Article
Surgery
Quentin Pellenc, Arnaud Roussel, Jean Senemaud, Pierre Cerceau, Jules Iquille, Aureline Boitet, Jean-Baptiste Leclere, Olivier Milleron, Guillaume Jondeau, Yves Castier
Summary: Staged hybrid repair of type II thoracoabdominal aortic aneurysms using thoracic endovascular aortic repair (TEVAR) for proximal repair followed by distal open repair appears to be effective in reducing postoperative complications and severity. No spinal cord ischemic events were observed during surgery, and the treatment strategy showed positive outcomes during postoperative follow-up.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Marina Dias-Neto, Andrea Vacirca, Ying Huang, Aidin Baghbani-Oskouei, Tomasz Jakimowicz, Bernardo C. Mendes, Tilo Kolbel, Jonathan Sobocinski, Luca Bertoglio, Barend Mees, Mauro Gargiulo, Nuno Dias, Andres Schanzer, Warren Gasper, Adam W. Beck, Mark A. Farber, Kevin Mani, Carlos Timaran, Darren B. Schneider, Luis Mendes Pedro, Nikolaos Tsilimparis, Stephan Haulon, Matthew P. Sweet, Emilia Ferreira, Matthew Eagleton, Kak Khee Yeung, Manar Khashram, Katarzyna Jama, Giuseppe Panuccio, Fiona Rohlffs, Thomas Mesnard, Roberto Chiesa, Andrea Kahlberg, Geert Willem Schurink, Charlotte Lemmens, Enrico Gallitto, Gianluca Faggioli, Angelos Karelis, Ezequiel Parodi, Vivian Gomes, Anders Wanhainen, Mohammed Habib, Jesus Porras Colon, Felipe Pavarino, Mirza S. Baig, Ryan Eduardo Costeloe De Melo, Sean Crawford, Sara L. Zettervall, Rita Garcia, Tiago Ribeiro, Goncalo Alves, Frederico Bastos Goncalves, Kaj Olav Kappe, Samira Elize Mariko van Knippenberg, Bich Lan Tran, Sinead Gormley, Gustavo S. Oderich, Int Multictr Aort Res Grp
Summary: Non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs) is associated with higher early mortality and major adverse events (MAEs), increased all-cause mortality, and aortic-related mortality (ARM) compared to elective repair. Long-term follow-up is necessary to justify the treatment.
Article
Multidisciplinary Sciences
Taehun Kim, Dayeong Hong, Junhyeok Ock, Sung Jun Park, Younju Rhee, Sangwook Lee, Guk Bae Kim, Dong Hyun Yang, Joon Bum Kim, Namkug Kim
Summary: The new techniques for repairing thoracoabdominal aortic aneurysms using patient-specific 3D-printed graft reconstruction guides have effectively addressed the challenges in positioning and guiding the visceral and segmental arteries. Evaluation based on accuracy, marking time, reproducibility, and surgeon feedback has demonstrated the efficiency and efficacy of these techniques in accurately reconstructing customized grafts.
SCIENTIFIC REPORTS
(2021)
Article
Cardiac & Cardiovascular Systems
Kelsie A. Kiser, Akiko Tanaka, Harleen K. Sandhu, Charles C. Miller, Samuel D. Leonard, Hazim J. Safi, Anthony L. Estrera
Summary: Extensive use of cell salvage is associated with adverse postoperative outcomes after descending/thoracoabdominal aortic aneurysm repair, with the risk increasing proportionally to the salvaged cell units.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Article
Surgery
Kyle R. Diamond, Jessica P. Simons, Allison S. Crawford, Edward J. Arous, Dejah R. Judelson, Francesco Aiello, Douglas W. Jones, Louis Messina, Andres Schanzer
Summary: Unlike open repair of thoracoabdominal aneurysms, the outcomes of fenestrated/branched endovascular aneurysm repair (F/BEVAR) were similar for extensive and nonextensive TAAAs. Differences in perioperative paraparesis, branch instability, and type I or III endoleak likely resulted from the increasing length of aortic coverage and number of target arteries involved. High-volume centers performing F/BEVAR can expect comparable outcomes for extensive and nonextensive TAAA repair.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Kazufumi Yoshida, Ken Nakamura, Masanosuke Ishigami, Makoto Kinoshita, Tadaaki Koyama
Summary: This study suggests that staged hybrid repair is an effective treatment for thoracoabdominal aortic aneurysm, with low morbidity and mortality. Secondary thoracic endovascular aneurysm repair should be performed promptly to reduce the risk of residual aneurysm rupture.
