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Article ; Online: Valve-sparing versus valve-replacing aortic root replacement in patients with aortic root aneurysm.

Malaisrie, S Chris / Kislitsina, Olga N / Wilsbacher, Lisa / Mendelson, Marla / Puthumana, Jyothy J / Vassallo, Patricia / Kruse, Jane / Andrei, Adin-Cristian / McCarthy, Patrick M

Journal of cardiac surgery

2022 Volume 37, Issue 7, Page(s) 1947–1956

Abstract: Background: Valve-sparing aortic root replacement (VSARR) is an alternative to valve-replacing aortic root replacement (VRARR) with valved-conduits based on recent guidelines for clinical practice. This study investigated outcomes of these two ... ...

Abstract	Background: Valve-sparing aortic root replacement (VSARR) is an alternative to valve-replacing aortic root replacement (VRARR) with valved-conduits based on recent guidelines for clinical practice. This study investigated outcomes of these two procedures in patients with nonstenotic valves. Methods: Between January 7, 2007 and June 30, 2019, 475 patients with aortic root aneurysm without aortic stenosis underwent VSARR (151) or VRARR (324) techniques. Propensity score-matching (PSM) was used to alleviate confounding. Endpoints were 30-day mortality, 8-year survival and reoperation, aortic regurgitation, and valve gradients. Results: PSM created 69 pairs of patients with a mean age 52 ± 13 years (10.1% Marfan syndrome, 34.8% bicuspid aortic valve). There was no statistically significant difference in major perioperative morbidity or 30-day mortality (0% VSARR vs. 1.4% VRARR; p = 0.316). Overall survival was significantly higher (p = 0.025) in the VSARR group versus the VRARR group (8-year estimates 100% vs. 88.9%, respectively), while freedom from valve reoperation was similar (p = 0.97, 8-year estimates 90.9% vs. 96.7%, respectively). Freedom from > moderate-severe AR was not significantly different (p = 0.08, 8-year estimates 90.0% VSARR group vs. 100% VRARR), but mean valve gradients at last follow-up were better in the VSARR group (5.9 vs. 13.2 mmHg, p < 0.001). Conclusions: VSARR is a safe operation in patients with aortic root aneurysm and nonstenotic aortic valves in the hands of experienced surgeons. Freedom from reoperation is similar and the mode of aortic valve failure differs between the two groups.
MeSH term(s)	Adult ; Aged ; Aortic Aneurysm, Thoracic/surgery ; Aortic Valve/surgery ; Aortic Valve Insufficiency/etiology ; Aortic Valve Insufficiency/surgery ; Heart Valve Prosthesis Implantation/methods ; Humans ; Middle Aged ; Reoperation ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.16473
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Article ; Online: Four-Dimensional Magnetic Resonance After Ross Procedure for Unicuspid Aortic Valve.

Drullinsky, David / Mehta, Christopher K / Scott, Michael B / Crawford, Erin / Markl, Michael / Bonow, Robert O / Mendelson, Marla A / El-Hamamsy, Ismail / Malaisrie, S Chris

Circulation. Cardiovascular imaging

2021 Volume 14, Issue 4, Page(s) e011500

Language	English
Publishing date	2021-04-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2435045-X
ISSN	1942-0080 ; 1941-9651
ISSN (online)	1942-0080
ISSN	1941-9651
DOI	10.1161/CIRCIMAGING.120.011500
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Zs.A 6743: Show issues

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Article ; Online: Corrected QT Interval and Methadone Dose and Concentrations in Pregnant and Postpartum Women.

Bogen, Debra L / Hanusa, Barbara H / Perel, James M / Sherman, Frederick / Mendelson, Marla A / Wisner, Katherine L

The Journal of clinical psychiatry

2017 Volume 78, Issue 8, Page(s) e1013–e1019

Abstract: Background: Methadone is a standard treatment for opioid dependence in pregnancy; however, its impact on maternal corrected QT interval (QTc) has not been evaluated. We studied the association between methadone dose and enantiomer-specific plasma ... ...

