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Wilson Szeto

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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
#1
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/28795434/concomitant-antegrade-stent-grafting-of-the-descending-thoracic-aorta-during-transverse-hemiarch-reconstruction-for-acute-debakey-i-aortic-dissection-repair-improves-aortic-remodeling
#2
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...
August 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28712581/cost-and-contribution-margin-of-transcatheter-versus-surgical-aortic-valve-replacement
#3
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
#4
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
#5
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
#6
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...
June 22, 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
#7
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/28527926/initial-and-midterm-results-of-the-bolton-relay-thoracic-aortic-endovascular-pivotal-trial
#8
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/28417602/novel-use-of-perfusion-balloon-inflation-to-avoid-outflow-tract-obstruction-during-transcatheter-mitral-valve-in-valve-replacement
#9
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
https://www.readbyqxmd.com/read/28402404/long-term-outcome-of-surgical-cryoablation-for-refractory-ventricular-tachycardia-in-patients-with-non-ischemic-cardiomyopathy
#10
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/28219551/concomitant-endografting-of-a%C3%A2-type-b-aortic-dissection-during-transfemoral-aortic-valve-replacement
#11
Arman Kilic, Mary A Siki, Wilson Y Szeto, Joseph E Bavaria, Saif Anwaruddin, Nimesh D Desai
An 87-year-old woman with severe aortic stenosis underwent a transfemoral transcatheter aortic valve replacement (TAVR). Intraoperative transesophageal echocardiography demonstrated a well-seated valve with no paravalvular leak; however, a new acute type B aortic dissection was identified. Endografts were delivered through the TAVR sheath and deployed, effectively treating the dissection. The patient did well postoperatively, with imaging at 2 years demonstrating a well-functioning aortic valve and no migration or endoleak of the thoracic endografts...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28017714/long-term-valve-performance-of-tavr-and-savr-a-report-from-the-partner-i-trial
#12
Melissa A Daubert, Neil J Weissman, Rebecca T Hahn, Philippe Pibarot, Rupa Parvataneni, Michael J Mack, Lars G Svensson, Deepika Gopal, Samir Kapadia, Robert J Siegel, Susheel K Kodali, Wilson Y Szeto, Raj Makkar, Martin B Leon, Pamela S Douglas
OBJECTIVES: The aim of this study was to evaluate the long-term performance of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) through longitudinal echocardiographic analysis. BACKGROUND: The long-term performance of the SAPIEN TAVR is not well-described. Therefore, we examined the hemodynamic and valvular profile of the SAPIEN TAVR over 5 years. METHODS: All patients receiving TAVR or SAVR with first post-implant (FPI) and 5-year echoes were analyzed for aortic valve (AV) peak velocity, AV mean gradient, AV area, peak left ventricular (LV) outflow tract and in-stent velocities, Doppler velocity index, aortic regurgitation (AR), LV mass index, stroke volume index, and cardiac index...
December 8, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27970206/tct-80-characterizing-the-incidence-and-predictors-of-paravalvular-regurgitation-after-transcatheter-aortic-valve-replacement-tavr-and-its-impact-on-outcomes-a-study-of-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapies
#13
Saif Anwaruddin, Ajay Kirtane, Vinod Thourani, Sreekanth Vemulapalli, Pratik Manandhar, Howard Herrmann, Joseph Bavaria, Jay Giri, Prashanth Vallabhajosyula, Birgitte Krogsgaard Andersen, Wilson Szeto
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970068/tct-691-sex-specific-differences-after-transcatheter-or-surgical-aortic-valve-replacement-in-intermediate-risk-patients-an-analysis-from-the-partner-2-randomized-trial
#14
Jonathan White, Darshan Doshi, Mathew Williams, Molly Szerlip, John Squiers, John Webb, Rebecca Hahn, Ajay Kirtane, Claire Litherland, David Cohen, E Murat Tuzcu, Wilson Szeto, Alan Zajarias, S Chris Malaisrie, Maria Alu, Craig Smith, Martin Leon, Michael Mack, Susheel Kodali
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970048/tct-672-outcomes-in-the-commercial-use-of-self-expanding-prostheses-in-transcatheter-aortic-valve-replacement-a-comparison-of-the-medtronic-corevalve-and-evolut-r-platforms-in-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve
