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Rita Milewski

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https://www.readbyqxmd.com/read/27318775/the-impact-of-deep-versus-moderate-hypothermia-on-postoperative-kidney-function-after-elective-aortic-hemiarch-repair
#1
George J Arnaoutakis, Prashanth Vallabhajosyula, Joseph E Bavaria, Ibrahim Sultan, Mary Siki, Suveeksha Naidu, Rita K Milewski, Matthew L Williams, W Clark Hargrove, Nimesh D Desai, Wilson Y Szeto
BACKGROUND: There remains concern that moderate hypothermic circulatory arrest (MHCA) with antegrade cerebral perfusion (ACP) may provide suboptimal distal organ protection compared with deep hypothermic circulatory arrest (DHCA) with retrograde cerebral perfusion (RCP). We compared postoperative acute kidney injury (AKI) in in patients who underwent elective hemiarch repair with either DHCA/RCP or MHCA/ACP. METHODS: This was a retrospective review of all patients undergoing elective aortic hemiarch reconstruction for aneurysmal disease between 2009 and 2014...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27261086/bicuspid-aortic-insufficiency-with-aortic-root-aneurysm-root-reimplantation-versus-bentall-root-replacement
#2
Prashanth Vallabhajosyula, Wilson Y Szeto, Andreas Habertheuer, Caroline Komlo, Rita K Milewski, Fenton McCarthy, Nimesh D Desai, Joseph E Bavaria
BACKGROUND: In patients with a bicuspid aortic valve presenting with aortic insufficiency (AI) and root aneurysm, we assessed whether outcomes with primary cusp repair with root reimplantation were equivalent to the gold standard Bentall procedures. METHODS: From 2002 to 2014, 710 patients with bicuspid aortic valve underwent aortic root procedures. Of these, only patients presenting with noncalcified type I bicuspid aortic valve with AI (n = 165) were included to maintain anatomic and physiologic homogeneity between the groups...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26897684/the-need-for-standardized-methods-for-measuring-the-aorta-multimodality-core-lab-experience-from-the-gentac-registry
#3
Federico M Asch, Eugene Yuriditsky, Siddharth K Prakash, Mary J Roman, Jonathan W Weinsaft, Gaby Weissman, Wm Guy Weigold, Shaine A Morris, William J Ravekes, Kathryn W Holmes, Michael Silberbach, Rita K Milewski, Barbara L Kroner, Ryan Whitworth, Kim A Eagle, Richard B Devereux, Neil J Weissman
OBJECTIVES: This study sought to evaluate variability in aortic measurements with multiple imaging modalities in clinical centers by comparing with a standardized measuring protocol implemented in a core laboratory. BACKGROUND: In patients with aortic disease, imaging of thoracic aorta plays a major role in risk stratifying individuals for life-threatening complications and in determining timing of surgical intervention. However, standardization of the procedures for performance of aortic measurements is lacking...
March 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/26725716/direct-innominate-artery-cannulation-an-alternate-technique-for-antegrade-cerebral-perfusion-during-aortic-hemiarch-reconstruction
#4
Arminder S Jassar, Prashanth Vallabhajosyula, Joseph E Bavaria, Jacob Gutsche, Nimesh D Desai, Matthew L Williams, Rita K Milewski, W Clark Hargrove, Wilson Y Szeto
OBJECTIVE: We describe an alternate technique for establishing antegrade cerebral perfusion (ACP) during hypothermic circulatory arrest via direct, central cannulation of the innominate artery. METHODS: From 2009 to 2015, 100 elective hemiarch reconstructions for proximal aortic aneurysms were performed under moderate hypothermic circulatory arrest (MHCA). Cerebral perfusion was instituted with ACP via direct cannulation of the innominate artery. RESULTS: Mean patient age was 63 ± 13 years (72 men; 72%)...
April 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26163355/bicuspid-aortic-valve-resuspension-in-acute-type-a-aortic-dissection-patients
#5
MULTICENTER STUDY
Bartosz Rylski, Matthias Siepe, Friedhelm Beyersdorf, Fabian A Kari, Linda Grün, Nimesh D Desai, Wilson Y Szeto, Rita K Milewski, Hideo Adachi, Naoyuki Kimura, Joseph E Bavaria
BACKGROUND: There are no data on the fate of the preserved bicuspid aortic valve (BAV) in patients with acute type A aortic dissection. We investigated surgical outcomes in BAV patients who had undergone aortic valve resuspension versus replacement for dissection type A. METHODS: Among 1,500 consecutive patients operated on for acute type A dissection between 1993 and 2013 at 3 tertiary centers, 66 had BAV (68% males, median age 60 ± 15 years). Thirteen BAV resuspension patients were compared with 53 BAV replacement patients...
