aortic aneurysms

Journal Article Interventional Cardiology (London) · June 1, 2013 Traditional open repair of descending thoracic aortic aneurysms is effective, although potentially associated with significant perioperative mortality and morbidity, including paraplegia, stroke, renal failure and pulmonary dysfunction. However, advances i ... Full text Cite

Plasma biomarkers for distinguishing etiologic subtypes of thoracic aortic aneurysm disease.

Journal Article J Thorac Cardiovasc Surg · May 2013 BACKGROUND: Thoracic aortic aneurysms (TAAs) develop through an asymptomatic process resulting in gross dilation that progresses to rupture if left undetected and untreated. If detected, patients with TAA are followed over time until the risk of rupture ou ... Full text Link to item Cite

Effects of institutional volumes on operative outcomes for aortic root replacement in North America.

Journal Article J Thorac Cardiovasc Surg · January 2013 OBJECTIVES: Hospital procedure volume has been strongly associated with postoperative mortality for a number of complex cardiovascular procedures. Although not yet described, a similar relationship might be expected for surgical procedures involving the ao ... Full text Link to item Cite

Reply to the editor.

Other J Thorac Cardiovasc Surg · January 2013 Full text Link to item Cite

Cardiac conduction system disease after transcatheter aortic valve replacement.

Journal Article Am Heart J · November 2012 Transcatheter aortic valve replacement (TAVR) is a rapidly-evolving technology for patients with severe, calcific aortic stenosis. Although these procedures lessen many of the risks and complications of open surgical aortic valve replacement, there remain ... Full text Link to item Cite

Results of thoracic endovascular aortic repair 6 years after United States Food and Drug Administration approval.

Journal Article Ann Thorac Surg · November 2012 BACKGROUND: Since United States Food and Drug Administration approval in 2005, the short-term safety and efficacy of thoracic endovascular aortic repair (TEVAR) have been established. However, longer-term follow-up data remain lacking. The objective of thi ... Full text Link to item Cite

Staged total abdominal debranching and thoracic endovascular aortic repair for thoracoabdominal aneurysm.

Journal Article J Vasc Surg · September 2012 OBJECTIVE: Thoracoabdominal aortic aneurysms (TAAAs) occur most commonly in elderly individuals, who are often suboptimal candidates for open repair because of significant comorbidities. The availability of a hybrid option, including open visceral debranch ... Full text Link to item Cite

Insurance status predicts non-elective case status but not outcomes of thoracic aortic operations

Conference Journal of the American College of Surgeons · September 2012 Full text Cite

Reply to the editor

Other Journal of Thoracic and Cardiovascular Surgery · July 1, 2012 Full text Cite

Intraoperative use of low-dose recombinant activated factor VII during thoracic aortic operations.

Journal Article Ann Thorac Surg · June 2012 BACKGROUND: Numerous studies have supported the effectiveness of recombinant activated factor VII (rFVIIa) for the control of bleeding after cardiac procedures; however safety concerns persist. Here we report the novel use of intraoperative low-dose rFVIIa ... Full text Link to item Cite

Cardiac catheterization within 1 to 3 days of proximal aortic surgery is not associated with increased postoperative acute kidney injury.

Journal Article J Thorac Cardiovasc Surg · June 2012 OBJECTIVE: Cardiac catheterization shortly before coronary artery bypass grafting or valve surgery has been associated with increased postoperative acute kidney injury. The relationship between catheterization timing and acute kidney injury after proximal ... Full text Link to item Cite

Retrograde ascending aortic dissection as an early complication of thoracic endovascular aortic repair.

Journal Article J Vasc Surg · May 2012 OBJECTIVE: Retrograde ascending aortic dissection (rAAD) is a potential complication of thoracic endovascular aortic repair (TEVAR), yet little data exist regarding its occurrence. This study examines the incidence, etiology, and outcome of this event. MET ... Full text Link to item Cite

Metabolic profiles predict adverse events after coronary artery bypass grafting.