#15
Paul Sorajja, Susheel Kodali, Michael Reardon, Wilson Szeto, Stanley Chetcuti, James Hermiller, David Adams, Jeffrey Popma
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970038/tct-661-the-clinical-impact-of-diabetes-mellitus-on-outcomes-after-transcatheter-aortic-valve-replacement-insights-from-the-partner-ii-sapien-3-cohort
#16
Yigal Abramowitz, Brian Lindman, Tarun Chakravarty, Hasanian Jilaihawi, Samir Kapadia, Wilson Szeto, Philippe Pibarot, Vasilis Babaliaros, Howard Herrmann, Richard Smalling, Lars Svensson, Torsten Vahl, Vinod Thourani, Susheel Kodali, Craig Smith, Yiran Zhang, Maria Alu, Michael Mack, Martin Leon, Raj Makkar
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969714/tct-36-frailty-in-intermediate-risk-patients-undergoing-transcatheter-or-surgical-aortic-valve-replacement-cut-points-and-relationship-with-outcomes-an-analysis-of-the-placement-of-aortic-transcatheter-valves-partner-2-cohort-a-randomized-trial
#17
Philip Green, Mark Russo, Suzanne Arnold, Darshan Doshi, Augusto Pichard, Wilson Szeto, Raj Makkar, Vasilis Babaliaros, William Fearon, Lars Svensson, John Webb, Tamim Nazif, Alan Zajarias, Nishath Quader, Rupa Parvataneni, Ajay Kirtane, David Cohen, Michael Mack, Martin Leon
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27815101/protection-against-cerebral-embolism-during-transcatheter-aortic-valve-replacement
#18
RANDOMIZED CONTROLLED TRIAL
Samir R Kapadia, Susheel Kodali, Raj Makkar, Roxana Mehran, Ronald M Lazar, Robert Zivadinov, Michael G Dwyer, Hasan Jilaihawi, Renu Virmani, Saif Anwaruddin, Vinod H Thourani, Tamim Nazif, Norman Mangner, Felix Woitek, Amar Krishnaswamy, Stephanie Mick, Tarun Chakravarty, Mamoo Nakamura, James M McCabe, Lowell Satler, Alan Zajarias, Wilson Y Szeto, Lars Svensson, Maria C Alu, Roseann M White, Carlye Kraemer, Azin Parhizgar, Martin B Leon, Axel Linke
BACKGROUND: Neurological complications after transcatheter aortic valve replacement (TAVR) may be reduced with transcatheter cerebral embolic protection (TCEP). OBJECTIVES: This study evaluated the safety and efficacy of TCEP during TAVR. METHODS: Nineteen centers randomized 363 patients undergoing TAVR to a safety arm (n = 123), device imaging (n = 121), and control imaging (n = 119). The primary safety endpoint consisted of major adverse cardiac and cerebrovascular events (MACCE) at 30 days, and the primary efficacy endpoint was reduction in new lesion volume in protected brain territories on magnetic resonance imaging scans at 2 to 7 days...
January 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27749338/veno-venous-extracorporeal-life-support-in-hemodynamically-unstable-patients-with-ards
#19
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
When clinicians consider extracorporeal life support (ECLS) for acute respiratory distress syndrome (ARDS) patients with hemodynamic instability, both veno-arterial (VA) and veno-venous (VV) ECLS are therapeutic possibilities. We analyzed 17 patients with ARDS on inotropic or vasopressor support requiring ECLS for refractory hypoxemia. After implementing VV ECLS, pressor requirements (based on norepinephrine equivalents) were significantly lower in all patients (P = .0001 for overall comparison across time points)...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27666785/central-repair-with-antegrade-tevar-for-malperfusion-syndromes-in-acute-debakey-i-aortic-dissection
#20
Prashanth Vallabhajosyula, Jean Paul Gottret, Rohan Menon, Ibrahim Sultan, Zara Abbas, Mary Siki, Matthew Kramer, Aaron Pulsipher, Suveeksha Naidu, Alberto Pochettino, Kariana Milewski, Wilson Y Szeto, Joseph E Bavaria
BACKGROUND: In acute DeBakey I aortic dissection presenting with malperfusion syndromes, we assessed whether standard open repair with concomitant antegrade stent grafting (thoracic endovascular aneurysm repair; TEVAR) of the descending thoracic aorta (DTA) improves outcomes compared with standard repair alone. METHODS: From 2005 to 2012, 277 patients with acute DeBakey I dissection underwent emergent operation. Of these, 104 patients (37%) presenting with end-organ malperfusion were divided into those undergoing standard distal repair entailing transverse hemiarch replacement (Standard group, n = 65) versus standard repair with concomitant DTA TEVAR during circulatory arrest (TEVAR group, n = 39)...
March 2017: Annals of Thoracic Surgery
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