Abstract	Background: Methadone is a standard treatment for opioid dependence in pregnancy; however, its impact on maternal corrected QT interval (QTc) has not been evaluated. We studied the association between methadone dose and enantiomer-specific plasma concentrations and QTc among pregnant and postpartum women and newborns. We assessed the relevance of QTc screening guidelines for pregnant women and infants. Methods: From 2006 to 2008, plasma methadone concentrations were measured during pregnancy, postpartum, and in cord blood in women treated for opioid dependence at a single treatment program. Electrocardiograms (ECGs) were obtained at peak methadone concentrations in mothers and within 48 hours of birth for infants. Pearson correlations were performed at each time point for QTc and R-methadone, S-methadone, and total methadone concentrations and ratio of R-methadone/S-methadone concentrations. Results: Mean (SD) daily methadone dose for the 25 women was 94.2 (39.1) mg during pregnancy and 112.5 (46.6) mg postpartum. During the third trimester, higher methadone dose and R-methadone concentration correlated with longer QTc (Pearson r = 0.67, P < .001 and Pearson r = 0.49, P = .02, respectively), while S-methadone concentration, R-methadone/S-methadone concentration ratio, and total methadone concentration did not. Postpartum, QTc did not significantly correlate with dose or enantiomer concentrations. Infant QTc did not correlate with maternal dose at delivery or enantiomer-specific cord methadone concentrations. In pregnant and postpartum women, 13% and 17%, respectively, had QTc ≥ 450 ms, as did 19% of infants. Conclusions: QTc correlated with dose and R-methadone concentration during the third trimester. However, longer QTc was common among women during and after pregnancy. Given the relatively high rate of QTc > 450 ms, an ECG before and after methadone initiation is advisable for pregnant and postpartum women.
MeSH term(s)	Adult ; Dose-Response Relationship, Drug ; Drug Monitoring/methods ; Electrocardiography/methods ; Female ; Fetal Blood ; Half-Life ; Humans ; Infant, Newborn ; Long QT Syndrome/diagnosis ; Long QT Syndrome/etiology ; Long QT Syndrome/therapy ; Methadone/administration & dosage ; Methadone/adverse effects ; Methadone/blood ; Narcotics/administration & dosage ; Narcotics/adverse effects ; Narcotics/blood ; Opiate Substitution Treatment/methods ; Opioid-Related Disorders/blood ; Opioid-Related Disorders/complications ; Opioid-Related Disorders/physiopathology ; Opioid-Related Disorders/therapy ; Postpartum Period/blood ; Postpartum Period/drug effects ; Pregnancy ; Pregnancy Complications/blood ; Pregnancy Complications/physiopathology ; Pregnancy Complications/therapy ; Pregnancy Trimester, Third/blood ; Pregnancy Trimester, Third/drug effects ; Statistics as Topic ; United States
Chemical Substances	Narcotics ; Methadone (UC6VBE7V1Z)
Language	English
Publishing date	2017-09-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	716287-x
ISSN	1555-2101 ; 0160-6689
ISSN (online)	1555-2101
ISSN	0160-6689
DOI	10.4088/JCP.16m11318
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Zs.B 108: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 247: Show issues

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Article ; Online: Sex Differences in Ischemic Heart Disease: Advances, Obstacles, and Next Steps.

Aggarwal, Niti R / Patel, Hena N / Mehta, Laxmi S / Sanghani, Rupa M / Lundberg, Gina P / Lewis, Sandra J / Mendelson, Marla A / Wood, Malissa J / Volgman, Annabelle S / Mieres, Jennifer H

Circulation. Cardiovascular quality and outcomes

2018 Volume 11, Issue 2, Page(s) e004437

Abstract: Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. ... ...

