Publications by authors named "Scott A Lemaire"
Article Synopsis
- This study investigated the effects of reinfusing larger volumes of unwashed autologous blood during thoracoabdominal aortic aneurysm (TAAA) repair to see if it led to more adverse events within 30 days post-surgery.
- Researchers analyzed data from 972 patients who underwent TAAA repair between 2007 and 2021, focusing on the volume of shed autologous blood (SAB) reinfused and its association with complications such as operative mortality, cardiac issues, pulmonary problems, and renal failure.
- Results showed that higher volumes of unwashed SAB did not increase the risk of composite adverse events or the individual outcomes evaluated, indicating that the practice may be safe for patients undergoing this procedure.
Article Synopsis
- Aortic dissection is a common issue during surgeries for thoracoabdominal aortic aneurysms (TAAAs), often chronic and linked to aortic dilation; this study aimed to compare patient outcomes between those with chronic dissection and those with non-dissection aneurysms.
- Researchers analyzed data from 3,470 TAAA surgeries and found that patients with chronic dissection were generally younger, had fewer heart disease risk factors, and experienced lower operative mortality (7.1%) compared to non-dissection patients (9.2%).
- Chronic dissection was not a significant predictor of operative mortality or adverse outcomes; instead, factors like emergency repairs and chronic kidney disease played a more critical role.
Article Synopsis
- A study evaluated outcomes of open extent I thoracoabdominal aortic aneurysm (TAAA) repairs in 992 patients, comparing those with heritable thoracic aortic disease (HTAD) to those without.
- Patients with HTAD had significantly lower rates of operative mortality (1.7% vs 7.0%) and adverse events (2.8% vs 12.3%), indicating better short-term outcomes.
- The findings suggest that open TAAA repair is effective for HTAD patients, with low risks and better long-term survival, advocating for this approach in their treatment.
Article Synopsis
- - Spinal cord deficit (SCD) is a serious complication that can occur after thoracoabdominal aortic aneurysm repair, so careful management during the entire surgical process is crucial to minimize this risk.
- - Preventive strategies during surgery include optimizing patient conditions beforehand and identifying those who are at greater risk for SCD, as well as using techniques like cerebrospinal fluid drainage and selective reimplantation of specific arteries.
- - It's essential to monitor blood pressure and anemia both during and after the procedure, and if SCD is detected early, timely treatment can help reduce potential damage.
Objective: Many patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair have had a previous myocardial infarction (MI). To address the paucity of data regarding outcomes in such patients, we aimed to compare outcomes after open TAAA repair in patients with and without previous MI.
Methods: From 1986 to 2022, we performed 3737 consecutive open TAAA repairs.
Objective: We assessed associations between outcomes after open thoracoabdominal aortic aneurysm (TAAA) repair and preoperative airflow limitation stratified by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric classification of chronic obstructive pulmonary disease (COPD) severity.
Methods: Among 2368 open elective TAAA repairs in patients with spirometric data, 1735 patients had COPD and 633 did not. Those with COPD were stratified by preoperative respiratory dysfunction as GOLD 1 (forced expiratory volume in the first second of expiration [FEV] ≥80% of predicted; n = 228), GOLD 2 (50% ≤ FEV < 80% of predicted; n = 1215), GOLD 3 (30% ≤ FEV < 50% of predicted; n = 260), or GOLD 4 (FEV < 30% of predicted; n = 32).
Article Synopsis
- * A study analyzed 65 subjects and found that a VTI-h threshold of ≥15.5 can help discriminate between individuals at risk for cardiovascular issues, with a sensitivity of 70% and specificity of 76%.
- * Age influences cardiovascular event rates, with VTI-h ≥15.5 showing a stronger correlation to events in high-risk variants among individuals under 40, indicating that genetic factors may modify the relationship between tortuosity and
Background: Smooth muscle cell (SMC) phenotypic switching has been increasingly detected in aortic aneurysm and dissection (AAD) tissues. However, the diverse SMC phenotypes in AAD tissues and the mechanisms driving SMC phenotypic alterations remain to be identified.
Methods: We examined the transcriptomic and epigenomic dynamics of aortic SMC phenotypic changes in mice with angiotensin II-induced AAD by using single-cell RNA sequencing and single-cell sequencing assay for transposase-accessible chromatin.