Journal Article J Thorac Cardiovasc Surg · April 2012 OBJECTIVE: Clinical models incompletely predict the outcomes after coronary artery bypass grafting. Novel molecular technologies can identify biomarkers to improve risk stratification. We examined whether metabolic profiles can predict adverse events in pa ... Full text Link to item Cite

Ascending-descending aortic bypass with valve-sparing root replacement for coarctation with aortic root aneurysm.

Journal Article J Thorac Cardiovasc Surg · February 2012 A 55-year-old man with critical aortic coarctation, aortic root aneurysm, and aortic insufficiency underwent median sternotomy for ascending–descending aortic bypass and aortic root replacement. The patient was found to have a salvageable trileaflet aortic ... Full text Link to item Cite

Renal protection strategies

Chapter · December 1, 2011 The well-known quote from the renal physiologist Dr. Homer Smith as he proposed that the composition of the blood is determined not by what the mouth ingests but by what the kidneys keep.1 highlights not only the kidneys' domain of influence, but why even ... Full text Cite

Management of patients with bicuspid aortic valve disease.

Journal Article Curr Treat Options Cardiovasc Med · December 2011 Our approach to the management of the patient with a bicuspid aortic valve (BAV) takes several factors into consideration. First, is the dysfunction of the valve due to aortic stenosis (AS), aortic regurgitation (AR), or a combination of stenosis and regur ... Full text Link to item Cite

Results of proximal arch replacement using deep hypothermia for circulatory arrest: is moderate hypothermia really justifiable?

Journal Article Am Surg · November 2011 The use of selective cerebral perfusion with warmer temperatures during circulatory arrest has been increasingly used for arch replacement over concerns regarding the safety of deep hypothermic circulatory arrest (DHCA). However, little data actually exist ... Link to item Cite

Mycotic aneurysm of the thoracoabdominal aorta in a child with end-stage renal disease.

Journal Article J Vasc Surg · October 2011 A 5-year-old child with nephrotic syndrome developed a mycotic saccular thoracoabdominal aortic aneurysm (TAAA) involving the visceral segment within a 4-month period following pneumococcal bacteremia and presumed spontaneous bacterial peritonitis (SBP). D ... Full text Link to item Cite

Relationship of the time interval between cardiac catheterization and elective coronary artery bypass surgery with postprocedural acute kidney injury.

Journal Article Circulation · September 13, 2011 BACKGROUND: Some prior studies have suggested that the time to cardiac surgery after cardiac catheterization is inversely related to postoperative acute kidney injury (AKI). However, these studies, because of the small number of patients, were unable to ad ... Full text Link to item Cite

Individualized thoracic aortic replacement for the aortopathy of biscuspid aortic valve disease.

Journal Article J Heart Valve Dis · July 2011 BACKGROUND AND AIM OF THE STUDY: Bicuspid aortic valve (BAV) disease is associated with an aortopathy resulting in aneurysmal dilatation spanning the root, ascending, and arch segments. To date, no large series of proximal aortic replacement in this popula ... Link to item Cite

Results with a selective revascularization strategy for left subclavian artery coverage during thoracic endovascular aortic repair.

Journal Article Ann Thorac Surg · July 2011 BACKGROUND: The need for routine left subclavian artery (LSCA) revascularization when this vessel is covered during thoracic endovascular aortic repair remains controversial. We report our results with a selective LSCA revascularization strategy during tho ... Full text Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

Total aortic replacement in Loeys-Dietz syndrome.

Journal Article J Card Surg · May 2011 Loeys-Dietz syndrome (LDS) is a recently identified genetic complex characterized in part by rapidly progressive aortic and branch vessel disease. We now describe total aortic replacement using an open Extent II thoracoabdominal repair followed by second-s ... Full text Link to item Cite

Pan-aortic hybrid treatment of mega-aorta syndrome.

Journal Article J Vasc Surg · May 2011 Hybrid procedures combining traditional open and newer endovascular techniques are increasingly used to treat complex aortic disease. We present a novel approach for total aortic replacement, including hybrid repair of the arch and thoracoabdominal aorta, ... Full text Link to item Cite

Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest.

