Research

Aortopathy, Valvular Heart Disease

Master
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Theme Leaders

People
First Name
Ying
Middle Name
H
Last Name
Shen
Honorific Title
M.D., Ph.D.
Professor
First Name
Vijay
Last Name
Nambi
Honorific Title
M.D.
Associate Professor
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Theme Description

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Current clinical projects include participation in key registries, industry-sponsored randomized clinical trials, the Cardiothoracic Surgical Trials Network, and provide an opportunity for investigator-initiated studies to surgeon-scientists using the ATLAS (Applied Statistics and Machine Learning for the Advancement of Surgery) platform and proprietary Aortic Surgery Patient Database, which houses data from over 10,000 aortic interventions performed within the Division of Cardiothoracic Surgery. Notably, the landmark multicenter study focused on aortic valve outcomes in patients with Marfan syndrome has resulted in several publications and will continue through 2030. Using large publicly available data sets, ATLAS aims to apply advanced statistical theory to identify predictors of adverse events and best-practice parameters in cardiothoracic surgery. Ongoing study of clinical outcomes for a variety of aortic and valvular procedures captured in the Aortic Surgery Patient Database have resulted in several landmark publications elucidating complex surgical scenarios to better understand operative risk. Regarding ongoing sponsored clinical trials, participation ensures exposure to cutting-edge technology as new devices are developed to treat valvular and aortic disease.

The broad basic research focus primarily aims to understand the mechanisms underlying thoracic aortic aneurysms and dissections. The Aortic Disease Research Laboratory at Baylor College of Medicine uses an integrative approach for studying aortic aneurysms and dissections by employing techniques in genetic analysis, human tissue and biomarker analysis, cell and molecular biology techniques, and experiments using mouse models of aortic disease. The laboratory also houses the Thoracic Aortic Disease Tissue Bank, which includes blood and aortic tissue samples and corresponding phenotypic data from over 4,500 patients with aortic aneurysms or dissections. This unique resource enables our laboratory to study the genetic and molecular aspects of thoracic aortic disease in distinct disease subgroups.
 

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Current Clinical Projects

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  • Aortic Valve Operative Outcomes in Marfan Patients
  • The International Registry for Acute Aortic Dissection
  • Montalcino Aortic Consortium: Precision Medicine for Heritable Thoracic Aortic Disease
  • Distal Aortic Dissection after Proximal Repair of Acute Type A Aortic Dissection
  • What is a “Bovine Aortic Arch”? A Call for the Houston Arch Classification
  • ATLAS: Applied Statistics and Machine Learning for the Advancement of Surgery
  • Core Clinical Center of the Cardiothoracic Surgical Trials Network
  • Evaluation of the Thoraflex Hybrid Device for use in the Repair or Replacement of the Ascending Aorta, Aortic Arch and Descending Aorta in an Open Surgical Procedure.
  • Evaluation of the Gore® TAG® Thoracic Branch Endoprosthesis in the Treatment of DeBakey Type I/II Aortic Dissection
  • Evaluation of the Gore® TAG® Thoracic Branch Endoprosthesis in the Treatment of Lesions of the Aortic Arch and Descending Thoracic Aorta
  • Evaluation of the Gore® Excluder® Thoracoabdominal Branch Endoprosthesis in the Treatment of Thoracoabdominal and Pararenal Aortic Aneurysms
  • Transcatheter Mitral Valve Replacement with The Medtronic Intrepid TMVR System in Patients with Severe Symptomatic Mitral Regurgitation
  • Small Annuli Randomized to Evolut or Sapien Trial
  • Post Market Clinical Follow-Up Study in Patients Treated with The On-X Ascending Aortic Prosthesis
  • A Prospective, Single Arm, Multi-Center Clinical Investigation to Evaluate the Safety and Effectiveness of AMDS in the Treatment of Acute DeBakey Type I Dissection
  • Prospective Randomized Single Arm Multicenter Evaluation of the Durability of Aortic Bioprostheses/Valves with Resilia Tissue in Subjects under 65
     
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Current Basic Research Projects

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  • Inflammatory Cytosolic DNA Sensor Signaling and Pyroptotic SMC Death in Aortic Degeneration, Dissection, and Rupture
  • Cellular and Molecular Drivers of Acute Aortic Dissections
  • Role of RIP3-Laden Extracellular Vesicles in Thrombosis and Aortic Aneurysm
  • Endothelial Dysfunction in the Development of Aortic Degeneration, Dissection, and Rupture
  • Mitochondrial Damage Induced Programmed Cell Death in Sporadic Ascending Thoracic Aortic Aneurysm and Dissection
  • Prediction of Aortic Dissection and Rupture in Marfan Syndrome Using Nano-Radiomics
  • Does Ciprofloxacin Increase the Susceptibility to Aortic Aneurysm and Vessel Rupture in Vascular Ehlers-Danlos Syndrome?
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Current Funding Agencies

