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Duke Center for Aortic Disease Research Program

Photo of George Charles Hughes IV, MD

George Charles Hughes IV, MD

Office: 3580 White Zone, Duke South, Durham, NC 27710
Campus Mail: Box 3051 Med Ctr, Durham, NC 27710
Phone: 919-668-0903

Scientific Focus


Objective: To further our understanding of the pathophysiology of aortic diseases, develop better surgical and non-surgical treatments, and improve short- and long-term outcomes after thoracic aortic surgery.

Key Projects

Treatment and Outcomes of Acute and Chronic Aortic Dissection

  • Risk factors for Type A dissection
  • Decision analysis in Type A dissection
  • Outcomes of acute Type A dissection repair
  • Management of acute and chronic Type B dissection
  • Understanding aortic remodeling in Type B dissection

Improving Outcomes after Proximal Aortic Surgery

  • Frailty and risk in proximal aortic surgery
  • Preoperative cardiac catheterization and acute kidney injury
  • Deep and moderate hypothermia in aortic arch surgery
  • Antegrade vs. retrograde cerebral perfusion
  • Predictors and management of intraoperative bleeding
  • Predictors of prolonged mechanical ventilation
  • Contemporary results for proximal aortic replacement
  • Circulatory arrest at advanced age

Improving Outcomes after Thoracic Endovascular Aortic Repair (TEVAR)

  • Endovascular repair of descending thoracic aortic aneurysm
  • The role of coronary evaluation before TEVAR
  • Selective preoperative lumbar drain placement for TEVAR
  • Selective left subclavian artery revascularization for TEVAR
  • Intrathoracic subclavian artery aneurysm repair
  • Complications of TEVAR
  • Risk factors for mortality after TEVAR
  • Results of TEVAR six years after FDA approval
  • Mid-term results with TEVAR for chronic Type B aortic dissection

Developing and Advancing Transcatheter Aortic Valve Replacement (TAVR)

  • Transcatheter aortic valve replacement with a self-expanding prosthesis
  • Comparison of short- and mid-term results of Balloon-expandable vs. Self-expanding TAVR
  • Learning curve for TAVR

Understanding the Impact of Socioeconomic Factors on Outcomes after Thoracic Aortic Surgery

  • Insurance status and outcomes of proximal aortic surgery

Management of Bicuspid Aortic Valve (BAV) Disease and Other Genetic Syndromes

  • Individualized thoracic aortic replacement for BAV
  • Total aortic replacement in Loeys-Dietz Syndrome

Understanding the Genetic Basis Underlying Thoracic Aortic Aneurysms (TAA)

  • Plasma biomarkers for distinguishing subtypes of TAA
  • Genomic and metabolomic profiling of TAA


  • Nicholas Andersen - Duke General Surgery Resident Research Award, 2nd Place Winner (2013)
  • Nicholas Andersen - Duke General Surgery Resident Research Award, 1st Place Winner (2014)
  • Brian R. Englum - Finalist AATS C. Walton Lillehei Resident Forum  (2014)
  • Asvin Ganapathi – NIH loan repayment program (2012-2014)
  • Asad Shah - American Thoracic Society International Conference Travel Award (2011)
  • Judson Williams - Samson Resident Finalist, Paul C. Samson Resident Manuscript Competition at the 37th Annual Meeting of the Western Thoracic Surgical Association (2011)
  • Judson Williams - First Place, Podium Presentation at SC-NC American College of Surgeons Annual Meeting, Scientific Session Competition (2010)

Latest Publications

Lam, Ka Yan, Michael J. Reardon, Steven J. Yakubov, Thomas Modine, Stephen Fremes, Pim A. L. Tonino, M Erwin Tan, et al. “Surgical Sutureless and Sutured Aortic Valve Replacement in Low-risk Patients.” Ann Thorac Surg 113, no. 2 (February 2022): 616–22.

Full Text

Meza, James M., Joseph R. Nellis, J Scott Rankin, Ryan M. Wolsky, Vinay Badhwar, G Chad Hughes, and Joseph W. Turek. “Complex Repair of a Completely Fused Nullicuspid Aortic Valve Late in Adolescence.” World J Pediatr Congenit Heart Surg 12, no. 6 (November 2021): 790–93.

Full Text

Vekstein, Andrew M., E Hope Weissler, Julie W. Doberne, Adam Williams, Ryan P. Plichta, Jeffrey G. Gaca, Chandler A. Long, and G Chad Hughes. “10-Year Outcomes After Endovascular Repair of Acute Complicated and High-Risk Type B Aortic Dissection.” In Journal of Vascular Surgery, 74:E232–33, 2021.


Armstrong, Jenna L., Andrew M. Vekstein, Joseph Nellis, Chandler A. Long, J Kevin Harrison, Richard A. Krasuski, and G Chad Hughes. “Algorithmic Approach to Treatment of Aortic Coarctation in Adults.” In Journal of Vascular Surgery, 74:E115–16, 2021.