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Wilson Szeto

Gilbert H L Tang, Wilson Y Szeto
No abstract text is available yet for this article.
February 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Fenton H McCarthy, Sreekanth Vemulapalli, Zhuokai Li, Vinod Thourani, Roland A Matsouaka, Nimesh D Desai, Ajay Kirtane, Saif Anwaruddin, Matthew L Williams, Jay Giri, Prashanth Vallabhajosyula, Robert H Li, Howard C Herrmann, Joseph E Bavaria, Wilson Y Szeto
BACKGROUND: The purpose of this study is to evaluate the association of tricuspid regurgitation (TR) severity with outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We analyzed data from 34,576 patients who underwent TAVR at 365 US hospitals from November 2011 through March 2015 submitted to The Society of Thoracic Surgeon/American College of Cardiology Transcatheter Valve Therapy Registry. We examined unadjusted mortality and heart failure readmission stratified by degree of preoperative TR and used multivariable models for 1-year mortality and heart failure readmission...
March 2, 2018: Annals of Thoracic Surgery
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
Danny Dvir, Thierry Bourguignon, Catherine M Otto, Rebecca T Hahn, Raphael Rosenhek, John G Webb, Hendrik Treede, Maurice E Sarano, Ted Feldman, Harindra C Wijeysundera, Yan Topilsky, Michel Aupart, Michael J Reardon, G Burkhard Mackensen, Wilson Y Szeto, Ran Kornowski, James S Gammie, Ajit P Yoganathan, Yaron Arbel, Michael A Borger, Matheus Simonato, Mark Reisman, Raj R Makkar, Alexandre Abizaid, James M McCabe, Gry Dahle, Gabriel S Aldea, Jonathon Leipsic, Philippe Pibarot, Neil E Moat, Michael J Mack, A Pieter Kappetein, Martin B Leon
Bioprostheses are prone to structural valve degeneration, resulting in limited long-term durability. A significant challenge when comparing the durability of different types of bioprostheses is the lack of a standardized terminology for the definition of a degenerated valve. This issue becomes especially important when we try to compare the degeneration rate of surgically inserted and transcatheter bioprosthetic valves. This document, by the VIVID (Valve-in-Valve International Data), proposes practical and standardized definitions of valve degeneration and provides recommendations for the timing of clinical and imaging follow-up assessments accordingly...
January 23, 2018: Circulation
Angelo B Biviano, Tamim Nazif, Jose Dizon, Hasan Garan, Mark Abrams, Jessica Fleitman, Dua Hassan, Samir Kapadia, Vasilis Babaliaros, Ke Xu, Josep Rodes-Cabau, Wilson Y Szeto, William F Fearon, Danny Dvir, Todd Dewey, Mathew Williams, Steven Kindsvater, Michael J Mack, John G Webb, D Craig Miller, Craig R Smith, Martin B Leon, Susheel Kodali
Atrial fibrillation (AF) is associated with worse outcomes in many cardiovascular diseases. There are few data examining pacemaker implantation rates and indications in patients with AF who undergo transcatheter aortic valve replacement (TAVR). To examine the impact of AF on the incidence of and indications for pacemakers in patients undergoing TAVR, we evaluated data of 1723 patients without pre-existing pacemakers who underwent TAVR in the Placement of AoRTic TraNscathetER Valve (PARTNER) trial. Permanent pacemaker implantation rates and indications were compared in groups based on baseline and discharge heart rhythm: sinus rhythm (SR) vs...
June 2017: Journal of Atrial Fibrillation
Ibrahim Sultan, Andreas Habertheuer, Tyler Wallen, Mary Siki, Wilson Szeto, Joseph E Bavaria, Matthew Williams, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Patients presenting with type A aortic dissection (TAAD) present with a wide clinical spectrum ranging from hemodynamic stability to multiorgan malperfusion with cardiovascular collapse. Extracorporeal membrane oxygenator (ECMO) therapy is increasingly being utilized as salvage therapy in patients with acute cardiopulmonary failure and for post-cardiotomy shock. We sought to determine the utility of ECMO implementation post-TAAD repair. METHODS: The Pennsylvania Health Care Cost Containment Council (PHC4) database, maintained by an independently functioning state agency, was retrospectively reviewed from 2004 to 2014...
December 2017: Journal of Cardiac Surgery
Jacob T Gutsche, Todd A Miano, William Vernick, Jesse Raiten, Christian Bermudez, Prashant Vallabjoysula, Karianna Milewski, Wilson Szeto, Meghan Lane Fall, Matthew L Williams, Prakash Patel, Mark E Mikkelsen, Cornel Chiu, Harish Ramakrishna, Jeremy Canon, John G Augoustides
OBJECTIVE: To understand if mobile extracorporeal membrane oxygenation reduces patient mortality during and after transport of patients requiring extracorporeal membrane oxygenation for acute respiratory distress syndrome. DESIGN: Retrospective chart review. SETTING: University affiliated tertiary care hospitals. PARTICIPANTS: Seventy-seven patients. INTERVENTIONS: Introduction of a mobile extracorporeal membrane oxygenation (ECMO) program designed to facilitate the implementation of ECMO at outside hospitals in patients too unstable for transport for ECMO...
