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keywords
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• Aortic Valve Disease
• Connective Tissue Disorders
• Aortic Aneurysm
• Aortic Dissection
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overview
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Mentored by the legendary aortic surgeon, Dr. E. Stanley Crawford, Dr. Coselli is today one of the world’s most experienced aortic surgeons and best known as the foremost expert in thoracoabdominal aortic aneurysm repair—he recently published a milestone paper describing results after 3309 such repairs. He has an extensive clinical database and encourages participation in clinical research by designing research projects based on specific interests within aortic surgery. With approval, access to de-identified data from the Aortic Surgery clinical database may be granted. Dr. Coselli routinely publishes on a wide variety of aortic topics, and several outstanding papers and presentations have been prepared by residents, fellows, and students. Key publications have influenced clinical practice trends by determining the best approaches towards preventing complications during aortic repair. Regarding thoracoabdominal aortic aneurysm repair, randomized clinical trials were conducted to establish the benefits of using cerebrospinal fluid drainage to protect the spinal cord (a technique now in widespread use in aortic repair) and renal perfusion as a protective measure against renal ischemia as well as performing retrospective analysis of left heart bypass as a protective measure against distal ischemia. Additionally, by routinely presenting informative academic lectures throughout the world, Dr. Coselli has disseminated the latest approach to surgical repairs of the aortic root (valve-sparing approaches, including those is patients with Marfan syndrome), aortic arch (Y-graft approaches, hybrid procedures), and thoracoabdominal aortic aneurysm repair (postoperative quality of life in patients with Marfan syndrome). Dr. Coselli continuously seeks out new treatment paradigms and participates in numerous investigator-initiated and industry-sponsored research projects conducted at Baylor College of Medicine and the Texas Heart Institute; studies include the use of transcatheter aortic valve replacement, rapid-deployment sutureless aortic valves, and a wide variety of stent-grafts.
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overview
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Dr. Coselli is an innovator and a leader in his field and he is highly experienced in complex aortic repair, such as repair performed in patients with connective tissue disorders (such as Marfan and Loeys-Dietz syndromes), as well as emergent repair performed in patients with conditions such as acute aortic dissection or aortic rupture. For example, many patients with Marfan syndrome and annuloaortic ectasia are suitable for valve-sparing aortic root replacement, which obviates the need for a life-long anticoagulation regimen.
Dr. Coselli has investigated methods to reduce postoperative mortality, paralysis, and stroke; his success in improving the process of aortic repair has resulted in better patient outcomes than those achieved in previous eras. Additionally, whenever feasible, Dr. Coselli has utilized endovascular technology to repair aortic aneurysms, because many limited aneurysms may be repaired by using thoracic stent-grafts. Encouraged by the results achieved in Europe, Dr. Coselli is currently participating in clinical trials involving the transcatheter implantation of aortic valve replacement (TAVR) devices. Dr. Coselli is especially attuned to the needs of international patients, and he routinely provides expert care to patients throughout the world. He has performed more than 7,000 surgical repairs of the aorta and nearly 3,000 open repairs of the thoracoabdominal aorta, for which he is the world’s most experienced surgeon.
The future of aortic surgery will undoubtedly be heavily influenced by advancements in multiple disciplines?genetics, cellular biology, biochemistry, engineering, and bioinformatics?as well as by innovations in imaging and in surgical and endovascular technology. Dr. Coselli continuously seeks out new treatment paradigms and has participated in numerous investigator-initiated and industry-sponsored research projects. Additionally, he has published several key papers describing the outcomes of clinical studies designed to determine the best approaches to preventing complications during aortic repair. These papers report the benefits of using cerebrospinal fluid drainage to protect the spinal cord (a technique now in widespread use in aortic repair), renal perfusion as a protective measure against renal ischemia, and left heart bypass as a protective measure against distal ischemia. Additionally, by routinely presenting informative academic lectures throughout the world, Dr. Coselli has disseminated the latest approach to surgical repairs of the aortic root (valve-sparing outcomes), aortic arch (Y-graft outcomes), and thoracoabdominal aorta (selecting adjuncts by extent of repair).
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