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Prashanth Vallabhajosyula

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https://www.readbyqxmd.com/read/29216679/the-role-of-extracorporeal-membrane-oxygenator-therapy-in-the-setting-of-type-a-aortic-dissection
#1
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 7, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29174745/stroke-after-transcatheter-aortic-valve-replacement-incidence-definitions-etiologies-and-management-options
#2
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/29143378/management-of-coronary-obstruction-following-transcatheter-aortic-valve-replacement
#3
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...
November 16, 2017: Journal of Cardiac 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
#4
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
#5
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/28691213/central-cannulation-strategy-for-extent-i-thoracoabdominal-aneurysm-repair-of-chronic-type-b-aortic-dissection
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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/28319051/tissue-specific-exosome-biomarkers-for-noninvasively-monitoring-immunologic-rejection-of-transplanted-tissue
#12
Prashanth Vallabhajosyula, Laxminarayana Korutla, Andreas Habertheuer, Ming Yu, Susan Rostami, Chao-Xing Yuan, Sanjana Reddy, Chengyang Liu, Varun Korutla, Brigitte Koeberlein, Jennifer Trofe-Clark, Michael R Rickels, Ali Naji
In transplantation, there is a critical need for noninvasive biomarker platforms for monitoring immunologic rejection. We hypothesized that transplanted tissues release donor-specific exosomes into recipient circulation and that the quantitation and profiling of donor intra-exosomal cargoes may constitute a biomarker platform for monitoring rejection. Here, we have tested this hypothesis in a human-into-mouse xenogeneic islet transplant model and validated the concept in clinical settings of islet and renal transplantation...
April 3, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28242077/ex%C3%A2-vivo-lung-perfusion-model-to-study-pulmonary-tissue-extracellular-microvesicle-profiles
#13
Prashanth Vallabhajosyula, Laxminarayana Korutla, Andreas Habertheuer, Sanjana Reddy, Christian Schaufler, Jared Lasky, Joshua Diamond, Edward Cantu
BACKGROUND: Extracellular microvesicles (EVs) are being increasingly studied for their diagnostic potential. We investigated the feasibility of studying the kinetics and tissue-specific profiles of pulmonary EVs in the context of ex vivo lung perfusion (EVLP) used for salvaging marginal lungs for transplantation. METHODS: Perfusate from six marginal donor lungs placed on EVLP was collected at the following time points: 0, 10, and 60 minutes after and after perfusate exchange with Steen Solution; 120 and 180 minutes...
June 2017: Annals of Thoracic Surgery
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
#14
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/27666785/central-repair-with-antegrade-tevar-for-malperfusion-syndromes-in-acute-debakey-i-aortic-dissection
#15
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
https://www.readbyqxmd.com/read/27544289/valve-selection-in-end-stage-renal-disease-should-it-always-be-biological
#16
COMPARATIVE STUDY
Matthew L Williams, Joseph E Bavaria, Michael A Acker, Nimesh D Desai, Prashanth Vallabhajosyula, W Clark Hargrove, Pavan Atluri, Wilson Y Szeto
BACKGROUND: When valve replacement is required in patients with end-stage renal disease (ESRD), it is not clear if mechanical or bioprosthetic valve selection is better. We compared outcomes between ESRD patients who underwent either mechanical or biologic valve replacements at our institution. METHODS: All patients with ESRD who underwent either mitral or aortic valve replacement from 2002 to 2014 at our institution were reviewed (n = 215; mechanical = 64, biological = 151)...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27542900/surgical-aortic-valve-replacement-clinical-update-on-recent-advances-in-the-contemporary-era
#17
REVIEW
Harish Ramakrishna, Prakash A Patel, Jacob T Gutsche, Prashanth Vallabhajosyula, Wilson Y Szeto, Emily MacKay, Jared W Feinman, Ronak Shah, Elizabeth Zhou, Stuart J Weiss, John G Augoustides
No abstract text is available yet for this article.
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27468895/transcatheter-aortic-valve-replacement-clinical-update-on-access-approaches-in-the-contemporary-era
#18
REVIEW
Harish Ramakrishna, Prakash A Patel, Jacob T Gutsche, Prashanth Vallabhajosyula, Warren Spitz, Jared W Feinman, Ronak Shah, Elizabeth Zhou, Stuart J Weiss, John G Augoustides
No abstract text is available yet for this article.
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27386414/routine-use-of-hemiarch-during-acute-type-a-aortic-dissection-repair
#19
REVIEW
Ibrahim Sultan, Jeremy McGarvey, Prashanth Vallabhajosyula, Nimesh D Desai, Joseph E Bavaria, Wilson Y Szeto
No abstract text is available yet for this article.
May 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27366883/concomitant-aortic-arch-reconstruction-using-deep-hypothermic-circulatory-arrest-during-heart-transplantation
#20
LETTER
Reilly Hobbs, Jean P Gottret, Rohan Menon, Caroline Komlo, Alberto Pochettino, Michael Acker, Prashanth Vallabhajosyula
No abstract text is available yet for this article.
August 2016: Journal of Cardiovascular Surgery
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