Journal Article J Thorac Cardiovasc Surg · May 2011 OBJECTIVE: Massive perioperative blood product transfusion may be required with thoracic aortic operations and is associated with poor outcomes. We analyzed independent predictors of massive transfusion in thoracic aortic surgical patients undergoing deep ... Full text Link to item Cite

Midterm results with thoracic endovascular aortic repair for chronic type B aortic dissection with associated aneurysm.

Journal Article J Thorac Cardiovasc Surg · February 2011 OBJECTIVE: Thoracic endovascular aortic repair for chronic type B aortic dissection with associated descending thoracic aneurysm remains controversial. Concerns include potential ischemic complications due to branch vessel origin from the chronic false lum ... Full text Link to item Cite

Outcomes for endocarditis surgery in North America: a simplified risk scoring system.

Journal Article J Thorac Cardiovasc Surg · January 2011 OBJECTIVE: Operation for infective endocarditis is associated with the highest mortality of any valve disease, with overall rates of in-hospital mortality exceeding 20%. The Society of Thoracic Surgeons Adult Cardiac Surgery Database was examined to develo ... Full text Link to item Cite

Pulmonary Dysfunction After Thoracic Aortic Surgery Utilizing Deep Hypothermic Circulatory Arrest

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2011 Link to item Cite

Richard E. Clark Award. Aortic dissection as a complication of cardiac surgery: report from the Society of Thoracic Surgeons database.

Journal Article Ann Thorac Surg · December 2010 BACKGROUND: Aortic dissection as a complication of cardiac surgery is a rare but often lethal event. We sought to determine the frequency of this complication in the STS (Society of Thoracic Surgeons) database as well as the outcomes of patients who suffer ... Full text Link to item Cite

Endovascular repair of descending thoracic aneurysms: results with "on-label" application in the post Food and Drug Administration approval era.

Journal Article Ann Thorac Surg · July 2010 BACKGROUND: Most studies of thoracic endovascular aortic repair (TEVAR) published since the technology gained US Food and Drug Administration (FDA) approval in March 2005 have included multiple applications including dissection, trauma, and "hybrid" approa ... Full text Link to item Cite

Glycosylated hemoglobin levels and outcome in non-diabetic cardiac surgery patients.

Journal Article Can J Anaesth · June 2010 PURPOSE: In diabetics, elevated preoperative hemoglobin A1c (HbA1c) levels are associated with increased complication rates after cardiac surgery. While many non-diabetics also have elevated HbA1c, the relationship with outcome in these patients is not wel ... Full text Link to item Cite

Two-stage total aortic replacement for Loeys-Dietz syndrome.

Journal Article J Card Surg · March 2010 Loeys-Dietz syndrome (LDS) is a recently described connective tissue disorder characterized by generalized arterial tortuosity and aggressive aortopathy that untreated leads to early death even at aortic dimensions as small as 4 cm. We report the case of a ... Full text Link to item Cite

Novel approach to the treatment of distal malperfusion secondary to ascending aortic dissection.

Journal Article J Card Surg · March 2010 Acute Type A dissection is a surgical emergency. The presence of visceral and extremity malperfusion syndromes increases perioperative mortality twofold. On occasion, significant malperfusion may best be addressed in a staged fashion with preliminary atten ... Full text Link to item Cite

Thoracic endografting in a patient with hereditary hemorrhagic telangiectasia presenting with a descending thoracic aneurysm.

Journal Article J Vasc Surg · February 2010 A 53-year-old woman with no classic risk factors for aneurysm disease presented with the sudden onset of chest pain and dyspnea. A large descending thoracic aortic aneurysm with focal type B dissection was identified and excluded by emergency thoracic endo ... Full text Link to item Cite

Utility of remote wireless pressure sensing for endovascular leak detection after endovascular thoracic aneurysm repair.