Abstract	Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in women in the United States. The important publication by the Institute of Medicine titled "Women's Health Research-Progress, Pitfalls, and Promise," highlights the persistent disparities in cardiovascular disease burden among subgroups of women, particularly women who are socially disadvantaged because of race, ethnicity, income level, and educational attainment. These important health disparities reflect underrepresentation of women in research, with the resultant unfavorable impact on diagnosis, prevention, and treatment strategies in women at risk for cardiovascular disease. Causes of disparities are multifactorial and related to differences in risk factor prevalence, access to care, use of evidence-based guidelines, and social and environmental factors. Lack of awareness in both the public and medical community, as well as existing knowledge gap regarding sex-specific differences in presentation, risk factors, pathophysiology, and response to treatment for ischemic heart disease, further contribute to outcome disparities. There is a critical need for implementation of sex- and gender-specific strategies to improve cardiovascular outcomes. This review is tailored to meet the needs of a busy clinician and summarizes the contemporary trends, characterizes current sex-specific outcome disparities, delineates challenges, and proposes transformative solutions for improvement of the full spectrum of ischemic heart disease clinical care and research in women.
MeSH term(s)	Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; Comorbidity ; Female ; Genetic Predisposition to Disease ; Health Status Disparities ; Healthcare Disparities ; Heredity ; Humans ; Incidence ; Life Style ; Male ; Middle Aged ; Myocardial Ischemia/diagnostic imaging ; Myocardial Ischemia/mortality ; Myocardial Ischemia/physiopathology ; Myocardial Ischemia/therapy ; Prognosis ; Risk Assessment ; Risk Factors ; Sex Distribution ; Sex Factors
Language	English
Publishing date	2018-02-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2483197-9
ISSN	1941-7705 ; 1941-7713
ISSN (online)	1941-7705
ISSN	1941-7713
DOI	10.1161/CIRCOUTCOMES.117.004437
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Zs.A 6744: Show issues

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Article ; Online: Comparison of outcomes and presentation in men-versus-women with bicuspid aortic valves undergoing aortic valve replacement.

Andrei, Adin-Cristian / Yadlapati, Ajay / Malaisrie, S Chris / Puthumana, Jyothy J / Li, Zhi / Rigolin, Vera H / Mendelson, Marla / Clennon, Colleen / Kruse, Jane / Fedak, Paul W M / Thomas, James D / Higgins, Jennifer A / Rinewalt, Daniel / Bonow, Robert O / McCarthy, Patrick M

The American journal of cardiology

2015 Volume 116, Issue 2, Page(s) 250–255

Abstract: Gender disparities in short- and long-term outcomes have been documented in cardiac and valvular heart surgery. However, there is a paucity of data regarding these differences in the bicuspid aortic valve (BAV) population. The aim of this study was to ... ...

Abstract	Gender disparities in short- and long-term outcomes have been documented in cardiac and valvular heart surgery. However, there is a paucity of data regarding these differences in the bicuspid aortic valve (BAV) population. The aim of this study was to examine gender-specific differences in short- and long-term outcomes after surgical aortic valve (AV) replacement in patients with BAV. A retrospective analysis was performed in 628 consecutive patients with BAV who underwent AV surgery from April 2004 to December 2013. To reduce bias when comparing outcomes by gender, propensity score matching obtained on the basis of potential confounders was used. Women with BAV who underwent AV surgery presented with more advanced age (mean 60.7 ± 13.8 vs 56.3 ± 13.6 years, p <0.001) and less aortic regurgitation (29% vs 44%, p <0.001) and had a higher risk for in-hospital mortality (mean Ambler score 3.4 ± 4.4 vs 2.5 ± 4.0, p = 0.015). After propensity score matching, women received more blood products postoperatively (48% vs 34%, p = 0.028) and had more prolonged postoperative lengths of stay (median 5 days [interquartile range 5 to 7] vs 5 days [interquartile range 4 to 6], p = 0.027). Operative, discharge, and 30-day mortality and overall survival were not significantly different. In conclusion, women with BAV who underwent AV surgery were older, presented with less aortic regurgitation, and had increased co-morbidities, lending higher operative risk. Although women received more blood products and had significantly longer lengths of stay, short- and long-term outcomes were similar.
MeSH term(s)	Aortic Valve/abnormalities ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Bicuspid Aortic Valve Disease ; Echocardiography ; Female ; Follow-Up Studies ; Heart Valve Diseases/diagnostic imaging ; Heart Valve Diseases/mortality ; Heart Valve Diseases/surgery ; Heart Valve Prosthesis ; Hospital Mortality/trends ; Humans ; Male ; Middle Aged ; Postoperative Complications/mortality ; Retrospective Studies ; Risk Factors ; Survival Rate/trends ; Treatment Outcome ; United States/epidemiology
Language	English
Publishing date	2015-04-18
Publishing country	United States
Document type	Clinical Trial ; Comparative Study ; Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2015.04.017
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Ui IV Zs.73: Show issues

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Article ; Online: From unicuspid to quadricuspid: influence of aortic valve morphology on aortic three-dimensional hemodynamics.

