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Nimesh Desai

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https://www.readbyqxmd.com/read/29391144/predicting-distal-aortic-remodeling-after-endovascular-repair-for-chronic-debakey-iii-aortic-dissection
#1
Ibrahim Sultan, Mary A Siki, Joseph E Bavaria, Taylor R Dibble, Danielle C Savino, Arman Kilic, Wilson Szeto, Prashanth Vallabhajosyula, Ronald M Fairman, Benjamin M Jackson, Grace J Wang, Nimesh D Desai
BACKGROUND: Chronic DeBakey III (CD3) aortic dissection is typically managed with open aortic reconstruction. Thoracic endovascular aortic grafting (TEVAR) has been attempted in patients with CD3 with improved outcomes over medical management, however with frequent failures. This study investigates factors associated with positive aortic remodeling from a large aortic center. METHODS: Three dimensional reconstructions (M2S, West Lebanon, NH) of computed tomography angiography scans of 48 patients who underwent TEVAR from 2005 to 2015 were analyzed...
January 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29337125/facilitating-hemostasis-after-proximal-aortic-surgery-results-of-the-protect-trial
#2
Ali Khoynezhad, Jacob DelaRosa, Marc R Moon, William T Brinkman, Richard B Thompson, Nimesh D Desai, S Chris Malaisrie, Leonard N Girardi, Joseph E Bavaria, T Brett Reece
BACKGROUND: This study intended to evaluate the safety and hemostatic efficacy of a novel vascular sealant (Tridyne™ , Neomend, Inc., Irvine, CA) compared to an accepted adjunctive hemostatic agent applied to aortotomy and sutures lines in cardiovascular surgery. METHODS: Subjects undergoing aortic valve replacement, ascending aortic replacement and/or aortic root replacement were randomized 2:1 to Tridyne™ (n =107) or Gelfoam®+ (Gelfoam®+, Baxter Healthcare Corp...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29331552/malperfusion-during-hypothermic-antegrade-cerebral-perfusion-cerebral-perfusion-index-an-early-indicator-compared-to-cerebral-oximetry
#3
Mark W Fegley, Audrey Spelde, David Johnson, Nimesh D Desai, Warren J Levy
No abstract text is available yet for this article.
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29242071/impact-of-acute-postoperative-limb-ischemia-after-cardiac-and-thoracic-aortic-surgery
#4
Ian W Folkert, Paul J Foley, Grace J Wang, Benjamin M Jackson, Joseph E Bavaria, Nimesh D Desai, Ronald M Fairman, Scott M Damrauer
OBJECTIVE: Acute limb ischemia (ALI) is the cause of significant morbidity and mortality. Although ALI after cardiac surgery is associated with high rates of morbidity and mortality, there are no robust, controlled analyses of the risk factors and outcomes of ALI in this setting. We aimed to identify risk factors for and to delineate outcomes after ALI in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of prospectively collected data on patients undergoing cardiac surgery at our institution between 2002 and 2012...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29178215/transfemoral-transcatheter-aortic-valve-replacement-with-a-self-expanding-valve-for-severe-aortic-regurgitation-in-a-patient-with-left-ventricular-assist-device
#5
Algae Garvey Rene, Nimesh Desai, Joyce Wald, Jesus Eduardo Rame, Jonathan K Frogel, Saif Anwaruddin
Aortic insufficiency following left ventricular assist device implantation (LVAD) has been reported in up to 40% of patients and is associated with a worse prognosis. We describe the case of a successful transfemoral transcatheter aortic valve replacement with a self-expanding bioprosthesis for aortic insufficiency following destination LVAD implantation.
November 26, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29174745/stroke-after-transcatheter-aortic-valve-replacement-incidence-definitions-etiologies-and-management-options
#6
REVIEW
Prakash A Patel, Saumil Patel, Jared W Feinman, Jacob T Gutsche, Prashanth Vallabhajosyula, Ronak Shah, Jay Giri, Nimesh D Desai, Elizabeth Zhou, Stuart J Weiss, John G Augoustides
Neurologic complications after transcatheter aortic valve replacement are devastating. The etiologies of stroke in this setting are best addressed in an integrated fashion during each phase of the perioperative pathway. The conduct of this triphasic approach will continue to be refined to reduce the stroke risks even further, given the major focus on aspects such as embolic protection devices and valve thrombosis. This neurologic focus in transcatheter aortic valve replacement has transformed the investigational approach to neurologic events in cardiovascular clinical trials, resulting in novel guidelines for the diagnosis and assessment of neurologic injury after cardiovascular interventions...