Journal Article Ann Thorac Surg · February 2010 BACKGROUND: The goal of thoracic endovascular aneurysm repair (TEVAR) is to exclude and depressurize the aneurysm sac. Type I and III endovascular leaks (EL) transmit systemic pressure and represent treatment failures. The significance of type II EL is mor ... Full text Link to item Cite

Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection.

Journal Article Ann Thorac Surg · January 2010 BACKGROUND: Thoracic endovascular aortic repair (TEVAR) for the management of type B aortic dissections has become more commonplace despite some controversy. Results of endovascular management of complicated acute (<2 weeks from symptom onset) and chronic ... Full text Link to item Cite

"Hybrid" repair of aneurysms of the transverse aortic arch: midterm results.

Journal Article Ann Thorac Surg · December 2009 BACKGROUND: Aneurysms of the transverse aortic arch, especially those involving the mid to distal arch, are technically challenging to repair with conventional open techniques. We present our results with a combined open/endovascular approach ("hybrid repa ... Full text Link to item Cite

Two-stage total cardioaortic replacement for end-stage heart and aortic disease in Marfan syndrome: case report and review of the literature.

Journal Article J Heart Lung Transplant · September 2009 A 24-year-old man with Marfan syndrome underwent mitral valve repair for prolapse at age 13. He sustained an acute type A aortic dissection at age 20 and underwent aortic root/ascending aortic replacement with a mechanical valved conduit. He initially did ... Full text Link to item Cite

Does negative pressure wound therapy have a role in preventing poststernotomy wound complications?

Journal Article Surg Innov · June 2009 BACKGROUND: Sternal wound infection (SWI) remains a devastating complication after cardiac surgery, decreasing long-term and short-term survival. In treating documented SWI, negative pressure wound therapy (NPWT) reduces wound edema and time to definitive ... Full text Link to item Cite

A previously unreported complication of apicoaortic conduit for severe aortic stenosis.

Journal Article Ann Thorac Surg · March 2009 Given the aging population, use of an apicoaortic conduit serves as an alternative method to treat severe aortic stenosis, especially in patients with a heavily calcified ascending aorta or prior cardiac surgery. Although an apicoaortic conduit fractionate ... Full text Link to item Cite

Hybrid thoracoabdominal aortic aneurysm repair: concomitant visceral revascularization and endovascular aneurysm exclusion.

Journal Article Semin Thorac Cardiovasc Surg · 2009 Thoracoabdominal aortic aneurysms (TAAA) remain a formidable surgical challenge, with conventional open repair associated with significant rates of mortality and morbidity. Furthermore, many of these patients are elderly with significant comorbidities and ... Full text Link to item Cite

Institutional response to FDA warning on aprotinin and impact on outcomes.

Journal Article HSR Proc Intensive Care Cardiovasc Anesth · 2009 INTRODUCTION: New evidence of potential risks of aprotinin in 2006 generated public concern about a previously approved drug that was routinely used. In response, we assembled a team of experts within the institution to form guidelines for the appropriate ... Link to item Cite

Endovascular approaches to complex thoracic aortic disease.

Journal Article Semin Cardiothorac Vasc Anesth · December 2008 Diseases of the thoracic aorta remain among the most lethal and difficult to treat conditions. In 2005, the US Food and Drug Administration approved the first endoprosthesis for the treatment of aneurysms of the descending thoracic aorta; at present, there ... Full text Link to item Cite

"Real world" thoracic endografting: results with the Gore TAG device 2 years after U.S. FDA approval.

Journal Article Ann Thorac Surg · November 2008 BACKGROUND: The Gore TAG thoracic endoprosthesis (W. L. Gore and Associates, Flagstaff, AZ) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of thoracic aortic aneurysms on March 23, 2005, and remains the only FDA approved thor ... Full text Link to item Cite

Pannus-related prosthetic valve dysfunction and life-threatening aortic regurgitation.