September 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25754965/outcomes-of-aortic-root-replacement-after-previous-aortic-root-replacement-the-true-redo-root
#6
Arminder S Jassar, Nimesh D Desai, Dale Kobrin, Alberto Pochettino, Prashanth Vallabhajosyula, Rita K Milewski, Fenton McCarthy, Jon Maniaci, Wilson Y Szeto, Joseph E Bavaria
BACKGROUND: Aortic reoperations are technically challenging. This study evaluated outcomes after "true" redo root replacement (previous full root replacement) stratified by cause of prosthesis failure. METHODS: Data were compared for 793 patients who underwent a first-time sternotomy (de novo group) and 120 patients who had previously undergone full aortic root replacement (redo group), of which 76 underwent reoperation due to structural valve deterioration (degenerative group), and 44 due to endocarditis (infection group)...
May 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25527171/distal-aortic-reintervention-after-surgery-for-acute-debakey-type-i-or-ii-aortic-dissection-open-versus-endovascular-repair
#7
MULTICENTER STUDY
Bartosz Rylski, Friedhelm Beyersdorf, Nimesh D Desai, Wulf Euringer, Matthias Siepe, Fabian A Kari, Prashanth Vallabhajosyula, Wilson Y Szeto, Rita K Milewski, Joseph E Bavaria
OBJECTIVES: Aortic dissection DeBakey type I and II may require distal reinterventions after initial proximal repair. We evaluated outcomes following open versus endovascular approaches to distal aortic pathologies after surgery for acute dissection. METHODS: One hundred and forty-one consecutive patients underwent 152 distal reinterventions after previous type I or II dissection repair [63 (first quartile, 55; third quartile, 72) years old; initially 86% DeBakey type I; 54% hemiarch, 39% isolated ascending, 7% total arch replacement] at two tertiary centres in the USA and Europe over the last 14 years...
August 2015: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/25442993/outcomes-of-surgery-for-chronic-type-a-aortic-dissection
#8
Bartosz Rylski, Rita K Milewski, Joseph E Bavaria, Emanuela Branchetti, Prashanth Vallabhajosyula, Wilson Y Szeto, Nimesh D Desai
BACKGROUND: Data on outcomes of surgery for chronic Stanford type A aortic dissection are limited. We investigated the primary surgery and long-term results in patients with chronic dissection of the native ascending aorta. METHODS: Between 1993 and 2013, among 696 patients (median age, 61 years [first quartile, 50; third quartile 73 years]; 64% males) who underwent surgery for type A dissection, 67 (10%) had chronic dissection by traditional criteria (>14 days)...
January 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25296451/valve-sparing-aortic-root-replacement-in-patients-with-marfan-syndrome-enrolled-in-the-national-registry-of-genetically-triggered-thoracic-aortic-aneurysms-and-cardiovascular-conditions
#9
Howard K Song, Liliana R Preiss, Cheryl L Maslen, Barbara Kroner, Richard B Devereux, Mary J Roman, Kathryn W Holmes, H Eser Tolunay, Patrice Desvigne-Nickens, Federico M Asch, Rita K Milewski, Joseph Bavaria, Scott A LeMaire
BACKGROUND AND AIM OF THE STUDY: The long-term outcomes of aortic valve-sparing (AVS) root replacement in Marfan syndrome (MFS) patients remain uncertain. The study aim was to determine the utilization and outcomes of AVS root replacement in MFS patients enrolled in the Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC). METHODS: At the time of this analysis, 788 patients with MFS were enrolled in the GenTAC Registry, of whom 288 had undergone aortic root replacement...
May 2014: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/25112930/long-term-results-of-aggressive-hemiarch-replacement-in-534-patients-with-type-a-aortic-dissection
#10
Bartosz Rylski, Rita K Milewski, Joseph E Bavaria, Prashanth Vallabhajosyula, William Moser, Wilson Y Szeto, Nimesh D Desai
OBJECTIVE: To present the outcomes of routinely performed hemiarch replacement in patients with acute type A aortic dissection. METHODS: From 1993 to 2013, among 629 patients with acute type A dissection, 534 patients (85%) underwent hemiarch, 63 patients (10%) underwent hemiarch and antegrade thoracic stent grafting, 26 patients (4%) underwent total arch, and 6 patients (1%) underwent isolated ascending replacement. Patients with hemiarch replacement comprised the study population...