August 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29074152/patients-with-type-a-acute-aortic-dissection-presenting-with-an-abnormal-electrocardiogram
#7
Nathaniel I Costin, Amit Korach, Gabriel Loor, Mark D Peterson, Nimesh D Desai, Santi Trimarchi, Carlo de Vincentiis, Takeyoshi Ota, T Brett Reece, Thoralf M Sundt, Himanshu J Patel, Edward P Chen, Dan G Montgomery, Christoph A Nienaber, Eric M Isselbacher, Kim A Eagle, Thomas G Gleason
BACKGROUND: The electrocardiogram (ECG) is often used in the diagnosis of patients presenting with chest pain to emergency departments. Because chest pain is a common manifestation of type A acute aortic dissection (TAAAD), ECGs are obtained in much of this population. We evaluated the effect of particular ECG patterns on the diagnosis and treatment of TAAAD. METHODS: TAAAD patients (N = 2,765) enrolled in the International Registry of Acute Aortic Dissection were stratified based on normal (n = 1,094 [39...
October 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28977503/extended-versus-limited-arch-replacement-in-acute-type-a-aortic-dissection
#8
Magnus Larsen, Santi Trimarchi, Himanshu J Patel, Marco Di Eusanio, Kevin L Greason, Mark D Peterson, Rossella Fattori, Stuart Hutchison, Nimesh D Desai, Amit Korach, Daniel G Montgomery, Eric M Isselbacher, Christoph A Nienaber, Kim A Eagle, Kristian Bartnes, Truls Myrmel
OBJECTIVES: The recommended extent of surgical resection and reconstruction of the arch in acute DeBakey Type I aortic dissection is an ongoing controversy. However, several recent reports indicate a trend towards a more extensive arch operation in several institutions. We have analysed the recent data from the International Registry of Acute Aortic Dissection to assess the choice of procedure over time and to evaluate the surgical outcome in a 'real-world' database. Our aim was to compare short- and mid-term outcomes of limited repairs versus complete arch surgery...
December 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28927697/aortic-regurgitation-in-acute-type-a-aortic-dissection-a-clinical-classification-for-the-perioperative-echocardiographer-in-the-era-of-the-functional-aortic-annulus
#9
REVIEW
Prakash A Patel, Joseph E Bavaria, Kamrouz Ghadimi, Jacob T Gutsche, Prashanth Vallabhajosyula, Hanjo A Ko, Nimesh D Desai, Emily Mackay, Stuart J Weiss, John G T Augoustides
The functional aortic annulus offers a clinical approach for the perioperative echocardiographer to classify the mechanisms of aortic regurgitation in acute type-A dissection. Comprehensive examination of the functional aortic annulus in this setting using transesophageal echocardiography can guide surgical therapy for the aortic root by considering the following important aspects: severity and mechanism of aortic regurgitation, extent of root dissection, and the pattern of coronary artery involvement. The final choice of surgical therapy also should take into account factors, such as patient presentation and surgical experience, to limit mortality and morbidity from this challenging acute aortic syndrome...
June 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28874033/thoracic-aortic-surgery-enters-the-era-of-big-data
#10
Joseph E Bavaria, Shinichi Fukuhara, Nimesh D Desai
No abstract text is available yet for this article.
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-ncdr%C3%A2-sts-acc-tvt-registry
#11
Matthew C Hyman, Sreekanth Vemulapalli, Wilson Y Szeto, Amanda Stebbins, Prakash A Patel, Roland A Matsouaka, Howard C Herrmann, Saif Anwaruddin, Taisei Kobayashi, Nimesh D Desai, Prashanth Vallabhajosyula, Fenton H McCarthy, Robert Li, Joseph E Bavaria, Jay Giri
Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014 and June 30, 2015. Raw and inverse probability of treatment weighted (IPTW) analyses were performed to compare general anesthesia patients with conscious sedation patients on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, ICU and hospital length-of-stay, and rates of discharge to home...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28833637/concomitant-transfemoral-transcatheter-aortic-and-mitral-valve-in-valve-replacement
#12
A Garvey Rene, Nimesh Desai, Saif Anwaruddin
The valve-in-valve (viv) procedure has been shown to be effective in treating patients with a degenerated bioprosthesis who are also considered high risk or inoperable for a reoperation. We describe a case of concomitant transfemoral transcatheter viv aortic and mitral valve replacements.
August 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28712581/cost-and-contribution-margin-of-transcatheter-versus-surgical-aortic-valve-replacement
#13
Fenton H McCarthy, Danielle C Savino, Chase R Brown, Joseph E Bavaria, Vinay Kini, Danielle D Spragan, Taylor R Dibble, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To compare the cost of and payments for transcatheter aortic valve replacement (TAVR), a novel and expensive technology, and surgical aortic valve replacement (SAVR). METHODS: Medicare claims provided hospital charges, payments, and outcomes between January and December 2012. Hospital costs and charges were estimated using hospital-specific cost-to-charge ratios. Costs and payments were examined in propensity score- matched TAVR and SAVR patients. RESULTS: Medicare spent $215,770,200 nationally on 4083 patients who underwent TAVR in 2012...