Journal Article J Heart Valve Dis · November 2008 Prosthetic valve dysfunction is a rare but life-threatening condition. A 66-year-old woman presented with shock 15 years after aortic valve replacement with a tilting-disc valve. Imaging demonstrated severe aortic insufficiency and a fixed-open prosthetic ... Link to item Cite

Use of custom Dacron branch grafts for "hybrid" aortic debranching during endovascular repair of thoracic and thoracoabdominal aortic aneurysms.

Journal Article J Thorac Cardiovasc Surg · July 2008 OBJECTIVES: A significant number of patients with thoracic and thoracoabdominal aortic aneurysms are unsuitable for endovascular repair owing to the absence of graft seal zones. "Hybrid" techniques, including open aortic debranching procedures, allow creat ... Full text Link to item Cite

Neurophysiologic intraoperative monitoring during endovascular stent graft repair of the descending thoracic aorta.

Journal Article J Clin Neurophysiol · August 2007 Conventional surgery on the descending thoracic aorta for aneurysm or dissection repair typically involves open thoracotomy and cross-clamping of the aorta. These procedures are associated with the potential for significant neurologic morbidity due to spin ... Full text Link to item Cite

Endovascular thoracic aortic aneurysm repair with concomitant myocardial and carotid revascularization.

Journal Article Ann Thorac Surg · July 2007 A 73-year-old woman presented with a large saccular aneurysm involving the distal aortic arch. Preoperative aortography and cardiac catheterization revealed left main coronary artery and left common carotid artery stenoses. Concomitant coronary artery bypa ... Full text Link to item Cite

Reimplantation technique (David operation) for multiple sinus of valsalva aneurysms.

Journal Article Ann Thorac Surg · August 2006 Sinus of Valsalva aneurysms are relatively uncommon, and surgical repair is indicated at the time of diagnosis whether or not symptoms are present. This generally entails closure using a patch technique because usually only one sinus is involved. We report ... Full text Link to item Cite

Short-term and intermediate-term outcomes of aortic root replacement with St. Jude mechanical conduits and aortic allografts.

Journal Article Ann Thorac Surg · August 2006 BACKGROUND: Few studies have directly evaluated outcomes in patients undergoing aortic root replacement with St. Jude mechanical conduits or aortic allografts (ALLO), yet both approaches have been advocated. The purpose of this study was to provide a detai ... Full text Link to item Cite

Angiogenic therapy for coronary artery and peripheral arterial disease.

Journal Article Expert Rev Cardiovasc Ther · May 2005 Neovascularization in chronically ischemic adult cardiac and skeletal muscle results from the processes of angiogenesis, arteriogenesis and vasculogenesis. Therapeutic angiogenesis describes an emerging field of cardiovascular medicine whereby new blood ve ... Full text Link to item Cite

Therapeutic angiogenesis in chronically ischemic porcine myocardium: comparative effects of bFGF and VEGF.

Journal Article Ann Thorac Surg · March 2004 BACKGROUND: Both vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) have been used in preclinical studies to induce new blood vessel growth in ischemic cardiac muscle with promising results. However, clinical trials have be ... Full text Link to item Cite

Regional cardiac sympathetic innervation early and late after transmyocardial laser revascularization.

Journal Article J Card Surg · 2004 BACKGROUND: Prior experimental and clinical studies have drawn disparate conclusions regarding the effects of transmyocardial laser revascularization (TMR) on regional cardiac innervation in the treated regions. Regional afferent denervation has been propo ... Full text Link to item Cite

Intramyocardial and intracoronary basic fibroblast growth factor in porcine hibernating myocardium: a comparative study.

Journal Article J Thorac Cardiovasc Surg · January 2004 OBJECTIVE: Therapeutic angiogenesis is an alternative method of revascularization for end-stage coronary artery disease. We determined the effects of intramyocardial and intracoronary basic fibroblast growth factor 2 on myocardial blood flow and function i ... Full text Link to item Cite

Translational physiology: porcine models of human coronary artery disease: implications for preclinical trials of therapeutic angiogenesis.

