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Prashanth Vallabhajosyula

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https://www.readbyqxmd.com/read/29760084/distinct-macrophage-populations-direct-inflammatory-versus-physiological-changes-in-adipose-tissue
#1
David A Hill, Hee-Woong Lim, Yong Hoon Kim, Wesley Y Ho, Yee Hoon Foong, Victoria L Nelson, Hoang C B Nguyen, Kavya Chegireddy, Jihoon Kim, Andreas Habertheuer, Prashanth Vallabhajosyula, Taku Kambayashi, Kyoung-Jae Won, Mitchell A Lazar
Obesity is characterized by an accumulation of macrophages in adipose, some of which form distinct crown-like structures (CLS) around fat cells. While multiple discrete adipose tissue macrophage (ATM) subsets are thought to exist, their respective effects on adipose tissue, and the transcriptional mechanisms that underlie the functional differences between ATM subsets, are not well understood. We report that obese fat tissue of mice and humans contain multiple distinct populations of ATMs with unique tissue distributions, transcriptomes, chromatin landscapes, and functions...
May 14, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29687970/hybrid-arch-surgery-challenges-other-forms-of-arch-treatment
#2
Tyler J Wallen, Joseph E Bavaria, Prashanth Vallabhajosyula
INTRODUCTION: The gold standard for aortic arch replacement remains total arch replacement (TAR) procedure. Hybrid techniques, utilizing a combination of open and endovascular approaches, have been developed with goal of lowering postoperative mortality and morbidity, as well as providing an alternative therapy for patients who are elderly, have significant comorbid burden, or patients in whom circulatory arrest may pose significant risk. EVIDENCE ACQUISITION: To date, there are no prospective randomized trials comparing hybrid aortic ach procedures to TAR...
April 24, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29673638/outcome-after-surgery-for-aortic-dissection-type-a-in-morbidly-obese-patients
#3
Maximilian Kreibich, Bartosz Rylski, Joseph E Bavaria, Emanuela Branchetti, Daniel Dohle, Patrick Moeller, Prashanth Vallabhajosyula, Wilson Y Szeto, Nimesh D Desai
BACKGROUND: The number of obese patients is increasing and more obese patients are likely to present for surgical repair of aortic dissection Type A (ADA). We evaluated the effect of this procedure on mortality and morbidity of patients based on their body-mass-index (BMI; kg*m-2 ). METHODS: A total of 667 patients that underwent surgical repair of ADA between 2003 and 2017 were retrospectively analyzed. Patients were divided into four groups according to BMI: normal weight (18≤BMI<25; n=186), overweight (25≤BMI<30; n=238), obese (30≤BMI<35, n=144), and morbidly obese (BMI≥35; n=99)...
April 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29663522/tricuspid-valve-endocarditis-in-the-era-of-the-opioid-epidemic
#4
Tyler J Wallen, Wilson Szeto, Matthew Williams, Pavan Atluri, George Arnaoutakis, Marci Fults, Ibrahim Sultan, Nimesh Desai, Michael Acker, Prashanth Vallabhajosyula
BACKGROUND AND AIM: We reviewed our institutional experience with tricuspid valve endocarditis to understand the impact of the opioid epidemic on the incidence of right heart endocarditis. METHODS: We retrospectively reviewed all cases of tricuspid endocarditis managed surgically from January of 2011 to May of 2017. There were no exclusion criteria. RESULTS: A total of 126 patients were identified. There were seven cases in 2011 and 36 in 2016...
May 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29610444/hemodynamic-effects-of-valve-asymmetry-in-sapien-3-transcatheter-aortic-valves
#5
Daniel R Mangels, Mary Siki, Rohan Menon, Joseph Bavaria, Saif Anwaruddin, Jay Giri, Nimesh Desai, Wilson Y Szeto, Prashanth Vallabhajosyula, Howard C Herrmann
BACKGROUND: Eccentric valve deployment after transcatheter aortic valve replacement (TAVR) has been associated with abnormal leaflet shear stresses that may accelerate structural valve deterioration (SVD). This phenomenon has not been studied in patients receiving Sapien 3 prostheses (Edwards Lifesciences). METHODS: A retrospective cohort analysis of 100 patients who received Sapien 3 valves between 2013 and 2015 at a single institution was performed. Axial fluoroscopic images from the co-planar view were used to assess TAVR asymmetry, which was defined as a ratio of left-to-right valve heights ≤0...