September 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Ibrahim Sultan, Mary Siki, Tyler Wallen, Wilson Szeto, Prashanth Vallabhajosyula
Although occlusion of the coronary arteries during transcatheter aortic valve replacement is rare, the mortality is high. In this review, we discuss the prevention and management of this complication. Occlusion of coronary ostia is a very rare, but serious, complication of transcatheter aortic valve replacement (TAVR). Although reported as only occurring in <1% of TAVR cases, it carries a high risk of fatality, with some series reporting a mortality rate as high as 40%. We present the management of an occluded left coronary artery after a self-expanding TAVR, and review the incidence, prevention, and management of this complication...
November 16, 2017: Journal of Cardiac Surgery
Paul Sorajja, Susheel Kodali, Michael J Reardon, Wilson Y Szeto, Stanley J Chetcuti, James Hermiller, Sharla Chenoweth, David H Adams, Jeffrey J Popma
OBJECTIVES: The authors sought to compare the outcomes of commercial transcatheter aortic valve replacement (TAVR) with the repositionable Evolut R platform to those observed with the CoreValve device in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry. BACKGROUND: TAVR continues to evolve, with rapid adoption of iterative changes for commercial practice. Insight into the outcomes of this adoption is needed...
October 23, 2017: JACC. Cardiovascular Interventions
Philippe Généreux, Philippe Pibarot, Björn Redfors, Michael J Mack, Raj R Makkar, Wael A Jaber, Lars G Svensson, Samir Kapadia, E Murat Tuzcu, Vinod H Thourani, Vasilis Babaliaros, Howard C Herrmann, Wilson Y Szeto, David J Cohen, Brian R Lindman, Thomas McAndrew, Maria C Alu, Pamela S Douglas, Rebecca T Hahn, Susheel K Kodali, Craig R Smith, D Craig Miller, John G Webb, Martin B Leon
Aims: In patients with aortic stenosis (AS), risk stratification for aortic valve replacement (AVR) relies mainly on valve-related factors, symptoms and co-morbidities. We sought to evaluate the prognostic impact of a newly-defined staging classification characterizing the extent of extravalvular (extra-aortic valve) cardiac damage among patients with severe AS undergoing AVR. Methods and results: Patients with severe AS from the PARTNER 2 trials were pooled and classified according to the presence or absence of cardiac damage as detected by echocardiography prior to AVR: no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage 1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4)...
December 1, 2017: European Heart Journal
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 National Cardiovascular Data Registry Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry was used to characterize the anesthesia choice and clinical outcomes of all US patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014, and June 30, 2015...
November 28, 2017: Circulation
Ibrahim Sultan, Tyler J Wallen, Andreas Habertheuer, Mary Siki, George J Arnaoutakis, Joseph Bavaria, Wilson Y Szeto, Rita Milewski, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Concomitant endovascular stent grafting of the descending thoracic aorta during open repair for acute DeBakey I aortic dissection can be performed in patients with extensive dissection and malperfusion. We analyzed the effects of this strategy on distal aortic remodeling. METHODS: From 2006-2014, acute DeBakey I dissection patients without primary aortic arch tear undergoing open distal hemiarch reconstruction (Standard group) versus those undergoing hemiarch with descending thoracic aorta (DTA) thoracic endovascular aortic repair (TEVAR group) were retrospectively reviewed...
September 2017: Journal of Cardiac Surgery
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
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
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
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
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
Mark A Farber, W Anthony Lee, Wilson Y Szeto, Jean M Panneton, Christopher J Kwolek
OBJECTIVE: To report the initial and midterm results of the Bolton Relay Thoracic Stent Graft for the endovascular treatment of thoracic aortic lesions [thoracic endovascular aortic repair (TEVAR)]. METHODS: The Bolton Relay Thoracic Aortic Endovascular Pivotal Trial was a prospective, nonrandomized, multicenter, U.S. Investigational Device Exemption study conducted at 27 U.S. investigational sites. One hundred twenty TEVAR subjects were treated with the Relay device between January 2007 and May 2010, with 13 patients enrolled during the continued access phase through September 2012...
June 2017: Journal of Vascular Surgery
Howard C Herrmann, Wilson Y Szeto, Harold Litt, William Vernick
Left ventricular outflow tract (LVOT) obstruction is a recognized complication of transcatheter mitral valve-in-valve replacement in previous surgical prostheses. We describe a patient who was high risk for repeat open surgery in whom the LVOT was compromised by a surgical strut and the potential for LVOT obstruction. A novel approach to avoiding this complication was utilized. A perfusion balloon was inflated in the outflow tract to provide an opposing force during mitral valve deployment resulting in less flaring of the strut into the outflow tract thereby improving the neo-LVOT area...
April 18, 2017: Catheterization and Cardiovascular Interventions
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
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