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  • Leducq Foundation
  • National Institutes of Health
  • The Marfan Foundation
  • American Heart Association
  • Industry sponsored research (Artivion, Abbott Laboratories, Cerus, CytoSorbents, Edwards Lifesciences, Medtronic, WL Gore, and Terumo Aortic) 
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Faculty

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  • Lauren Barron, M.D. – Surgery – Cardiothoracic Surgery; Complex aortic and valve surgery, especially aortic root replacement, alternative access transcatheter valve replacement (TAVR), patient optimization for surgery
  • Neal Barshes, M.D., M.P.H. – Surgery – Vascular Surgery & Endovascular Therapy; Peripheral vascular disease, diabetes mellitus
  • Jeffrey T. Bates, M.D. – Medicine – Cardiovascular Research; General Internal Medicine, Vascular Medicine, Hypertension
  • Jayer Chung, M.D. – Surgery – Vascular Surgery & Endovascular Therapy; Cardiovascular disease, especially acute limb ischemia, coronary artery disease, and peripheral vascular disease
  • Lorraine Cornwell, M.D. – Surgery – Cardiothoracic Surgery; TAVR, optimization of clinical outcomes of cardiothoracic surgery, especially minimally invasive procedures, off-pump CABG, valve repair, and VATS lobectomy
  • Joseph Coselli, M.D. – Surgery – Cardiothoracic Surgery; Complex aortic open surgical and endovascular repair, especially the aortic root, aortic arch, and thoracoabdominal aorta, clinical outcomes, Marfan syndrome 
  • Heather Dickerson, M.D. – Pediatrics – Cardiology and Cardiac Critical Care; Pediatric cardiac critical care, including ventricular assist devices and extracorporeal membrane oxygenation, pediatric cardiology with a focus in echocardiography and single ventricle cardiac lesions
  • Ravi Ghanta, M.D. – Surgery – Cardiothoracic Surgery; Aortic and valve surgery, ventricular remodeling in cardiac failure, CABG, tissue engineering, application of artificial intelligence and machine learning to clinical outcomes
  • Srikanth Koneru, M.D. – Medicine – Cardiology; Structural Interventional Imaging, Cardiac CT and MRI Imaging, Cardio-Oncology and Strain Imaging, General Cardiology, Valvular Heart Disease, Disease of Aorta, Echocardiographic guided AV Optimization, HOCM, Cardiomyopathy
  • Veronica Lenge De Rosen, M.D. – Radiology – Cardiothoracic Imaging; Imaging of coronary vasculature, imaging of ischemic and non-ischemic cardiomyopathy, imaging of lung and pleural malignancy, lung transplant, and interstitial lung disease 
  • Yanming Li, Ph.D. – Surgery – Cardiothoracic Surgery; Mechanisms for aortic aneurysm and dissection, advanced computational analysis
  • Joseph Mills, M.D. – Surgery – Vascular Surgery & Endovascular Therapy; Approaches to reduce diabetes-related lower extremity amputation
  • Tamer Mohamed, Ph.D. – Surgery – Cardiothoracic; Endogenous heart repaire and cardiac regeneration
  • Marc Moon, M.D. – Surgery – Cardiothoracic Surgery; Complex aortic and valve surgery, especially repair of the mitral valve and aortic repair during pregnancy, TAVR, CABG, arrythmia ablation 
  • Shaine Morris, M.D., M.P.H. – Pediatrics – Cardiology; Advanced imaging techniques for genetically triggered aortopathy
  • Vicente Orozco-Sevilla, M.D. – Surgery – Cardiothoracic Surgery; Complex aortic open surgical and endovascular repair, hybrid repair approaches, clinical outcomes
  • Wei Pan, M.D. – Aneshesiology – Cardiothoracic; Autologous blood transfusion during complex aortic repair, temperature management during hypothermic circulatory arrest, cerebrospinal fluid drainage
  • Todd Rosengart, M.D. – Surgery – Cardiothoracic Surgery; Cardiothoracic surgery, off-pump surgery, minimally invasive aortic, coronary and valvular surgery, mitral valve repair or replacement
  • Ying Shen, M.D. – Surgery – Cardiothoracic Surgery; Mechanisms for aortic aneurysm and dissection
  • Guilherme Vianna Silva, M.D. – Medicine – Cardiology; Transcatheter treatments for valvular disease
  • Addison Taylor, M.D., Ph.D. – Medicine – Hypertension; Hypertension, clinical pharmacology
     
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Illustration of a normal aorta root seen in a healthy individual (left) and a dilated aorta root causing aortic valve leakage in a patient with Marfan syndrome.
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Illustration of a normal aorta root seen in a healthy individual (left) and a dilated aorta root causing aortic valve leakage in a patient with Marfan syndrome.

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Illustration of an innovative valve-in-valve approach to address a late valvular complication in a patient with prior aortic root replacement using a porcine bioprosthetic root
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Illustration of an innovative valve-in-valve approach to address a late valvular complication in a patient with prior aortic root replacement using a porcine bioprosthetic root (left). In lieu of a repeat sternotomy to fix the degenerated aortic valve, transcatheter aortic valve replacement (TAVR) was performed endovascularly, placing the device within the older valve (right).