Donald M Botta

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BACKGROUND Optimal operative decision making in thoracic aortic aneurysms requires accurate information on the risk of complications during expectant management. Cumulative and yearly risks of rupture, dissection, and death before operative repair increase with increasing aortic size, but previous work has not addressed the impact of relative aortic size on(More)
BACKGROUND Patients with bicuspid aortic valve (BAV) are at risk for valvular disease and ascending aortic aneurysms and dissections. Although others have investigated the need for concomitant repair, the natural history of aortic disease has not been addressed. METHODS A review of our institutional clinical database identified 514 patients (326 male, 188(More)
BACKGROUND Although type A aortic dissections represent a surgical emergency, some patients present late after the onset of symptoms. Optimal management of this cohort has not been defined. METHODS Data on 195 patients with type A dissections followed up at a single institution between 1985 and 2005 were collected prospectively. Of these, 93 patients(More)
The authors reviewed all published series of type A iatrogenic aortic dissections and performed meta-analyses to investigate the management and outcomes of this complication. The majority of type A iatrogenic aortic dissections occurred during cardiac surgery, but the incidence of iatrogenic aortic dissection was considerably higher during thoracic(More)
Left ventricular assist device (LVAD) placement is a serious surgical procedure. At our center, we accumulated a very large experience with the Novacor LVAD from the very first clinical trial, as well as from more recent experiences with the Jarvik 2000 and the HeartMate II. This article discusses technical issues that are common to all durable LVAD(More)
In an era of increasingly common and detailed imaging of the thorax, thoracic aortic aneurysms are being discovered in their precomplicated state with increasing frequency. At the same time, the list of potential treatments for thoracic aneurysms is beginning to expand. Deciding which treatment method to employ and which aneurysm to treat is often(More)
OBJECTIVES To investigate the impact of hypovolaemic shock on the aortic diameter in a porcine model, and to determine the implications for the endovascular management of hypovolaemic patients with traumatic thoracic aortic injury (TTAI). MATERIALS AND METHODS The circulating blood volume of seven Yorkshire pigs was gradually lowered in 10% increments. At(More)
PURPOSE The purpose of this study is to identify the peripheral vascular complications associated with the use of percutaneous suture-mediated closure (PSMC) devices and compare them with postcatheterization femoral artery complications not associated with PSMC devices. METHODS This is a retrospective review of all patients admitted to the vascular(More)
Identification of biomarkers for thoracic aortic aneurysm (TAA) disease is important because complications of TAAs are common. Preemptive operative repair of TAAs is effective in improving survival. However, elective surgical repair for asymptomatic aneurysms remains a clinical decision that must be based on the patient's operative risk and the risk that a(More)