Entezari, Pegah / Schnell, Susanne / Mahadevia, Riti / Malaisrie, Chris / McCarthy, Patrick / Mendelson, Marla / Collins, Jeremy / Carr, James C / Markl, Michael / Barker, Alex J

Journal of magnetic resonance imaging : JMRI

2013 Volume 40, Issue 6, Page(s) 1342–1346

Abstract: Purpose: To assess the impact of aortic valve morphology on aortic hemodynamics between normal tricuspid and congenitally anomalous aortic valves ranging from unicuspid to quadricuspid morphology.: Materials and methods: Aortic three-dimensional (3D) ...

Abstract	Purpose: To assess the impact of aortic valve morphology on aortic hemodynamics between normal tricuspid and congenitally anomalous aortic valves ranging from unicuspid to quadricuspid morphology. Materials and methods: Aortic three-dimensional (3D) blood flow was evaluated by 4D flow MRI in 14 healthy volunteers with normal trileaflet valves and 14 patients with unicuspid (n = 3), bicuspid (n = 9, 3 "true" bicuspid, 3 right-left (RL), 3 right-noncoronary (RN) leaflet fusion, and quadricuspid aortic valves (n = 2). Data analysis included the co-registered visualization of aortic valve morphology with systolic 3D blood flow. The influence of valve morphology on aortic hemodynamics was quantified by valve flow angle. Results: All RL-bicuspid aortic valve (BAV) were associated with flow jets directed toward the right anterior aortic wall while RN-fusion and unicuspid valves resulted in flow jet patterns toward the right-posterior or posterior wall. Flow angles were clearly influenced by valve morphology (47° ± 10, 28° ± 2, 29° ± 18, 18° ± 12, 15° ± 2 for unicuspid, true BAV, RN-BAV, RL-BAV, quadricuspid valves) and increased compared with controls (7.2° ± 1.1, P = 0.001). Conclusion: Altered 3D aortic hemodynamics are impacted by the morphology of congenitally malformed aortic valves.
MeSH term(s)	Adult ; Aortic Valve/abnormalities ; Aortic Valve/pathology ; Aortic Valve/physiopathology ; Bicuspid Aortic Valve Disease ; Blood Flow Velocity ; Cohort Studies ; Female ; Heart Valve Diseases/pathology ; Heart Valve Diseases/physiopathology ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods ; Imaging, Three-Dimensional/methods ; Magnetic Resonance Angiography/methods ; Magnetic Resonance Imaging, Cine/methods ; Male ; Multimodal Imaging/methods ; Myocardial Perfusion Imaging/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique ; Young Adult
Language	English
Publishing date	2013-11-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1146614-5
ISSN	1522-2586 ; 1053-1807
ISSN (online)	1522-2586
ISSN	1053-1807
DOI	10.1002/jmri.24498
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Zs.A 3648: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Sex-based biomedical research policy needs an implementation plan.

Women's health (London, England)

2015 Volume 11, Issue 4, Page(s) 449–452

MeSH term(s)	Animals ; Biomedical Research ; Female ; General Surgery ; Humans ; Male ; Sexism
Language	English
Publishing date	2015-07
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2274503-8
ISSN	1745-5065 ; 1745-5057
ISSN (online)	1745-5065
ISSN	1745-5057
DOI	10.2217/WHE.15.28
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Article ; Online: Valve-sparing versus valve-replacing aortic root replacement in patients with aortic root aneurysm.

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Article ; Online: Four-Dimensional Magnetic Resonance After Ross Procedure for Unicuspid Aortic Valve.

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Article ; Online: Corrected QT Interval and Methadone Dose and Concentrations in Pregnant and Postpartum Women.

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Article ; Online: Sex Differences in Ischemic Heart Disease: Advances, Obstacles, and Next Steps.

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Article ; Online: Comparison of outcomes and presentation in men-versus-women with bicuspid aortic valves undergoing aortic valve replacement.

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Article ; Online: From unicuspid to quadricuspid: influence of aortic valve morphology on aortic three-dimensional hemodynamics.

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Article ; Online: Sex-based biomedical research policy needs an implementation plan.

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