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https://www.readbyqxmd.com/read/29747952/awake-thoracic-endovascular-aneurysm-repair-for-aortic-rupture-a-case-series
#1
Jessica Forcillo, Yazan M Duwayri, William D Jordan, Bradley G Leshnower
Thoracic endovascular aortic repair (TEVAR) has been proven to be the optimal therapy for patients with a ruptured descending thoracic aortic pathology. In these emergent settings, TEVAR provides a rapid delivery of treatment to an unstable patient with a lethal disease. Typically, the greatest challenge is maintaining hemodynamic stability until the time of graft deployment. In this report, we describe our technique of performing awake TEVAR for ruptured descending thoracic aortic disease.
April 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29611551/the-impact-of-thoracic-endovascular-aortic-repair-on-long-term-survival-in-type-b-aortic-dissection-response-to-editorial
#2
COMMENT
Xiaoying Lou, Bradley G Leshnower
No abstract text is available yet for this article.
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29605244/transcatheter-mitral-valve-replacement-after-transcatheter-electrosurgical-laceration-of-alfieri-stitch-elastic-first-in-human-report
#3
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
https://www.readbyqxmd.com/read/29602220/degenerative-mitral-regurgitation-predicts-worse-outcomes-in-patients-undergoing-transcatheter-aortic-valve-replacement
#4
Bryan Kindya, Elisha Ouzan, Stamatios Lerakis, Erhan Gonen, Vasilis Babaliaros, Eren Karayel, Vinod H Thourani, Israel Gotsman, Chandan M Devireddy, Haim D Danenberg, Bradley G Leshnower, Ronen Beeri, Yi-An Ko, Dan Gilon, Hina Ahmed, Chang Liu, Chaim Lotan, Kreton Mavromatis
OBJECTIVES: To evaluate the role mitral regurgitation (MR) etiology and severity play in outcomes for patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Multiple prior studies have investigated the influence of MR severity on outcomes for patients undergoing TAVR. Less has been published regarding the effects of MR etiology on outcomes, including its impact on heart failure hospitalization. METHODS: Two hundred and seventy patients undergoing TAVR at 2 hospitals were enrolled...
March 30, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29594688/coupled-morphological-hemodynamic-computational-analysis-of-type-b-aortic-dissection-a-longitudinal-study
#5
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
https://www.readbyqxmd.com/read/29439812/better-candy-for-the-false-lumen
#6
EDITORIAL
Bradley G Leshnower
No abstract text is available yet for this article.
May 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29348004/predictors-and-clinical-outcomes-of-next-day-discharge-after-minimalist-transfemoral-transcatheter-aortic-valve-replacement
#7
Norihiko Kamioka, John Wells, Patricia Keegan, Stamatios Lerakis, Jose Binongo, Frank Corrigan, Jose Condado, Ateet Patel, Jessica Forcillo, Leslie Ogburn, Andy Dong, Hope Caughron, Amy Simone, Bradley Leshnower, Chandan Devireddy, Kreton Mavromatis, Robert Guyton, James Stewart, Vinod Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: This study sought to investigate predictors and safety of next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Information about predictors and safety of NDD after TAVR is limited. METHODS: The study reviewed 663 consecutive patients who underwent elective balloon-expandable TAVR (from July 2014 to July 2016) at our institution. We first determined predictors of NDD in patients who underwent minimalist transfemoral TAVR...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29167026/safety-of-moderate-hypothermia-with-antegrade-cerebral-perfusion-in-total-aortic-arch-replacement
#8
W Brent Keeling, David H Tian, Brad G Leshnower, Satoshi Numata, G Chad Hughes, George Matalanis, Yutaka Okita, Tristan D Yan, Nicholas Kouchoukos, Edward P Chen
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 (ACP) for TOTAL were examined. METHODS: The ARCH International aortic database was queried and 3,265 patients undergoing TOTAL using ACP were identified. Patients were divided into groups based on lowest cooling temperature: MHCA (20° to 28°C) or deep hypothermia (DHCA) (12° to 20°C)...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29102217/type-a-intramural-hematoma-an-unstable-unpredictable-enigma
#9
EDITORIAL
Bradley G Leshnower
No abstract text is available yet for this article.
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28965619/transcatheter-aortic-valve-replacement-in-patients-with-aortic-stenosis-and-mitral-regurgitation
#10
MULTICENTER STUDY
Kreton Mavromatis, Vinod H Thourani, Amanda Stebbins, Sreekanth Vemulapalli, Chandan Devireddy, Robert A Guyton, Roland Matsouaka, Nima Ghasemzadeh, Peter C Block, Bradley G Leshnower, James P Stewart, John S Rumsfeld, Stamatios Lerakis, Vasilis Babaliaros
BACKGROUND: Many patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis also have significant mitral regurgitation (MR). We sought to understand the association of concomitant MR with TAVR clinical outcomes, as well changes in MR after TAVR. METHODS: Patients who underwent TAVR in the US Transcatheter Valve Therapy Registry from January 3, 2012, to December 31, 2013, were studied, with longer-term clinical outcomes from Center for Medicare Services data...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28942076/assessment-of-commonly-used-frailty-markers-for-high-and-extreme-risk-patients-undergoing-transcatheter-aortic-valve-replacement
#11
Jessica Forcillo, Jose F Condado, Yi-An Ko, Michael Yuan, Jose N Binongo, Nnaemeka M Ndubisi, John J Kelly, Vasilis Babaliaros, Robert A Guyton, Chandan Devireddy, Bradley G Leshnower, James P Stewart, Louis P Perrault, Paul Khairy, Vinod H Thourani
BACKGROUND: The effect of frailty on outcomes after transcatheter aortic valve replacement (TAVR) remains incompletely understood. The objective of this study was to evaluate the performance of four commonly used frailty markers as predictors of early and late outcomes among patients undergoing TAVR. METHODS: A review was performed of 361 high- and extreme-risk patients undergoing TAVR from 2011 to 2015. Four frailty variables were assessed: serum albumin (g/dL), 5-m walk (seconds), grip strength (kg), and Katz index of independence in activities of daily living...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28811003/the-impact-of-thoracic-endovascular-aortic-repair-on-long-term-survival-in-type-b-aortic-dissection
#12
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
https://www.readbyqxmd.com/read/28673705/reoperative-aortic-root-replacement-outcome-in-a-contemporary-series
#13
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Vinod H Thourani, Edward P Chen
OBJECTIVES: Reoperative aortic root replacement is a challenging procedure associated with significant mortality and morbidity. The purpose of this study was to investigate the outcomes of reoperative aortic root replacement when performed in a number of complex clinical settings and to identify risk factors for operative mortality and long-term survival. METHODS: From 2006 to 2015, 280 consecutive patients at an academic center underwent reoperative aortic root replacement after a variety of previous aortic or cardiac operations...