JOURNAL OF CARDIOTHORACIC SURGERY
(2022)
Article
Surgery
Antonio R. Polanco, Alex M. D'Angelo, Nicholas J. Shea, Philip Allen, Hiroo Takayama, Virendra I. Patel
Summary: The study found that patients with TAAA in the United States have significantly lower mortality and morbidity when operated on at high-volume centers compared to low-volume centers, with the difference being consistent across elective and urgent/emergent surgeries. Increasing TAAA volume was associated with increased use of distal aortic perfusion.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Sadia Ilyas, David H. Stone, Richard J. Powell, Aravind S. Ponukumati, David P. Kuwayama, Philip P. Goodney, Jesse A. Columbo, Bjoern D. Suckow
Summary: The economic evaluation of physician-modified endograft repairs for pararenal/thoracoabdominal aortic aneurysms shows a significantly negative operating margin, primarily driven by high device costs. Device cost alone exceeds the total technical revenue, highlighting the need for cost reduction opportunities. Additionally, increasing reimbursement for FB-EVAR, especially among Medicare beneficiaries, is crucial for facilitating patient access to this innovative technology.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Maral Ouzounian, Rami O. Tadros, Lars G. Svensson, Sean P. Lyden, Gustavo S. Oderich, Joseph S. Coselli
Summary: Thoracoabdominal aortic disease is a rare but life-threatening condition that requires expert multidisciplinary collaborative management. Both open repair and endovascular approaches are viable options for repair, but specialized expertise is necessary for successful outcomes.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Xiu-Hua Dong, Yi-Peng Ge, Rong Wang, Xu-Dong Pan, Jia-Kai Lu, Wei-Ping Cheng
Summary: The study compared the effectiveness of aorto-iliac bypass and extracorporeal circulatory assistance in spinal cord protection during TAAA repair, showing that both methods are comparable. The study also identified cerebrospinal fluid pressure and lowest postoperative day hemoglobin level as independent predictors of SCI.
HEART LUNG AND CIRCULATION
(2022)
Article
Surgery
Rodolfo V. Rocha, Charles De Mestral, Derrick Y. Tam, Douglas S. Lee, Mohammed Al-Omran, Peter C. Austin, Thomas L. Forbes, Maral Ouzounian, Thomas F. Lindsay
Summary: This study compared the 1-year healthcare costs of endovascular and open repairs for thoracoabdominal aortic aneurysm (TAAA), finding that endovascular repair had higher costs in the first month post-procedure compared to open repair, but no significant differences in costs from 1 to 12 months post-repair. Older age, urgent procedures, and history of stroke were associated with increased costs in the first month postoperatively.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Jahan Mohebali, Christopher A. Latz, Richard P. Cambria, Virendra Patel, Emel A. Ergul, R. Todd Lancaster, Mark F. Conrad, W. Darrin Clouse
Summary: The study found excellent long-term patency of visceral and renal reconstructions after open TAAA repair, regardless of the reconstructive technique used. There were no significant differences in patency even when target vessel disease was addressed during reconstruction. These findings further support the effective long-term durability of open TAAA repair and are relevant to the ongoing evolution of endovascular strategies.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Christopher A. Latz, Srihari Lella, Laura T. Boitano, Charles DeCarlo, Zach Feldman, C. Y. Maximilian Png, Jahan Mohebali, Anahita Dua, Mark Conrad
Summary: The study found that performing splenectomy during open TAAA repair did not result in increased perioperative mortality, but did lead to significantly higher perioperative morbidity and longer hospital stays. Results showed that splenectomy did not have an impact on long-term survival outcomes for patients undergoing TAAA repair.
JOURNAL OF VASCULAR SURGERY
(2021)
Review
Surgery
Marethania M. Akmal, Dara R. Pabittei, Tossapol Prapassaro, Raden Suhartono, Frans L. Moll, Joost A. van Herwaarden
Summary: The study systematically reviewed different techniques for excluding persistent type II endoleaks after EVAR, showing a wide variety of techniques and embolic agents used. Despite varying technical success rates, the overall technical success rate was 62%. Further studies with longer follow-up are urgently needed to determine the most effective treatment for a durable exclusion of persistent type II endoleaks.
INTERNATIONAL JOURNAL OF SURGERY
(2021)
Review
Health Care Sciences & Services
Federico Marturano, Fulvio Nisi, Enrico Giustiniano, Francesco Benedetto, Federico Piccioni, Umberto Ripani
Summary: Thoraco-abdominal aortic repair is a high-risk surgery with the major complication of spinal cord injury leading to paralysis. Modern techniques involve multiple strategies to reduce the risk of spinal cord ischemia, with lumbar CSF drainage being one of the most effective strategies.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Robert B. Hawkins, J. Hunter Mehaffey
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Adishesh K. Narahari, J. Hunter Mehaffey, Michael Salerno, Robert Battle, Gorav Ailawadi
Summary: Arterial switch operations (ASO) are performed on neonates to treat transposition of the great arteries, but future operations on the neoaorta may be required due to dilation. We present a unique case of a 25-year-old female who required a David procedure for neoaorta dilation due to the anterior lie of the pulmonary artery after ASO. Our approach to this patient's surgery with the unique anatomy is described.
