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Using transcriptomics really helps micro dissect the change of gene expression of the media of the vessel due to TGFBR1 mutation.

Great work from Dr Grubb and colleague

Great to have Sarah Chen, CT resident fro UC Davis visiting us for a week as the winner of TSRA/STS Traveling Fellowship in Cardiothoracic Surgery

Congratulations to our graduating aortic fellows, Alex Brescia, Ken Hassler and Farhang Yazdchi. You all have done a great job. The world is waiting for you!! Good luck to your new jobs. You all have bright future!! Save more patients!!

annalscts.com/issue/view/651 this is the link to the issue in May in ACS, papers, presentations, videos by experts in TAVR-SAVR trials, PPM, valve size, root anatomy, SVD, techniques of annular enlargement, pitfalls and updates, illustrations of Y-incision. It’s open to everyone

Explanted 23 sapient, enlarged the annulus from 19 to 25. The opening of old TAVR valve was < 1/3 of the new SAVR valve. coronary Ostia were above the SAVR valve. Aortic annular enlargement should be routine in SAVR like LIMA in CABG, especially in redo SAVR after SAVR or TAVR.

We enlarge the crown shape annulus and root liberally. All my fellows mastered this technique. But I don’t put size 29 in every pt. Some gets 25 or 27 which matches the native annulus of 19-21mm. When the LCA ostium is low, <5 mm, downsize from the largest size by 1 valve size.

I showed this case to leaders in cardiology. Their comments are this is good results. But most surgeons in the US would put a size 19 or 21 for this pt. Not sure that is better than TAVR.

The application for aortic fellowship at Michigan will open soon

Last case with our aortic fellow, Ken Hassler. Congratulations, Ken, a bright future is waiting for you!!

Wrapping up #OkitaAortic with a fantastic #Tokyo evening boat ride - amazing fun with unbelievable camaraderie from the #aortic greats. Thank you for the opportunity and privilege to be the #SoMe ambassador!

We made Arc modification of Y-AAE to avoid the tensing of the suture line of the patch to the aorta-mitral curtain (a bar below the valve). It maintains most aorta-mitral curtain, the flexibility of the aortic root, the shape of the basal ring. annalsthoracicsurgeryshortrep.org/article/S2772-…

Michigan Aortic Club at STS 2025! Very proud of our graduated fellows and current fellow

A podcast by EACTS on Y-incision aortic annular enlargement: Expanding Aortic Roots and Surgical Horizons eacts.org/publications/a…

Using a mitral composite valve graft with a sling to enlarge both mitral and aortic annuli by 3 valve sizes - JTCVS Techniques. Simpler and more effective than Commando. Does not obstruct the LVOT. Great potential for future TMVR and TAVR if needed. jtcvstechniques.org/article/S2666-…

This study emphasizes the importance of aortic annular/root enlargement during SAVR to implant size 27-29 valves to avoid PPM, PVL and slow down SVD (larger EOA at implantation). TAVR can’t enlarge the aortic annulus/root. Surgeons need to do more AAE in SAVR.

Y-incision AAE has been criticized not enlarging the basal ring/LVOT. Nor does Ross, Bentall, Ozaki procedure. All four techniques place a valve with large opening above the LVOT with great hemodynamics. Y-AAE is the simplest and prepare for TAVR. AV stenosis is not LVOT stenosis

Congrats to our graduated aortic fellow, Dr. Candis Jones. Great job and fantastic case log. A bright future is waiting for you!!