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B Leshnower

Xiaoying Lou, Bradley G Leshnower
No abstract text is available yet for this article.
February 2018: Annals of Translational Medicine
Jaffar M Khan, Robert J Lederman, Saurabh Sanon, Bradley G Leshnower, Altayyeb Yousef, Patrick Gleason, Stamatios Lerakis, Toby Rogers, Adam B Greenbaum, Vasilis C Babaliaros
No abstract text is available yet for this article.
March 22, 2018: JACC. Cardiovascular Interventions
Huijuan Xu, Marina Piccinelli, Bradley G Leshnower, Adrien Lefieux, W Robert Taylor, Alessandro Veneziani
Progressive false lumen aneurysmal degeneration in type B aortic dissection (TBAD) is a complex process with a multi-factorial etiology. Patient-specific computational fluid dynamics (CFD) simulations provide spatial and temporal hemodynamic quantities that facilitate understanding this disease progression. A longitudinal study was performed for a TBAD patient, who was diagnosed with the uncomplicated TBAD in 2006 and treated with optimal medical therapy but received surgery in 2010 due to late complication...
March 28, 2018: Annals of Biomedical Engineering
Xiaoying Lou, Edward P Chen, Yazan M Duwayri, Ravi K Veeraswamy, William D Jordan, Carl A Zehner, Bradley G Leshnower
BACKGROUND: Currently, optimal medical therapy is first-line therapy for uncomplicated acute type B aortic dissection (aTBAD) despite poor long-term outcomes. This study examines the impact of thoracic endovascular aortic repair (TEVAR) in the acute and chronic phases on short-term and long-term survival of patients presenting with aTBAD. METHODS: A review of the Emory aortic database from 2000 to 2016 identified 398 patients diagnosed with aTBAD. At index hospitalization, complicated patients underwent TEVAR (aTEVAR [thoracic endovascular aortic repair in the acute phase], n = 80) and uncomplicated patients received optimal medical therapy (n = 318)...
January 2018: Annals of Thoracic Surgery
Joav Birjiniuk, Lucas H Timmins, Mark Young, Bradley G Leshnower, John N Oshinski, David N Ku, Ravi K Veeraswamy
Understanding of the hemodynamics of Type B aortic dissection may improve outcomes by informing upon patient selection, device design, and deployment strategies. This project characterized changes to aortic hemodynamics as the result of dissection. We hypothesized that dissection would lead to elevated flow reversal and disrupted pulsatile flow patterns in the aorta that can be detected and quantified by non-invasive magnetic resonance imaging. Flexible, anatomic models of both normal aorta and dissected aorta, with a mobile intimal flap containing entry and exit tears, were perfused with a physiologic pulsatile waveform...
September 2017: Cardiovascular Engineering and Technology
Frances Y Hu, Zachary B Fang, Bradley G Leshnower, Yazan Duwayri, William D Jordan, Theresa W Gillespie, Ravi K Veeraswamy
OBJECTIVE: During the past decade, thoracic endovascular aortic repair (TEVAR) has increased as a treatment option for a variety of aortic pathologic processes. Despite this rise in the use of thoracic stent grafts, real-world outcomes from a robust, adjudicated, contemporary data set have yet to be reported. Previous studies have shown periprocedural mortality rates between 1.5% and 9.5% and procedure-related stroke rates of 2.3% to 8.2%. With advances in device engineering and increased experience of physicians, we hypothesized that the rates of these complications would be reduced in a more recent sample set...
September 2017: Journal of Vascular Surgery
Bradley G Leshnower, Yazan M Duwayri, Edward P Chen, Chun Li, Carl A Zehner, Jose N Binongo, Ravi K Veeraswamy
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is the optimal therapy for complicated acute type B aortic dissection (aTBAD). This study examined clinical outcomes and aortic remodeling parameters after TEVAR for patients with complicated aTBAD. METHODS: From January 2012 to December 2015, 51 patients underwent TEVAR for complicated aTBAD. Preoperative and postoperative imaging studies were analyzed for sizes of the true lumen (TL) and false lumen (FL) and for the FL thrombosis status at five locations in the thoracic and abdominal aorta...
June 2017: Annals of Thoracic Surgery
Apoorva Girish, Muralidhar Padala, Kanika Kalra, Bryant V McIver, Ravi K Veeraswamy, Edward P Chen, Bradley G Leshnower
BACKGROUND: Partial false lumen (FL) thrombosis is a risk factor for long-term mortality in acute type B aortic dissection (ATBAD). This study investigates FL pressures in models of ATBAD with patent and partially thrombosed FL. METHODS: Twenty-five porcine aortas were used to create five models of ATBAD that were connected to a pulsatile flow loop. Models A through C had a patent FL with the following morphologies: model A, single proximal tear; model B, single distal tear; and model C, single proximal and single distal tear...
December 2016: Annals of Thoracic Surgery
Richard C Gilmore, Vinod H Thourani, Hanna A Jensen, Jose Condado, José Nilo G Binongo, Eric L Sarin, Chandan M Devireddy, Bradley Leshnower, Kreton Mavromatis, Amjad Syed, Robert A Guyton, Peter C Block, Amy Simone, Patricia Keegan, James Stewart, Mohammad Rajaei, Brian Kaebnick, Stamatios Lerakis, Vasilis C Babaliaros
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been identified as a risk factor for morbidity and mortality after transcatheter aortic valve replacement (TAVR). We hypothesized that a portion of pulmonary dysfunction in patients with severe aortic stenosis may be of cardiac origin, and has potential to improve after TAVR. METHODS: A retrospective analysis was made of consecutive TAVR patients from April 2008 to October 2014. Of patients who had pulmonary function testing and serum B-type natriuretic peptide data available before and after TAVR, 58 were found to have COPD (26 mild, 14 moderate, and 18 severe)...