Background: Marfan syndrome (MFS) is a heritable thoracic aortic disease with pervasive cardiovascular effects, including commonly, a dilated aortic root. Traditionally, the root is replaced using a mechanical composite valve graft (CVG); however, this valve-replacing (VR) approach necessitates a lifelong regimen of anticoagulation with a potential for late bleeding complications. In time, valve-sparing (VS) approaches were developed.
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- A genome-wide association study (GWAS) was conducted on thoracic aortic aneurysms and dissections (TAAD) involving nearly 450,000 participants, identifying 21 genetic risk loci, 17 of which are new findings.
- The study utilized various analytical methods to pinpoint specific genes and cell types linked to TAAD, reinforcing that it is a unique condition not caused by the usual vascular disease factors.
- The research highlights that the genetic basis of TAAD is complex, similar to other traits, and is not only influenced by significant protein-altering gene variants.
Introduction: NIH funding to departments of surgery reported as benchmark Blue Ridge Institute for Medical Research (BRIMR) rankings are unclear.
Methods: We analyzed inflation-adjusted BRIMR-reported NIH funding to departments of surgery and medicine between 2011 and 2021.
Results: NIH funding to departments of surgery and medicine both increased 40% from 2011 to 2021 ($325 million to $454 million; $3.
Objective: We aimed to identify outcomes and factors that independently associate with early mortality after open repair of Crawford extent IV thoracoabdominal aortic aneurysms, defined as aneurysms confined to the segment below the diaphragm.
Methods: This retrospective analysis included 721 extent IV thoracoabdominal aortic aneurysm repairs performed in our institution from 1986 to 2021. Indications for repair were aneurysm without dissection in 627 cases (87.
Background: When aortic cells are under stress, such as increased hemodynamic pressure, they adapt to the environment by modifying their functions, allowing the aorta to maintain its strength. To understand the regulation of this adaptive response, we examined transcriptomic and epigenomic programs in aortic smooth muscle cells (SMCs) during the adaptive response to AngII (angiotensin II) infusion and determined its importance in protecting against aortic aneurysm and dissection (AAD).
Methods: We performed single-cell RNA sequencing and single-cell sequencing assay for transposase-accessible chromatin (scATAC-seq) analyses in a mouse model of sporadic AAD induced by AngII infusion.
Racial disparities in thoracic aortic surgery: Myth or reality?
J Thorac Cardiovasc Surg
January 2024
Objective: We examined the relationship between Black or White race and adverse outcomes in patients who underwent surgery of the ascending aorta, aortic root, or aortic arch at our center.
Methods: We analyzed 2335 consecutive patients who identified as Black (n = 217, 9.3%) or White (n = 2118, 90.
Background: Without surgical repair, acute type A aortic dissection (TAAD) is usually fatal. However, some patients survive without an early operation and progress to the chronic phase. Contemporary outcomes of primary surgical repair of chronic TAAD are unclear, so we evaluated them at our single-practice service.
View Article and Find Full Text PDFObjective: We evaluated the relationship among community socioeconomic factors (poverty, income, and education), gender, and outcomes in patients who underwent ascending aortic, root, and arch surgery.
Methods: For 2634 consecutive patients, we associated patients' ZIP codes with community socioeconomic factors. The composite adverse outcome comprised death, persistent neurological injury, and renal failure necessitating dialysis at discharge.
Objective: In this prospective US investigational device exemption trial, we assessed the safety and 1-year clinical outcomes of the Thoraflex Hybrid device (Terumo Aortic) for the frozen elephant trunk technique to repair the ascending aorta, aortic arch, and descending thoracic aorta.
Methods: For the trial, which involved 12 US sites, 65 patients without rupture were recruited into the primary study group, and 9 patients were recruited into the rupture group. All patients underwent open surgical repair of the ascending aorta, aortic arch, and descending thoracic aorta in cases of aneurysm and/or dissection.
Objective: Mycotic aortic aneurysm and its associated complications are often catastrophic. In this study, we examined the early and late outcomes of surgical repair of mycotic aortic aneurysm at our center over the last 3 decades.
Methods: We retrospectively reviewed our prospectively maintained aortic surgery database with supplemental adjudication of medical records.
Background: The GenTAC (Genetically Triggered Thoracic Aortic Aneurysm and Cardiovascular Conditions) Registry enrolled patients with genetic aortopathies between 2007 and 2016.
Objectives: The purpose of this study was to compare age distribution and probability of elective surgery for proximal aortic aneurysm, any dissection surgery, and cardiovascular mortality among aortopathy etiologies.
Methods: The GenTAC study had a retrospective/prospective design.