April 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29502934/association-of-tricuspid-regurgitation-with-transcatheter-aortic-valve-replacement-outcomes-a-report-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#6
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...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29499866/donor-tissue-specific-exosome-profiling-enables-noninvasive-monitoring-of-acute-rejection-in-mouse-allogeneic-heart-transplantation
#7
Andreas Habertheuer, Laxminarayana Korutla, Susan Rostami, Sanjana Reddy, Priti Lal, Ali Naji, Prashanth Vallabhajosyula
OBJECTIVE: In heart transplantation, there is a critical need for development of biomarkers to noninvasively monitor cardiac allografts for immunologic rejection or injury. Exosomes are tissue-specific nanovesicles released into circulation by many cell types. Their profiles are dynamic, reflecting conditional changes imposed on their tissue counterparts. We proposed that a transplanted heart releases donor-specific exosomes into the recipient's circulation that are conditionally altered during immunologic rejection...
February 1, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29391144/predicting-distal-aortic-remodeling-after-endovascular-repair-for-chronic-debakey-iii-aortic-dissection
#8
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 aortic dissection is typically managed with open aortic reconstruction. Thoracic endovascular aortic grafting (TEVAR) has been attempted in patients with chronic DeBakey III 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...
June 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29338381/effect-of-the-diabetic-state-on-islet-engraftment-and-function-in-a-large-animal-model-of-islet-kidney-transplantation
#9
Prashanth Vallabhajosyula, Atsushi Hirakata, Matthew Weiss, Adam Griesemer, Akira Shimizu, Hanzhou Hong, Andreas Habertheuer, Vaja Tchipashvili, Kazuhiko Yamada, David H Sachs
In islet transplantation, in addition to immunologic and ischemic factors, the diabetic/hyperglycemic state of the recipient has been proposed, although not yet validated, as a possible cause of islet toxicity, contributing to islet loss during the engraftment period. Using a miniature swine model of islet transplantation, we have now assessed the effect of a persistent state of hyperglycemia on islet engraftment and subsequent function. An islet-kidney (IK) model previously described by our laboratory was utilized...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29216679/the-role-of-extracorporeal-membrane-oxygenator-therapy-in-the-setting-of-type-a-aortic-dissection
#10
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
https://www.readbyqxmd.com/read/29174745/stroke-after-transcatheter-aortic-valve-replacement-incidence-definitions-etiologies-and-management-options
#11
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...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29143378/management-of-coronary-obstruction-following-transcatheter-aortic-valve-replacement
#12
REVIEW
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...
December 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-national-cardiovascular-data-registry-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#13
COMPARATIVE STUDY
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
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
#14
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
https://www.readbyqxmd.com/read/28691213/central-cannulation-strategy-for-extent-i-thoracoabdominal-aneurysm-repair-of-chronic-type-b-aortic-dissection
#15
COMPARATIVE STUDY
Reilly D Hobbs, Tyler J Wallen, Caroline M Komlo, Patrick J Moeller, Alberto Pochettino, Joseph E Bavaria, Prashanth Vallabhajosyula
INTRODUCTION: We evaluated the safety profile of a central cardiopulmonary bypass (CPB) cannulation strategy for repair of extent I thoracoabdominal aortic aneurysms (TAAA) with chronic type B dissection in comparison to traditional peripheral CPB cannulation strategies. METHODS: Patients undergoing extent I TAAA repair for chronic type B dissection from 2002 to 2011 were retrospectively reviewed. Patients were grouped by their CPB cannulation strategy. Patients in Group I underwent central aortic cannulation (n = 28) through a left thoracotomy incision...
August 2017: Journal of Cardiac Surgery
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/28457780/aortic-leaflet-billowing-as-a-risk-factor-for-repair-failure-after-aortic-valve-repair
#19
REVIEW
Clare Ridley, Benjamin Sohmer, Prashanth Vallabhajosyula, John G T Augoustides
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
#20
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...
March 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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