December 2014: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/24998700/modeling-of-predissection-aortic-size-in-acute-type-a-dissection-more-than-90-fail-to-meet-the-guidelines-for-elective-ascending-replacement
#11
Bartosz Rylski, Emanuela Branchetti, Joseph E Bavaria, Prashanth Vallabhajosyula, Wilson Y Szeto, Rita K Milewski, Nimesh D Desai
OBJECTIVES: The current guidelines for ascending aortic replacement were determined from already dissected aorta diameters. Previous computed tomography-based work on humans who underwent imaging before and directly after aortic dissection onset has shown an average 30% increase in the ascending aortic diameter with acute dissection. The present investigation evaluated the incidence of predissection ascending aortic dilatation in acute type A dissection. METHODS: From 2002 to 2013, 495 patients presented with acute type A aortic dissection to 1 center...
September 2014: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/24928674/long-term-results-of-neomedia-sinus-valsalva-repair-in-489-patients-with-type-a-aortic-dissection
#12
Bartosz Rylski, Joseph E Bavaria, Rita K Milewski, Prashanth Vallabhajosyula, William Moser, Emily Kremens, Alberto Pochettino, Wilson Y Szeto, Nimesh D Desai
BACKGROUND: Acute type A aortic dissection frequently occurs in patients with normally sized aortic roots. The aim of this investigation was to describe the durability of aortic valve resuspension and root repair with a novel technique of reconstruction in type A dissection. METHODS: From 1993 to 2013, among 629 patients operated on for acute type A dissection 489 (62% male, median age 62 years (53; 73) underwent aortic valve resuspension and reinforcement of the sinus of Valsalva with a Teflon felt neomedia...
August 2014: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/24786861/aortic-valve-morphology-determines-the-presentation-and-surgical-approach-to-acute-type-a-aortic-dissection
#13
Bartosz Rylski, Nimesh D Desai, Joseph E Bavaria, Prashanth Vallabhajosyula, William Moser, Alberto Pochettino, Wilson Y Szeto, Rita K Milewski
BACKGROUND: Data on acute type A aortic dissection in patients with bicuspid aortic valve (BAV) syndrome are limited. This investigation evaluated the clinical details in patients with type A dissection stratified according to aortic valve morphology. METHODS: Between 1993 and 2013, 629 patients (median age 61 years [50; 73], 64% men) underwent surgical procedures for type A dissection. Forty-one patients with BAV were compared with 588 patients with tricuspid aortic valve (TAV)...
June 2014: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/24762037/development-of-a-single-endovascular-device-for-aortic-valve-replacement-and-ascending-aortic-repair
#14
Bartosz Rylski, Wilson Y Szeto, Joseph E Bavaria, Emanuela Branchetti, William Moser, Rita K Milewski
BACKGROUND AND AIM OF THE STUDY: Transcatheter aortic valve implantation (TAVI) is contraindicated in the presence of an ascending aortic aneurysm. Our aim was to design a composite endovascular device enabling ascending aortic repair and TAVI. METHODS: From 2007 to 2013, among 1196 patients with severe aortic stenosis screened for TAVI, 79 nonbicuspid patients had ascending aortic diameter >45 mm. Proximal aortic geometry was assessed in those with computed tomography angiography...
May 2014: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/24629304/type-a-aortic-dissection-after-previous-cardiac-surgery-results-of-an-integrated-surgical-approach
#15
COMPARATIVE STUDY
Bartosz Rylski, Nimesh D Desai, Joseph E Bavaria, William Moser, Prashanth Vallabhajosyula, Alberto Pochettino, Wilson Y Szeto, Rita K Milewski
BACKGROUND: Stanford type A aortic dissection in patients with previous cardiac surgery (PCS) is a catastrophic disease. This investigation evaluates the results of a standardized integrated approach to type A dissection after PCS. METHODS: Between 1993 and 2013, 629 patients with acute type A dissection (median age 61 [50 to 73] years, 64% males) underwent aortic repair utilizing a standardized integrated approach. Of these, 56 (9%) patients had PCS. Median follow-up was 4...