June 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28712578/outcomes-readmissions-and-costs-in-transfemoral-and-alterative-access-transcatheter-aortic-valve-replacement-in-the-us-medicare-population
#14
Fenton H McCarthy, Danielle D Spragan, Danielle Savino, Taylor Dibble, Ashley C Hoedt, Katherine M McDermott, Joseph E Bavaria, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To comprehensively evaluate and compare utilization, outcomes, and especially costs of transfemoral (TF), transapical (TA), and transaortic (TAO) transcatheter aortic valve replacement (TAVR). METHODS: All Medicare fee-for-service patients undergoing TF (n = 4065), TA (n = 691), or TAO (n = 274) TAVR between January 1, 2011, and November 30, 2012, were identified using Health Care Procedure Classification Codes present on Medicare claims. Hospital charges from Medicare claims were converted to costs using hospital-specific Medicare cost-to-charge ratios...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28654432/in-response
#15
Jacob T Gutsche, Mark E Mikkelsen, Fenton H McCarthy, Todd A Miano, William J Vernick, Harish Ramakrishna, Prakash A Patel, Yianni Augoustides, Wilson Y Szeto, Nimesh D Desai, Meghan B Lane-Fall, Matthew L Williams
No abstract text is available yet for this article.
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28648536/outcomes-of-elective-aortic-hemiarch-reconstruction-for-aneurysmal-disease-in-the-elderly
#16
COMPARATIVE STUDY
Arman Kilic, George J Arnaoutakis, Joseph E Bavaria, Ibrahim Sultan, Nimesh D Desai, Prashanth Vallabhajosyula, Matthew L Williams, Rita K Milewski, Wilson Y Szeto
BACKGROUND: This study evaluated outcomes of elective aortic hemiarch reconstruction for aneurysmal disease in the elderly. METHODS: Patients undergoing elective aortic hemiarch reconstruction for aneurysmal disease at a single institution between 2009 and 2014 were retrospectively reviewed. Patients were stratified into nonelderly (aged less than 75 years) versus elderly (aged 75 years or more). Outcomes included operative mortality and morbidity. RESULTS: In all, 629 patients (95 elderly; 15%) were included...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28599977/fate-of-remnant-sinuses-of-valsalva-in-patients-with-bicuspid-and-trileaflet-valves-undergoing-aortic-valve-ascending-aorta-and-aortic-arch-replacement
#17
Rita Karianna Milewski, Andreas Habertheuer, Joseph E Bavaria, Mary Siki, Wilson Y Szeto, Eric Krause, Varun Korutla, Nimesh D Desai, Prashanth Vallabhajosyula
OBJECTIVE: In patients presenting with aortic valvulopathy with concomitant ascending aortic aneurysm, surgical management of the sinus of Valsalva segment remains undefined, especially for moderately dilated aortic roots. In patients with this pathology undergoing aortic valve replacement with supracoronary ascending aorta replacement, we assessed the fate of the remnant preserved sinus of Valsalva segment stratified by aortic valve morphology and pathology. METHODS: From 2002 to 2015, 428 patients underwent elective aortic valve replacement with supracoronary ascending aorta replacement...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28476446/anesthetic-evolution-in-transcatheter-aortic-valve-replacement-expert-perspectives-from-high-volume-academic-centers-in-europe-and-the-united-states
#18
Prakash A Patel, Abraham M Ackermann, John G T Augoustides, Joerg Ender, Jacob T Gutsche, Jay Giri, Prashanth Vallabhajosyula, Nimesh D Desai, Megan Kostibas, Mary Beth Brady, Eun J Eoh, Jeffrey G Gaca, Annemarie Thompson, Michael G Fitzsimons
No abstract text is available yet for this article.
June 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28402404/long-term-outcome-of-surgical-cryoablation-for-refractory-ventricular-tachycardia-in-patients-with-non-ischemic-cardiomyopathy
#19
Jackson J Liang, Brian P Betensky, Daniele Muser, Erica S Zado, Elad Anter, Nimesh D Desai, David J Callans, Rajat Deo, David S Frankel, Mathew D Hutchinson, David Lin, Michael P Riley, Robert D Schaller, Gregory E Supple, Pasquale Santangeli, Michael A Acker, Joseph E Bavaria, Wilson Y Szeto, Prashanth Vallabhajosyula, Francis E Marchlinski, Sanjay Dixit
Aims: Limited data exist on the long-term outcome of patients (pts) with non-ischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) refractory to conventional therapies undergoing surgical ablation (SA). We aimed to investigate the long-term survival and VT recurrence in NICM pts with VT refractory to radiofrequency catheter ablation (RFCA) who underwent SA. Methods and results: Consecutive pts with NICM and VT refractory to RFCA who underwent SA were included...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28329296/extension-of-a-stanford-type-a-aortic-dissection-into-the-feeding-vessel-of-a-pulmonary-sequestration
#20
Mary A Siki, Ibrahim Sultan, George J Arnaoutakis, Nimesh D Desai
No abstract text is available yet for this article.
August 1, 2017: European Journal of Cardio-thoracic Surgery
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