Aravind Krishnan

• Doctor of Medicine
• Medical Doctor at Stanford University

Importance The use of ex vivo normothermic organ perfusion has enabled the use of deceased after circulatory death (DCD) donors for heart transplants. However, compared with conventional brain death donation, DCD heart transplantation performed with ex vivo organ perfusion involves an additional period of warm and cold ischemia, exposing the allogr...

Heart transplantation utilizing deceased after circulatory death (DCD) donors has expanded the donor pool through the use of ex vivo normothermic perfusion. Compared with brain death donation, the conventional method of performing DCD heart transplantation includes an additional period of warm and cold ischemia. We have developed a beating heart im...

Background: Severe Coronavirus Disease 2019 (COVID-19) infection is associated with prolonged intubation and its complications. Tracheal stenosis is one such complication that may require specialized surgical management. We aimed to describe the surgical management of post-COVID-19 tracheal stenosis. Methods: This case series describes consecuti...

Background Lung transplantation is the definitive treatment for end-stage lung failure. However, there have been no large, long-term studies on the impact of acute in-hospital stroke in this population. Research Question What are the trends, risk factors, and outcomes of acute stroke in patients undergoing lung transplantation in the United States?...

Background: Contemporary series of aortic arch replacement at the time of aortic root surgery are limited in number of patients and mostly address hemiarch replacement. We describe outcomes after aortic root and concomitant arch replacement, including total arch replacement. Methods: This single-institution retrospective review studied 1196 cons...

Limited aortic root repair for acute type A dissection is associated with greater risk of proximal reoperations compared to full aortic root replacement. Surgical outcomes for patients undergoing reoperative root replacement after previous dissection repair are unknown. This study seeks to determine outcomes for these patients to further inform the...

Objective To evaluate the effect of perioperative allogeneic packed red blood cell (RBC) transfusion during aortic root replacement. Method We reviewed patients undergoing aortic root replacement at our institution between March 2014 to April 2020. 760 patients underwent aortic root replacement, of which 442 (58%) received a perioperative RBC tran...

Background : Pulmonary antibody-mediated rejection (AMR) consensus criteria categorize AMR by diagnostic certainty. This study aims to define the clinical features and associated outcomes of these recently defined AMR categories. Methods : Adjudication committees reviewed clinical data of 335 lung transplant recipients to define clinical or subcli...

Introduction The National Institutes of Health (NIH) recently developed the relative citation ratio (RCR), calculated as article citations benchmarked to NIH-funded publications in the same field. Here, we characterized the scholarly impact of academic cardiothoracic (CT) surgeons and their research using the RCR. Materials and methods Using a dat...

Ischemic heart disease is the leading cause of death around the world, and though the advent of coronary revascularization has revolutionized its treatment, many patients who sustain ischemic injury to the heart will go on to develop heart failure. Biofabrication of ventricular myocardium for replacement of irreversibly damaged ischemic myocardium...

Objectives Cardiothoracic (CT) surgeons with National Institutes of Health (NIH) R01 funding face a highly competitive renewal process. The factors that contribute to successful grant renewal for CT surgeons remain poorly defined. We hypothesized that renewed basic science grants are associated with high research output and scholarly impact during...

Background There is increasing concern regarding the attrition of surgeon-scientists in cardiothoracic (CT) surgery. However, the characteristics of CT surgeons who are actively leading basic science research (BSR) have not been examined. We hypothesized that early exposure to BSR during training and active grant funding are important factors that...

Background The purpose of this study was to evaluate outcomes in people with cystic fibrosis (CF) who underwent lung transplant (LT) at a transplant center with an accredited Cystic Fibrosis Care Center (CFCC) in the United States. Methods We reviewed the Scientific Registry of Transplant Recipients for all adult patients with CF who received a fi...

Background The donor shortage poses a major limitation to use of heart transplantation. Novel strategies such as use of expanded-criteria donors with prolonged ischemia times are being employed to address this need. Recent developments in static hypothermia have allowed for the safe use of cardiac allografts with prolonged ischemic times. Case Rep...

Background: Surgeons are traditionally categorized as working either in academic or private/community practice, but some transition between the two environments. Here, we profile current academic cardiothoracic surgeons who began their attending careers in private or community practice. We hypothesized that research activity may distinguish cardio...

As the world responds to the global crisis of the COVID-19 pandemic an increasing number of patients are experiencing increased morbidity as a result of multi-organ involvement. Of these, a small proportion will progress to end-stage lung disease, become dialysis dependent, or both. Herein, we describe the first reported case of a successful combin...

Introduction Improvement in preservation and transportation conditions has the potential to enhance organ quality at the time of transplant, optimize patient outcomes, and prolong the acceptable maximum allograft ischemic time. Herein, we describe our initial successful experience with the static hypothermic preservation system (Paragonix) for a do...