September 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28669506/risk-factors-for-late-aortic-valve-dysfunction-after-the-david-v-valve-sparing-root-replacement
#14
COMPARATIVE STUDY
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. METHODS: A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28608325/pulsatile-flow-leads-to-intimal-flap-motion-and-flow-reversal-in-an-in-vitro-model-of-type-b-aortic-dissection
#15
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
https://www.readbyqxmd.com/read/28551049/hypothermia-and-selective-antegrade-cerebral-perfusion-is-safe-for-arch-repair-in-type-a-dissection
#16
W Brent Keeling, Bradley G Leshnower, John C Hunting, Jose Binongo, Edward P Chen
BACKGROUND: Unilateral selective antegrade cerebral perfusion with moderate hypothermic circulatory arrest has been shown to be a safe and effective method of cerebral protection during surgery for acute type A dissection. This study evaluates the impact of this cerebral protection strategy on clinical outcomes after extended aortic arch reconstruction in patients undergoing emergent repair of acute type A dissection. METHODS: A retrospective review from 2004 to 2016 at a US academic center of patients undergoing surgery for acute type A dissections using moderate hypothermic circulatory arrest and selective antegrade cerebral perfusion was performed...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28532575/readmission-rates-after-transcatheter-aortic-valve-replacement-in-high-and-extreme-risk-patients-with-severe-aortic-stenosis
#17
Jessica Forcillo, Jose F Condado, Jose N Binongo, Yi Lasanajak, Hope Caughron, Vasilis Babaliaros, Chandan Devireddy, Bradley Leshnower, Robert A Guyton, Peter C Block, Amy Simone, Patricia Keegan, Paul Khairy, Vinod H Thourani
OBJECTIVE: In high- or extreme-risk patients undergoing transcatheter aortic valve replacement, readmissions have not been adequately studied and are the subject of increased scrutiny by healthcare systems. The objectives of this study were to determine the incidence of 30-day and 1-year cardiac and noncardiac readmissions, identify predictors of readmission, and assess the association between readmission and 1-year mortality. METHODS: A retrospective review was performed on 714 patients who underwent transcatheter aortic valve replacement from September 2007 to January 2015 at Emory University...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28502542/contemporary-evaluation-of-mortality-and-stroke-risk-after-thoracic-endovascular-aortic-repair
#18
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
https://www.readbyqxmd.com/read/28471092/anatomical-risk-models-for-paravalvular-leak-and-landing-zone-complications-for-balloon-expandable-transcatheter-aortic-valve-replacement
#19
Jose F Condado, Frank E Corrigan, Stamatios Lerakis, Ioannis Parastatidis, Arthur E Stillman, Jose N Binongo, James Stewart, Kreton Mavromatis, Chandan Devireddy, Bradley Leshnower, Robert Guyton, Jessica Forcillo, Ateet Patel, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
BACKGROUND: Though several anatomical characteristics have been reported separately as risk factors for paravalvular leak (PVL) and landing zone (LZ) complications after transcatheter aortic valve replacement (TAVR), multivariate risk models are needed. METHODS: Patients that underwent balloon-expandable TAVR with multidetector cardiac computed tomography (MDCT) sizing were studied. MDCT images were analyzed and the association between anatomical factors and ≥mild PVL, ≥moderate PVL, and LZ complications (annular rupture, requirement of new permanent pacemaker, and coronary obstruction) was determined, and subsequently competing predictive models were developed and validated...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28460021/hypothermia-and-cerebral-protection-strategies-in-aortic-arch-surgery-a-comparative-effectiveness-analysis-from-the-sts-adult-cardiac-surgery-database
#20
MULTICENTER STUDY
Brian R Englum, Xia He, Brian C Gulack, Asvin M Ganapathi, Joseph P Mathew, J Matthew Brennan, T Brett Reece, W Brent Keeling, Bradley G Leshnower, Edward P Chen, Jeffrey P Jacobs, Vinod H Thourani, G Chad Hughes
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 (CP) strategies in aortic arch surgery. METHODS: Using the Society of Thoracic Surgeons Database, cases of aortic arch surgery with hypothermic circulatory arrest from 2011 to 2014 were categorized by hypothermia strategy-deep/profound (D/P; ≤20°C), low-moderate (L-M; 20...
September 1, 2017: European Journal of Cardio-thoracic Surgery
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