Journal Article J Appl Physiol (1985) · May 2003 "Therapeutic angiogenesis" describes an emerging field of cardiovascular medicine whereby new blood vessels are induced to grow to supply oxygen and nutrients to ischemic cardiac or skeletal muscle. Various methods of producing therapeutic angiogenesis hav ... Full text Link to item Cite

A comparison of mechanical and laser transmyocardial revascularization for induction of angiogenesis and arteriogenesis in chronically ischemic myocardium.

Journal Article J Am Coll Cardiol · April 3, 2002 OBJECTIVES: The purpose of the present study was to compare the use of a mechanical transmyocardial implant (TMI) device with transmyocardial laser revascularization (TMR) for induction of therapeutic angiogenesis and arteriogenesis in the chronically isch ... Full text Link to item Cite

Changes in systolic and diastolic function during multivessel off-pump coronary bypass grafting.

Journal Article Eur J Cardiothorac Surg · November 2001 OBJECTIVE: To measure the changes in systolic and diastolic left ventricular function that occur during off-pump coronary artery bypass grafting (OPCAB) as a consequence of positioning the heart and interrupting coronary flow. METHODS: 2-D Transoesophageal ... Full text Link to item Cite

Is chronically dysfunctional yet viable myocardium distal to a severe coronary stenosis hypoperfused?

Journal Article Ann Thorac Surg · July 2001 BACKGROUND: Controversy exists regarding the perfusion status of chronically dysfunctional yet viable myocardium. Studies investigating the pathophysiology of this condition have reached different conclusions, with some suggesting that myocardial blood flo ... Full text Link to item Cite

Lasers in cardiothoracic surgery

Journal Article Optics and Photonics News · January 1, 2001 The use of lasers in cardiothoracic surgery was discussed. Transmyocardial laser revascularization (TMR), a potential treatment option for patients with end-stage coronary artery disease, involved using a laser to create transmural channels from the epicar ... Full text Cite

Induction of angiogenesis after TMR: a comparison of holmium: YAG, CO2, and excimer lasers.

Journal Article Ann Thorac Surg · August 2000 BACKGROUND: Transmyocardial laser revascularization (TMR) is an emerging treatment for end-stage coronary artery disease. A variety of lasers are currently available to perform the procedure, although their relative efficacy is unknown. The purpose of this ... Full text Link to item Cite

An experimental model of chronic myocardial hibernation.

Journal Article Ann Thorac Surg · May 2000 BACKGROUND: Hibernating myocardium describes persistently impaired ventricular function at rest caused by reduced coronary blood flow. However, a realistic animal model reproducing this chronic ischemic state does not exist. The purpose of this study was t ... Full text Link to item Cite

Non-blood-contacting biventricular support: Direct mechanical ventricular actuation

Journal Article Operative Techniques in Thoracic and Cardiovascular Surgery · November 1, 1999 Full text Cite

Transmyocardial laser revascularization limits in vivo adenoviral-mediated gene transfer in porcine myocardium.

Journal Article Cardiovasc Res · October 1999 OBJECTIVE: Transmyocardial laser revascularization (TMR) is emerging as a potential treatment option for patients with end-stage CAD, and adjuvant gene therapy may be helpful in further improving the results of the procedure. However, the effects of TMR on ... Full text Link to item Cite

Transmyocardial laser revascularization: experimental and clinical results.

Journal Article Can J Cardiol · July 1999 BACKGROUND: Transmyocardial laser revascularization (TMR) is an emerging therapy for the treatment of coronary artery disease not amenable to percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass surgery (CABG). OBJECTIVE: To summ ... Link to item Cite

Metabolic changes in the normal and hypoxic neonatal myocardium.

Journal Article Ann N Y Acad Sci · June 30, 1999 Hypoxia is characterized by inadequate oxygen delivery to the myocardium with a resulting imbalance between oxygen demand and energy supply. Several adaptive mechanisms occur to preserve myocardial survival during hypoxia. These include both short- and lon ... Full text Link to item Cite

Diagnosis, incidence, and clinical significance of early postoperative ischemia after transmyocardial laser revascularization.

