Publications by authors named "Kuduvalli M"
The David Versus the Bentall Procedure for Acute Type A Aortic Dissection.
J Cardiovasc Dev Dis
November 2024
: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD).
View Article and Find Full Text PDFBackground: The current study aims to report the presentation of the malperfusion syndrome in patients with acute type A aortic dissection admitted to surgery and its impact on mortality.
Methods: Data were retrieved from the multicenter European Registry of Type A Aortic Dissection. The Penn classification was used to categorize malperfusion syndromes.
Article Synopsis
- Thoracic aortic aneurysms usually show no symptoms until they lead to severe complications, known as acute aortic syndrome.
- The risk of developing these complications is linked to the size of the aorta and various factors, including genetics and existing health conditions.
- General population screening is challenging due to resource limitations, so targeted screening for high-risk groups and opportunistic imaging during lung cancer screenings are more practical, while healthcare professionals should remain vigilant about aortic issues in patients with chest pain.
Objectives: Post-cardiac and aortic surgery stroke is often underreported. We detail our single-centre experience the following introduction of comprehensive consultant-led daily stroke service, to demonstrate the efficacy of a stroke team in recovery from stroke following cardiac and aortic surgeries.
Methods: This retrospective, single-centre observational cohort study analysed consecutive patients undergoing cardiac and aortic surgery at our institution from August 2014 to December 2020.
Article Synopsis
- The study investigates gender differences in outcomes after type A aortic dissection (TAAD) surgery, focusing on both short- and long-term results.
- Data was collected from a multicenter European registry including 3902 TAAD surgery patients from 2005-2021, with a gender breakdown of 30.4% females.
- Results showed no significant early postoperative differences between genders, although males had a slightly better ten-year relative survival rate compared to females, despite advancements in surgical techniques over time.
Article Synopsis
- The study investigates the effects of different arterial cannulation methods (femoral, supra-aortic, and direct aortic) on outcomes for patients undergoing surgery for acute Stanford type A aortic dissection (TAAD).
- Results show that in-hospital mortality rates for patients using femoral or supra-aortic cannulation are similar, while direct aortic cannulation yields lower mortality rates compared to femoral cannulation.
- Additionally, switching cannulation sites during surgery increases the risk of in-hospital mortality, while long-term outcomes (10-year mortality) remain consistent across the groups.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) often leads to neurological complications, which were analyzed in a study of 3,902 patients from the European Registry of Type A Aortic Dissection.
- Out of these patients, 18.5% experienced strokes or global brain ischemia during hospitalization, with significant increases in in-hospital mortality linked to these complications: 25.6% for ischemic stroke, 48.7% for hemorrhagic stroke, and 74.0% for global brain ischemia.
- Although neurologic complications sharply increased early and midterm mortality, this negative impact on survival tended to diminish about one year post-surgery.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) has a high early mortality risk, with in-hospital mortality rates increasing based on the urgency of the procedure, ranging from 10% for urgent surgeries to over 57% for the most critical salvage procedures.
- A multicenter study using data from the European Registry of TAAD (ERTAAD) found that preoperative arterial lactate levels correlate with procedure urgency, indicating that more critical cases are associated with poorer outcomes.
- The urgency classification enhances the ability to predict patient risk, suggesting that despite high mortality in severe cases, salvage surgeries are often justified as many patients can still survive to discharge.
Background: Surgery for type A aortic dissection (TAAD) is associated with high risk of mortality. Current risk scoring methods have a limited predictive accuracy.
Methods: Subjects were patients who underwent surgery for acute TAAD at 18 European centers of cardiac surgery from the European Registry of Type A Aortic Dissection (ERTAAD).
Background: Acute type A aortic dissection (TAAD) is associated with significant mortality and morbidity. In this study we evaluated the prognostic significance of preoperative arterial lactate concentration on the outcome after surgery for TAAD.
Methods: The ERTAAD registry included consecutive patients who underwent surgery for acute type A aortic dissection (TAAD) at 18 European centers of cardiac surgery.
Article Synopsis
- A study compared direct aortic cannulation to supra-aortic cannulation methods during surgery for type A aortic dissection to see which leads to better patient outcomes.
- Data from 3,902 patients in the European registry showed that direct aortic cannulation resulted in lower in-hospital mortality (12.7% vs. 18.1%) and fewer postoperative complications, including issues like paralysis and infections.
- The findings suggest that direct aortic cannulation is a safer option for patients undergoing surgery for acute type A aortic dissection.
Purpose: To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD).
Methods: This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals.
Results: Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality.
Importance: Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement and is the treatment of choice for patients at high operative risk. The role of TAVI in patients at lower risk is unclear.
Objective: To determine whether TAVI is noninferior to surgery in patients at moderately increased operative risk.
Reinterventions and new aortic events after aortic surgery in Marfan syndrome.
Eur J Cardiothorac Surg
November 2021
Objectives: Pre-emptive strategies to manage the aortic complications of Marfan syndrome have resulted in improved life expectancy yet, secondary to the variation of phenotypic expression, anticipating the risk and nature of future aortic events is challenging. We examine rates of new aortic events and reinterventions in a Marfan cohort following initial aortic presentation.
Methods: Retrospective cohort study of Marfan patients with aortic pathology presenting to our institution 1998-2018.
Objective: Deep hypothermic circulatory arrest (DHCA) in aortic surgery is associated with morbidity and mortality despite evolving strategies. With the advent of antegrade cerebral perfusion (ACP), moderate hypothermic circulatory arrest (MHCA) was reported to have better outcomes than DHCA. There is no standardised guideline or consensus regarding the hypothermic strategies to be employed in open aortic surgery.
View Article and Find Full Text PDFArticle Synopsis
- The study looked at the results of a heart surgery called surgical aortic valve replacement (SAVR) in over 31,000 people in the UK, including those who also had another surgery called CABG.
- It found that the risk of dying from the surgery was low, around 1.9% for those with only SAVR and a bit higher for those who had CABG too.
- The study showed that the type of surgery and the patient's health before surgery affected the outcomes, but most surgeries were planned ahead of time rather than done in emergencies.
Article Synopsis
- Acute Stanford type A aortic dissection (TAAD) is a serious condition requiring surgery, but it's associated with high early mortality and complications.
- A multicenter observational registry (ERTAAD) across 19 cardiac surgery centers in Europe will analyze patient data from 2005 to 2021 to understand how comorbidities and surgical strategies affect patient outcomes.
- The study aims to provide insights into the factors that influence early postoperative risks and the long-term effectiveness of various surgical approaches for TAAD.
Article Synopsis
- - The study analyzed the outcomes of repairing acute type A aortic dissection (ATAAD) over 21 years, comparing in-hours (daytime) and out-of-hours (night) operations before and after establishing a specialized aortic service.
- - A total of 286 patients were included, with 83% more cases handled after the introduction of the specialized service, showing similar 30-day mortality rates regardless of operation timing in both phases of the study.
- - The results indicate that centralized care by a dedicated aortic team can lead to improved outcomes, highlighting that the time of day for surgery doesn't significantly affect patient survival in a specialized setting.
Objectives: Management of infected prosthetic aortic grafts in the ascending and or root is complex and multifaceted. We report our diagnostic pathway, management and outcomes, identifying successful strategies.
Methods: This was a retrospective, single center, observational study.