Professor and Cullen Foundation Endowed Chair | Chief, Division of Cardiothoracic Surgery and Vice-Chair of Surgery | Michael E. DeBakey Department of Surgery, Baylor College of Medicine
Chief, Adult Cardiac Surgery | Texas Heart Institute
Chief, Adult Cardiac Surgery Section | Associate Chief, Cardiovascular Service | Baylor St. Luke’s Medical Center
Dr. Joseph Coselli is professor of surgery and chief of cardiothoracic surgery. He has dedicated his career to optimizing the care of patients with aortic life-threatening thoracoabdominal aortic aneurisms, or TAAAs, focusing on reducing the risk of neurological and renal complications following TAAA repair. Through his study published in the Annals of Thoracic Surgery, he was able to demonstrate the value of using left heart bypass to reduce the problem of inadequate organ blood supply. In another study reported in the Journal of Vascular Surgery, he showed that cerebrospinal fluid drainage reduces the risk of spinal cord injury. In a report appearing in the Journal of Vascular Surgery, he addressed the problem of renal complications on a subsequent study demonstrating that providing cold crystalloid perfusion to the kidneys reduces the risk of renal problems. Dr. Coselli’s studies have made TAAA surgery safer. Patient outcomes have significantly improved and the practice of aortic surgery has changed. His multimodal approach to organ protection is now used in many major aortic centers around the world. In 2016, he published in the Journal of Thoracic and Cardiovascular Surgery the results of his 30 years of experience performing open TAAA repairs, presenting the largest series of patients treated for TAAAs ever reported.
Dr. Coselli’s nomination was based on the following publication(s):
Coselli JS, LeMaire SA, Preventza O, de la Cruz KI, Cooley DA, Price MD, Stolz AP, Green SY, Arredondo CN, Rosengart TK. Outcomes of 3309 thoracoabdominal aortic aneurysm repairs. J Thorac Cardiovasc Surg. 2016 May;151(5):1323-37. doi: 10.1016/j.jtcvs.2015.12.050. Epub 2016 Jan 14. PubMed PMID: 26898979.
Thoracoabdominal aortic aneurysm surgery: quest for organ protection and survival
Dr. Coselli received the award for his work in developing measures to reduce morbidity and mortality in thoracoabdominal aortic aneurysm. Dr. Coselli's research has focused upon the challenges encountered in the surgical treatment of patients suffering from aortic aneurysms, aortic dissection and Marfan syndrome. He has a particular interest in patients with extensive aneurysms involving both the chest and abdomen; i.e., thoracoabdominal aortic aneurysms. He has investigated the techniques to reduce the risks of surgical treatment of such aneurysms for both mortality and morbidity. The primary morbidities following such procedures include loss of function of the spinal cord and kidneys. In addition to curative operative intervention, organ protection and preservation are the focus of Dr. Coselli's research. To reduce spinal cord injury and its consequent development of paraplegia or paraparesis, perfusion beyond the location of repair using left heart bypass has been evaluated in a large series of patients. Cerebrospinal fluid drainage validated its favorable impact upon decreasing the incidence of paraplegia/paraparesis during a prospective randomized trial. Similarly, regarding preservation of kidney function, again using a prospective randomized evaluation, cold crystalloid perfusion reducing the kidney temperature was demonstrated to be superior to normothermic blood perfusion. Focusing upon mortality and major morbidity following thoracoabdominal aortic aneurysm repairs, Dr. Coselli has prospectively evaluated his large contemporary series to identify specific risk factors and develop predictive models for adverse outcomes. The latter serve as valuable tools for surgeons and patients deliberating operative intervention.
Dr. Coselli’s nomination was based on the following publications:
Coselli JS, LeMaire SA. Left heart bypass reduces paraplegia rates after thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 1999 Jun;67(6):1931-4; discussion 1953-8.
Coselli JS, LeMaire SA, Miller CC 3rd, Schmittling ZC, Koksoy C, Pagan J, Curling PE. Mortality and paraplegia after thoracoabdominal aortic aneurysm repair: a risk factor analysis. Ann Thorac Surg. 2000 Feb;69(2):409-14.
LeMaire SA, Miller CC 3rd, Conklin LD, Schmittling ZC, Koksoy C, Coselli JS. A new predictive model for adverse outcomes after elective thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2001 Apr;71(4):1233-8.