December 2015: Annals of Thoracic Surgery
Vinod H Thourani, Hanna A Jensen, Vasilis Babaliaros, Susheel K Kodali, Jeevanantham Rajeswaran, John Ehrlinger, Eugene H Blackstone, Rakesh M Suri, Creighton W Don, Gabriel Aldea, Mathew R Williams, Raj Makkar, Lars G Svensson, James M McCabe, Larry S Dean, Samir Kapadia, David J Cohen, Augusto D Pichard, Wilson Y Szeto, Howard C Herrmann, Chandan Devireddy, Bradley G Leshnower, Gorav Ailawadi, Hersh S Maniar, Rebecca T Hahn, Martin B Leon, Michael Mack
BACKGROUND: This study describes short-term and mid-term outcomes of nonagenarian patients undergoing transfemoral or transapical transcatheter aortic valve replacement (TAVR) in the Placement of Aortic Transcatheter Valve (PARTNER)-I trial. METHODS: From April 2007 to February 2012, 531 nonagenarians, mean age 93 ± 2.1 years, underwent TAVR with a balloon-expandable prosthesis in the PARTNER-I trial: 329 through transfemoral (TF-TAVR) and 202 transapical (TA-TAVR) access...
September 2015: Annals of Thoracic Surgery
Bradley G Leshnower, Vinod H Thourani, Michael E Halkos, Eric L Sarin, William B Keeling, Mark J Lamias, Robert A Guyton, Edward P Chen
BACKGROUND: Despite improved results with surgical therapy for acute type A aortic dissection (ATAAD), there remains a lack of consensus regarding the optimal method of cerebral protection and circulation management during ATAAD. The purpose of this study is to determine whether in the setting of antegrade cerebral perfusion, moderate hypothermic circulatory arrest (MHCA) provides equivalent cerebral and visceral protection as deep hypothermic circulatory arrest (DHCA) for patients undergoing emergent ATAAD repair...
November 2015: Annals of Thoracic Surgery
Joav Birjiniuk, Jean Marie Ruddy, Elizabeth Iffrig, Travis S Henry, Bradley G Leshnower, John N Oshinski, David N Ku, Ravi K Veeraswamy
BACKGROUND: Stanford type B dissection of the descending aorta is a potentially fatal condition that is poorly understood. Limited scientific understanding of the role of current interventional techniques, as well as heterogeneity in the condition, contributes to lack of consensus as to the most effective treatment strategy. This study introduces an anatomically accurate model for investigating aortic dissection in a laboratory setting. MATERIALS AND METHODS: A silicone model was fabricated and filled with fluid to mimic human blood...
October 2015: Journal of Surgical Research
William B Keeling, Bradley G Leshnower, Vinod H Thourani, Patrick S Kilgo, Edward P Chen
Proximal thoracic aortic reconstruction performed with or without hypothermic circulatory arrest (HCA) is an effective surgical strategy for aortic pathology. In this study, the clinical outcomes of patients undergoing reoperative proximal thoracic aortic surgery were evaluated. A retrospective review was performed for reoperative proximal aortic surgery from 2004 to date. Patient data were abstracted from the society of thoracic surgeons (STS) institutional database and patient charts. Univariate analysis was conducted on the HCA group in order to determine the impact of variables on in-hospital mortality...
July 2012: Interactive Cardiovascular and Thoracic Surgery
B G Leshnower, J T Potts, M G Garry, J H Mitchell
It is well known that the exercise pressor reflex (EPR) is mediated by group III and IV skeletal muscle afferent fibers, which exhibit unique discharge responses to mechanical and chemical stimuli. Based on the difference in discharge patterns of group III and IV muscle afferents, we hypothesized that activation of mechanically sensitive (MS) fibers would evoke a different pattern of cardiovascular responses compared with activation of both MS and chemosensitive (CS) fibers. Experiments were conducted in chloralose-urethane-anesthetized cats (n = 10)...
January 2001: Journal of Applied Physiology
J T Potts, I E Fuchs, J Li, B Leshnower, J H Mitchell
1. The tachykinin substance P was recovered from the commissural subdivision of the nucleus tractus solitarii (cNTS) using in vivo microdialysis during activation of cardiorespiratory and skeletal muscle receptors in thirteen chloralose-anaesthetized cats. 2. Tetanic muscle contraction was evoked by stimulating L7-S1 ventral roots (n = 7). Electrically induced muscle contraction increased mean arterial pressure (MAP) by 55 +/- 10 mmHg and heart rate by 29 +/- 6 beats min-1. During contraction the dialysate concentration increased 154 % above resting control levels (from 0...
February 1, 1999: Journal of Physiology
H B Shumacker, A C Leshnower
No abstract text is available yet for this article.
October 1974: Annals of Thoracic Surgery
A C Leshnower, H B Shumacker
No abstract text is available yet for this article.
October 1974: Archives of Surgery
A C Leshnower, H B Shumacker, A N Shariatzadeh
No abstract text is available yet for this article.
September 1974: American Journal of Surgery
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