Publications by authors named "Arminder S Jassar"

Background: This study examined the association between cardiopulmonary bypass (CPB) hematocrit and postoperative acute renal failure (ARF) in patients undergoing aortic arch surgery with hypothermic circulatory arrest.

Methods: The Society of Thoracic Surgeons Adult Cardiac Surgery Database was queried from 2011 to 2019 for patients undergoing aortic arch surgery with hypothermic circulatory arrest. A multivariable logistic regression model estimated the adjusted odds of postoperative ARF on the basis of CPB hematocrit.

View Article and Find Full Text PDF
Article Synopsis
  • Recent advancements in transcatheter technologies have led to updated guidelines, increasing treatment options for aortic stenosis.
  • New "rapid deployment" or "sutureless valves" have been developed to simplify valve implantation and reduce surgery time by eliminating the need for sutures.
  • The effectiveness of these sutureless valves compared to traditional surgical methods and TAVR is still under discussion, with the review focusing on existing evidence and outcomes for each method.
View Article and Find Full Text PDF

Objective: To evaluate whether a machine learning algorithm (i.e. the "NightSignal" algorithm) can be used for the detection of postoperative complications prior to symptom onset after cardiothoracic surgery.

View Article and Find Full Text PDF

A 71-year-old male presented with 1-day history of back pain. Imaging displayed an enlarging thoracic aortic aneurysm with gas in the aortic wall. Blood cultures grew .

View Article and Find Full Text PDF

• Percutaneous closure of ascending aortic pseudoaneurysms is feasible in selected patients. • Procedural planning with multimodality imaging and multidisciplinary discussion is key. • TEE can be instrumental for intraprocedural guidance.

View Article and Find Full Text PDF

Objective: Approximately one-quarter of patients with acute type A aortic dissection (TAAD) present with concomitant malperfusion of coronary arteries, mesenteric circulation, lower extremities, kidneys, brain, and/or coma. It is generally accepted that TAAD patients who present with malperfusion experience higher mortality rates than patients without, although how specific malperfusion syndromes, alone or in combination, affect mortality is not well described.

Methods: The International Registry of Acute Aortic Dissection database was queried for patients who underwent surgical repair of TAAD.

View Article and Find Full Text PDF

Background: Collaboration among cardiac surgeons and radiologists is essential to fully leverage advanced imaging technologies and improve the care of cardiac surgery patients. In this review, a cardiac surgeon and cardiovascular radiologist discuss imaging pearls and considerations in aortic dissection cases.

Methods: The surgeon and the radiologist discuss imaging considerations in two aortic dissection cases.

View Article and Find Full Text PDF

Background Many patients with severe aortic stenosis (AS) and an indication for aortic valve replacement (AVR) do not undergo treatment. The reasons for this have not been well studied in the transcatheter AVR era. We sought to determine how patient- and process-specific factors affected AVR use in patients with severe AS.

View Article and Find Full Text PDF

The incidence of injection drug use-associated infective endocarditis has been increasing rapidly over the last decade. Patients with drug use-associated infective endocarditis present an increasingly common clinical challenge with poor long-term outcomes and high reinfection and readmission rates. Their care raises issues unique to this population, including antibiotic selection and administration, indications for and ethical issues surrounding surgical intervention, and importantly management of the underlying substance use disorder to minimize the risk of reinfection.

View Article and Find Full Text PDF

Pericardial-esophageal fistula and/or atrial-esophageal fistula after cardiac ablation is nearly universally fatal if not detected and treated expeditiously. This condition should be assumed and ruled out in anyone with a recent history of cardiac ablation presenting with signs of sepsis, pneumomediastinum, pneumopericardium, or chest pain. Computed tomography scan of the chest is a rapid and a sensitive diagnostic modality.

View Article and Find Full Text PDF

Background: Consensus guidelines recommend multidisciplinary models to manage infective endocarditis, yet often do not address the unique challenges of treating people with drug use-associated infective endocarditis (DUA-IE). Our center is among the first to convene a Drug Use Endocarditis Treatment (DUET) team composed of specialists from Infectious Disease, Cardiothoracic Surgery, Cardiology, and Addiction Medicine.

Methods: The objective of this study was to describe the demographics, infectious characteristics, and clinical outcomes of the first cohort of patients cared for by the DUET team.

View Article and Find Full Text PDF
Article Synopsis
  • Despite an increase in aortic valve replacement (AVR) procedures for aortic stenosis (AS), a significant number of patients who need the treatment remain untreated, especially those in low gradient subgroups.
  • The study analyzed data from 10,795 patients over 18 years to determine trends in AVR utilization based on various clinical indications and AS classifications.
  • While the overall number of AVR procedures increased, the proportion of patients who received AVR, particularly in low gradient categories, highlighted persistent undertreatment issues among those with severe AS.
View Article and Find Full Text PDF

Background: Ischemic gastrointestinal complications (IGIC) following cardiac surgery are associated with high morbidity and mortality and remain difficult to predict. We evaluated perioperative risk factors for IGIC in patients undergoing open cardiac surgery.

Methods: All patients that underwent an open cardiac surgical procedure at a tertiary academic center between 2011 and 2017 were included.

View Article and Find Full Text PDF

Objectives: Drug use-associated infective endocarditis is a rapidly growing clinical problem. Although operative outcomes are generally satisfactory, reinfection secondary to recurrent substance use is distressingly common, negatively affects long-term survival, generates practical and ethical challenges, and creates potential conflict among care team members. We established a Drug Use Endocarditis Treatment team including surgeons, infectious disease, and addiction medicine experts specifically focused on the unique complexities of drug use-associated infective endocarditis.

View Article and Find Full Text PDF

Objective: Aortic valve disease is a risk factor for atrial fibrillation (AF), and AF is associated with increased late mortality and morbidity after cardiac surgery. The evolution of alternative approaches to AF prophylaxis, including less invasive technologies and medical therapies, has altered the balance between risk and potential benefit for prophylactic intervention at the time of surgical aortic valve replacement (SAVR). Such interventions impose incremental risk, however, making an understanding of predictors of new onset AF that persists beyond the perioperative episode relevant.

View Article and Find Full Text PDF

Objectives: Real-time noninvasive monitoring of cerebral blood flow (CBF) during surgery is key to reducing mortality rates associated with adult cardiac surgeries requiring hypothermic circulatory arrest (HCA). We explored a method to monitor cerebral blood flow during different brain protection techniques using diffuse correlation spectroscopy (DCS), a noninvasive optical technique which, combined with frequency-domain near-infrared spectroscopy (FDNIRS), also provides a measure of oxygen metabolism.

Methods: We used DCS in combination with FDNIRS to simultaneously measure hemoglobin oxygen saturation (SO), an index of cerebral blood flow (CBF), and an index of cerebral metabolic rate of oxygen (CMRO) in 12 patients undergoing cardiac surgery with HCA.

View Article and Find Full Text PDF

Objectives: Kommerell diverticulum (KD) is a rare congenital vascular anomaly often associated with an aberrant subclavian artery (ASCA). Definitive indications for intervention remain unclear. We present open and endovascular (EV) operative outcomes in a large contemporary series and propose a management algorithm.

View Article and Find Full Text PDF