Journal Article Am Heart J · June 1999 BACKGROUND: Clinical improvement after transmyocardial laser revascularization (TMR) is typically delayed, and patients therefore remain at risk for ischemic events after the procedure. The purpose of this study was to define the range of creatine phosphok ... Full text Link to item Cite

Improved perfusion and contractile reserve after transmyocardial laser revascularization in a model of hibernating myocardium.

Journal Article Ann Thorac Surg · June 1999 BACKGROUND: Transmyocardial laser revascularization (TMR) has been demonstrated effective for relieving angina, although prior studies have yielded inconsistent results regarding postoperative myocardial perfusion and function. This study evaluated long-te ... Full text Link to item Cite

Thoracic complications of peritoneal dialysis.

Journal Article Ann Thorac Surg · May 1999 Approximately 20% of the 100,000 patients in the United States currently undergoing dialysis therapy for end-stage renal disease use the technique of peritoneal dialysis. We present a patient on peritoneal dialysis who developed a large posterior mediastin ... Full text Link to item Cite

Perioperative morbidity and mortality after transmyocardial laser revascularization: incidence and risk factors for adverse events.

Journal Article J Am Coll Cardiol · March 15, 1999 OBJECTIVES: The purpose of this study was to describe the incidence and spectrum of perioperative cardiac and noncardiac morbidity and mortality after transmyocardial laser revascularization (TMR) and to identify predictors of these adverse clinical events ... Full text Link to item Cite

Stimulation of long-chain fatty acid uptake by dipyridamole in isolated myocytes.

Journal Article J Cardiovasc Pharmacol · January 1999 This study was designed to investigate the effects of the cardiovascular drug dipyridamole on fatty acid metabolism in isolated cardiac myocytes. Effects of dipyridamole on the oxidation of long-chain (palmitate) fatty acid, medium-chain (octanoate) fatty ... Full text Link to item Cite

Neovascularization after transmyocardial laser revascularization in a model of chronic ischemia.

Journal Article Ann Thorac Surg · December 1998 BACKGROUND: The mechanism of clinical improvement after transmyocardial laser revascularization (TMR) is unknown. One hypothesis holds that TMR causes increased myocardial perfusion through neovascularization. This study sought to determine whether angioge ... Full text Link to item Cite

Combined TMR and mitral valve replacement via left thoracotomy.

Journal Article Ann Thorac Surg · April 1998 Transmyocardial laser revascularization is an emerging technique for treatment of patients with coronary artery disease not amenable to standard revascularization by either percutaneous transluminal coronary angioplasty or coronary artery bypass grafting. ... Full text Link to item Cite

An Experimental Model of Myocardial Hibernation

Conference Journal of the American College of Cardiology · February 1998 Full text Cite

Perioperative Morbidity and Mortality Following Transmyocardial Laser Revascularization

Conference Journal of the American College of Cardiology · February 1998 Full text Cite

A phase I/II study of polymerized bovine hemoglobin in adult patients with sickle cell disease not in crisis at the time of study.

Journal Article J Investig Med · June 1997 BACKGROUND: The painful episodes of sickle cell disease (SCD) involve vaso-occlusion and impaired oxygen delivery. HBOC-201, a hemoglobin-based oxygen carrier, has been shown to support oxygen delivery in animal studies and to be safe and well tolerated in ... Link to item Cite

An explanation for various rectus femoris strain injuries using previously undescribed muscle architecture.

Journal Article Am J Sports Med · 1995 We performed cadaveric dissection of the rectus femoris muscle to correlate the various lesions of strain injury seen with imaging studies to the muscular anatomy. The proximal tendon is composed of a superficial, anterior portion from the direct head, and ... Full text Link to item Cite

Incomplete, intrasubstance strain injuries of the rectus femoris muscle.

Journal Article Am J Sports Med · 1995 Rectus femoris muscle strain injuries commonly occur at the distal muscle-tendon junction of the quadriceps tendon. However, we have recently recognized a pattern of strain injury that consists of an incomplete intrasubstance tear at the muscle-tendon junc ... Full text Link to item Cite