Introduction Validated scoring tools, such as the Nutritional Risk Index (NRI), can aid clinicians in quantifying the degree of malnourishment in patients prior to an operation. We evaluated the association between NRI and outcomes after heart transplantation. Methods The United Network for Organ Sharing (UNOS) database was used to identify adult...

Background Lung volume reduction surgery (LVRS) is treatment for chronic obstructive pulmonary disease (COPD), the second most common indication for lung transplantation (LTx) in the US. LVRS prior to LTx is controversial. Single institution studies report contradicting results, and the impact of undergoing LVRS prior to LTx on outcomes after LTx i...

Introduction: There is growing concern regarding the attrition of surgeon-scientists in cardiothoracic (CT) surgery. The academic impact of conducting basic science research (BSR) during training, however, remains unknown. We hypothesized that CT surgeons who publish a first-author BSR paper during training exhibit enhanced future academic producti...

Background Malnourishment is associated with poor outcomes following Lung Transplant (LTx). Validated screening tools for patients awaiting lung transplants are needed. We assessed the association of Nutritional Risk Index (NRI) with outcomes following LTx. Methods We categorized adult patients (age>18) undergoing incident LTx in the Scientific Re...

Purpose We aimed to assess the prognostic value of Neutrophil to Lymphocyte Ratio (NLR) on long-term outcomes and graft dysfunction after lung transplantation. Methods We retrospectively reviewed all patients receiving a lung transplant at our institution from 2011 to 2014. The primary exposure was elevated NLR at the time of transplant, defined b...

Objective: Lung ischemia-reperfusion injury (IRI) is a common complication after lung transplantation, and immune cells have been implicated in modulating outcomes. We hypothesized that a newly described subset of αβ T-cell receptor positive cells; that is, CD4-CD8- (double negative [DN]) T cells, are found in lungs and can protect against lung IR...

Background: The sympathetic nervous system plays an important role in arrhythmogenesis in arrhythmogenic right ventricular cardiomyopathy (ARVC). Sudden cardiac death commonly occurs during exertion, and β-blockers are associated with a reduction in arrhythmia burden. Bilateral cardiac sympathetic denervation (BCSD) has been shown to reduce implan...

Importance Mohs micrographic surgery (MMS) is a skin cancer treatment that uses staged excisions based on margin status. Wide surgeon-level variation exists in the mean number of staged resections used to treat a tumor, resulting in a cost disparity and question of appropriateness. Objective To evaluate the effectiveness of a behavioral interventi...

Objectives: Management of acute aortic intramural hematomas (IMHs) involving the ascending aorta and root remains controversial. Some series have suggested that delaying operative intervention beyond the first 24-hours may be beneficial. Methods: A retrospective single-institution analysis was performed to identify patients presenting with type...

Introduction: Frailty is an important component of risk prognostication in transcatheter aortic valve replacement (TAVR). Objective markers of frailty, including sarcopenia, the modified Frailty Index (mFI), and albumin levels, have emerged, but little is known how such markers compare to each other in predicting outcomes after TAVR. We sought to...

Background: Sarcopenia, a known component of frailty, defined by diminished cross-sectional area of the psoas muscles, is associated with poor outcomes after a range of surgical procedures. However, little is known of the relationship between sarcopenia of the psoas muscles (SPM) and long-term survival, decline in pulmonary function, and graft fai...

3D and 4D bioprinting of the heart are exciting notions in the modern era. However, myocardial bioprinting has proven to be challenging. This review outlines the methods, materials, cell types, issues, challenges and future prospects in myocardial bioprinting. Advances in 3D bioprinting technology have significantly improved the manufacturing proce...

Objective New platforms for patient imaging present opportunities for improved surgical planning in complex congenital heart disease (CHD). Virtual reality (VR) allows for interactive manipulation of high-resolution representations of patient-specific imaging data, as a supplement to traditional 2D visualizations and 3D printed heart models. Desi...

We describe the novel use of bilateral cardiac sympathectomy in a woman with end-stage heart failure caused by ventricular tachycardia refractory to standard medical therapy who was under consideration for heart transplantation. Postoperatively, our patient has not experienced any symptoms of ventricular tachycardia, has returned to normal physical...

Importance: Outlier physician practices in health care can represent a significant burden to patients and the health system. Objective: To study outlier physician practices in Mohs micrographic surgery (MMS) and the associated factors. Design, setting, and participants: This retrospective analysis of publicly available Medicare Part B claims d...

More approaches to support weight control are needed, especially among racial minorities who shoulder a disproportionate obesity burden. Using an approach influenced by regulatory fit theory, we conducted a 28-day, 4-arm experimental trial with 89 obese adults recruited from urban, predominantly African American churches to ascertain the efficacy o...

Background: Although bariatric surgery is a safe and effective treatment for morbid obesity, long-term reoperation remains a significant source of morbidity and mortality for the patient. Methods: We performed a retrospective analysis of all patients undergoing laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) surgeries...