JOURNAL OF CARDIAC SURGERY
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Robert B. Hawkins, J. Hunter Mehaffey
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Hunter Mehaffey, Robert B. Hawkins
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Catherine Wagner, Robert B. Hawkins
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Robert B. Hawkins, Raymond J. Strobel, J. Hunter Mehaffey, Mohammed A. Quader, Mark Joseph, Gorav Ailawadi
Summary: Rheumatic mitral valve disease is common in the region and its proportion is increasing. There are significant variations among hospitals. Rheumatic mitral surgery has similar short-term outcomes compared to nonrheumatic pathology, but requires greater resource utilization.
JOURNAL OF CARDIAC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Kenan W. Yount, Robert B. Hawkins, J. Hunter Mehaffey, Nicholas R. Teman, Leora T. Yarboro, John A. Kern, Gorav Ailawadi
Summary: This study compares the intermediate-term outcomes of the Magna and Trifecta valves. The Trifecta valve, despite having lower postoperative mean gradients, may have an increased risk of mid-term structural valve degeneration.
JOURNAL OF CARDIAC SURGERY
(2022)
Editorial Material
Health Care Sciences & Services
Robert B. Hawkins, Brahmajee K. Nallamothu
BMJ QUALITY & SAFETY
(2023)
Article
Cardiac & Cardiovascular Systems
Christopher L. Cramer, Katherine Marsh, Elizabeth D. Krebs, Hunter Mehaffey, Jared P. Beller, W. Zachary Chancellor, Nicholas R. Teman, Leora T. Yarboro
Summary: This study investigated the employment status after heart transplant and identified factors influencing employment. The study found that approximately 22% of patients were employed at 1 year post-transplant, and this increased to 32% at 2 years. Employment was associated with factors such as being white, male, having prior job experience, and having private insurance. The study also found that employment was associated with decreased mortality risk, with employed individuals having a 26% lower risk of mortality.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Cardiac & Cardiovascular Systems
J. Hunter Mehaffey, J. W. Awori Hayanga, Mohammad Kawsara, Ankit Sakhuja, Christopher Mascio, J. Scott Rankin, Vinay Badhwar
Summary: Contemporary real-world data from Medicare patients with multivessel disease reveal that coronary artery bypass grafting (CABG) outcomes were superior to percutaneous coronary intervention (PCI), providing important longitudinal data to guide patient care and policy development.
ANNALS OF THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Robert B. Hawkins, G. Michael Deeb, Devraj Sukul, Himanshu J. Patel, Sarah K. Gualano, Stanley J. Chetcuti, P. Michael Grossman, Gorav Ailawadi, Shinichi Fukuhara
Summary: This study found that there is a higher risk associated with redo surgery after transcatheter aortic valve replacement (TAVR), and the number of patients requiring reoperation after TAVR is increasing. Therefore, patients with a longer life expectancy and unsuitable anatomy for redo-TAVR should consider surgical aortic valve replacement (SAVR) as the first-line treatment option.
JACC-CARDIOVASCULAR INTERVENTIONS
(2023)
Article
Surgery
Robert B. Hawkins, Raymond J. Strobel, J. Hunter Mehaffey, Mohammed A. Quader, Mark Joseph, Alan M. Speir, Leora T. Yarboro, Gorav Ailawadi
Summary: This study analyzed the relationship between pulmonary artery systolic pressure (PASP) and the risk of mitral valve operations and coronary artery bypass grafting (CABG) operations. The results showed that PASP was associated with mortality and major morbidity in both operations. However, for mitral valve operations, an increase in PASP was associated with lower risk, while for CABG operations, it was associated with higher risk. Therefore, further research and optimization of perioperative management for patients with pulmonary hypertension are needed to improve care for these patients.
JOURNAL OF SURGICAL RESEARCH
(2023)
Article
Cardiac & Cardiovascular Systems
Raymond J. Strobel, Adishesh K. Narahari, Evan P. Rotar, Andrew M. Young, Jeffrey Vergales, J. Hunter Mehaffey, Nicholas R. Teman, John A. Kern, Leora T. Yarboro, Irving L. Kron, Michael R. Nelson, Mark Roeser
Summary: This study evaluated the effect of cardiopulmonary bypass (CPB) on COVID-19 vaccination antibody concentration after cardiac surgery. The results showed that antibody concentration was significantly reduced in the short-term following CPB but returned to pre-CPB levels within 1 month. Heightened precautions in the perioperative period for cardiac surgery patients may be necessary.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Michael Edmiston, Ali Darehzereshki, Vinay Badhwar, J. Hunter Mehaffey