May 2014: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/24594630/type-a-aortic-dissection-in-marfan-syndrome-extent-of-initial-surgery-determines-long-term-outcome
#16
MULTICENTER STUDY
Bartosz Rylski, Joseph E Bavaria, Friedhelm Beyersdorf, Emanuela Branchetti, Nimesh D Desai, Rita K Milewski, Wilson Y Szeto, Prashanth Vallabhajosyula, Matthias Siepe, Fabian A Kari
BACKGROUND: Data on outcomes after Stanford type A aortic dissection in patients with Marfan syndrome are limited. We investigated the primary surgery and long-term results in patients with Marfan syndrome who suffered aortic dissection. METHODS AND RESULTS: Among 1324 consecutive patients with aortic dissection type A, 74 with Marfan syndrome (58% men; median age, 37 years [first and third quartiles, 29 and 48 years]) underwent surgical repair (85% acute dissections; 68% DeBakey I; 55% composite valved graft, 30% supracoronary ascending replacement, 15% valve-sparing aortic root replacement; 12% total arch replacement; 3% in-hospital mortality) at 2 tertiary centers in the United States and Europe over the past 25 years...
April 1, 2014: Circulation
https://www.readbyqxmd.com/read/24534676/surgical-treatment-of-bicuspid-aortic-valve-disease-knowledge-gaps-and-research-perspectives
#17
REVIEW
Alessandro Della Corte, Simon C Body, Anna M Booher, Hans-Joachim Schaefers, Rita K Milewski, Hector I Michelena, Arturo Evangelista, Philippe Pibarot, Patrick Mathieu, Giuseppe Limongelli, Prem S Shekar, Sary F Aranki, Andrea Ballotta, Giuseppe Di Benedetto, Natzi Sakalihasan, Gianantonio Nappi, Kim A Eagle, Joseph E Bavaria, Alessandro Frigiola, Thoralf M Sundt
No abstract text is available yet for this article.
June 2014: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/24509277/how-does-the-ascending-aorta-geometry-change-when-it-dissects
#18
MULTICENTER STUDY
Bartosz Rylski, Philipp Blanke, Friedhelm Beyersdorf, Nimesh D Desai, Rita K Milewski, Matthias Siepe, Fabian A Kari, Martin Czerny, Thierry Carrel, Christian Schlensak, Tobias Krüger, Michael J Mack, William T Brinkman, Friedrich W Mohr, Christian D Etz, Maximilian Luehr, Joseph E Bavaria
OBJECTIVES: The purpose of this study is to delineate changes in aortic geometry and diameter due to dissection. BACKGROUND: Aortic diameter is the major criterion for elective ascending aortic replacement for dilated ascending aortas to prevent aortic dissection. However, recommendations are made on the basis of clinical experience and observation of diameters of previously dissected aortas. METHODS: Six tertiary centers on 2 continents reviewed their acute aortic dissection type A databases, which contained 1,821 patients...
April 8, 2014: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/24431164/gender-related-changes-in-aortic-geometry-throughout-life
#19
Bartosz Rylski, Benoit Desjardins, William Moser, Joseph E Bavaria, Rita K Milewski
OBJECTIVES: Aortic geometry changes throughout life are not well defined. This investigation delineates aortic geometry across the adult age spectrum and determines the gender-related influence of aging on aortic morphometry. METHODS: Contrast-enhanced computed tomography scans of all aortic segments in 195 subjects (94 women, 101 men, average age 57 ± 20 years) free of vascular disease were analysed. Lengths and diameters of each aortic segment as well as width, height and tortuosity of the thoracic aorta were compared between both genders...
May 2014: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/24420370/transcatheter-aortic-valve-implantation-in-patients-with-ascending-aortic-dilatation-safety-of-the-procedure-and-mid-term-follow-up%C3%A2
#20
Bartosz Rylski, Wilson Y Szeto, Joseph E Bavaria, Elizabeth Walsh, Saif Anwaruddin, Nimesh D Desai, William Moser, Howard C Herrmann, Rita K Milewski
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) does not enable concomitant or simultaneous ascending aortic intervention. This investigation evaluates the safety of TAVI in patients with ascending aortic dilatation and demonstrates mid-term follow-up. METHODS: From November 2007 to December 2012, among 1143 patients with severe aortic stenosis screened for TAVI, a cohort of 457 patients met the inclusion criteria. Of these, a total of 98 patients [71% males, median age 85...
August 2014: European Journal of Cardio-thoracic Surgery
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