About

Alexander S. Fairman, MD, is an Assistant Professor of Surgery at the Hospital of the University of Pennsylvania. He is an active surgeon at Penn Presbyterian Medical Center, Pennsylvania Hospital, and the Children’s Hospital of Philadelphia, where he also serves as the Director of Pediatric Vascular Surgery and Endovascular Therapy. Additionally, he is the Vascular Surgery Director at the Armellino Center of Excellence for Williams Syndrome and the Pediatric Aortic Director at the Aortic Center at the Hospital of the University of Pennsylvania. Dr. Fairman specializes in pediatric vascular surgery, trauma management, and endovascular therapies, with a focus on complex vascular conditions in pediatric patients. His work includes managing pediatric traumatic lower extremity vascular injuries, pediatric iliac artery aneurysm repair, and renal artery transplantation in children. He has contributed to the field through numerous case reports and research articles, emphasizing innovative approaches to vascular and pediatric surgical care.

Research topics

• Surgery
• Medicine
• Anesthesia
• Radiology
• Internal medicine

Selected publications

• Cutting Balloon Angioplasty for Resistant Pediatric Renal Artery Stenosis: A Single Institutional Experience

  Journal of Vascular and Interventional Radiology · 2026-01-28

  article
  PublisherDOI

• Long Term Outcomes of Zone 2 Thoracic Endovascular Aortic Repair with Branched Endoprosthesis or Carotid–Subclavian Bypass: A Propensity Matched Study

  European Journal of Vascular and Endovascular Surgery · 2026-03-01

  article
  PublisherDOI

• Management of pediatric traumatic lower extremity vascular injuries

  Journal of Vascular Surgery · 2025-04-28 · 3 citations

  review1st authorCorresponding
  PublisherDOI

• Treatment of persistent sciatic artery with limb length discrepancy

  Annals of Vascular Surgery - Brief Reports and Innovations · 2025-05-16

  articleOpen accessSenior author

  This case report describes the treatment of a five-year-old male with a persistent sciatic artery and significant limb-length discrepancy due to chronic ischemia. The patient presented with asymptomatic hypertension and was found to have left renal artery stenosis, and a Pillet-Gauffre Type 2a incomplete persistent sciatic artery. Surgical intervention involved an iliac-femoral bypass using a cadaveric superficial femoral artery to restore normal blood flow. Post-operative care included anticoagulation and aspirin therapy, with follow-up ultrasounds confirming patency. The report highlights the rarity of a persistent sciatic artery, its classification, and the importance of surgical management in pediatric cases to mitigate long-term morbidity associated with limb length discrepancy. Further research is needed on long-term outcomes of cadaveric arterial reconstructions in children.

  PublisherDOI

• Pediatric idiopathic iliac artery aneurysm repair with limited conduit options

  Vascular · 2025-09-11

  articleOpen accessSenior author

  ObjectivesPediatric arterial aneurysms are very uncommon. Those without an underlying identifiable etiology such as infection or autoimmune disease are even rarer. In young children, options for repair are limited. We report the case of a pediatric common iliac artery aneurysm that was surgically repaired.MethodsA 27-month-old male presenting for an evaluation of persistent hypertension underwent an abdominal CT scan and was incidentally found to have a large right common iliac artery aneurysm along with a thrombosed, proximal right internal iliac artery aneurysm. Given the size, the aneurysm was repaired with a bypass constructed from cryopreserved femoral artery allograft.ResultsThe procedure was uncomplicated, with continued patency of the graft determined via ultrasound at 7 months.ConclusionA pediatric iliac artery aneurysm was successfully repaired with a cadaveric femoral artery graft in the setting of limited conduit options.

  PublisherOA PDFDOI

• Kidney auto-transplantation in a 7-year-old with complex renal artery anatomy and multi-drug-resistant hypertension: a case report

  Journal of Pediatric Surgery Case Reports · 2025-12-17

  articleOpen accessSenior author
  PublisherDOI

• Ice Water Drowning Survival After 147-Minute Submersion and 7 °C Hypothermic Circulatory Arrest

  JACC Case Reports · 2025-08-01 · 2 citations

  articleOpen access

  BACKGROUND: Young patients may survive accidental deep hypothermia with prolonged asystolic circulatory arrest because of protective effects of cold. CASE SUMMARY: An 8-year-old boy fell through pond ice and was submerged for ≥147 minutes. Nadir peripheral body temperature was 7 °C (45 °F). After rewarming with extracorporeal membrane oxygenation, prolonged hospitalization, and neurorehabilitation, the child recovered. DISCUSSION: This is the longest submersion time and nadir body temperature survived in medical literature. Findings inform and extend time and temperature limits from which human life may be rescued from asystolic hypothermia. This case raises clinical, scientific, and ethical considerations for drowning rescue, organ preservation, and neurologic recovery after prolonged total body ischemia. TAKE-HOME MESSAGES: Resuscitation and extracorporeal rewarming to save a child may be considered for upward of 2.5 hours of asystolic hypothermia with temperature as low as 7 °C (45 °F). If neurologic recovery is not observed, end-organ preservation on extracorporeal membrane oxygenation may bridge to pediatric organ donation.

  PublisherDOI

• Anatomic predictors of distal landing zone failure after endovascular repair of thoracic aortic aneurysm

  European Journal of Cardio-Thoracic Surgery · 2025-07-01 · 1 citations

  article

  OBJECTIVES: To analyse anatomic factors of the distal landing zone (dLZ) associated with the durability of endovascular repair of thoracic aortic aneurysm (TAA). METHODS: Consecutive patients undergoing thoracic endovascular aortic repair (TEVAR) for undissected TAA were queried from a single centre from 2004 to 2022. Patient and operative factors were considered as well as detailed anatomic factors at the dLZ assessed by 3D reconstruction of pre-TEVAR imaging. The outcome of interest was the long-term risk of TEVAR failure at the dLZ. RESULTS: A total of 101 patients undergoing TEVAR repair of TAA were considered, of whom 17 suffered distal TEVAR failure over a median follow-up period of 2.7 years. Two anatomic factors showed outsized influence on long-term outcomes: dLZ diameter and dLZ length (the length of non-dilated aortic tissue above the coeliac artery). Patients who progressed to distal TEVAR failure had larger dLZ diameter (34.2 mm vs 30.7 mm, P = 0.034) and far shorter dLZ length (3.8 cm vs 7.5 cm, P = 0.008). Patients with dLZ diameter greater than 35 mm had much greater risk of mortality or distal TEVAR failure within 2 years (34% vs 5%, P = 0.012), as did those with dLZ length less than 4 cm (27% vs 6%, P = 0.006). CONCLUSIONS: In this study, mild dilation at the dLZ beyond 35 mm and short length at the dLZ less than 4 cm are both clear anatomic risk factors for poor long-term outcome after supraceliac TEVAR. It may be appropriate to consider repair via branched endografts landing beyond the coeliac artery in patients with these risk factors.

  PublisherDOI

• 154: Changes in Cerebral and Peripheral Oxygenation and Blood Flow Following VA to VAV ECMO Conversion in the Setting of Pediatric Differential Hypoxemia

  ASAIO Journal · 2025-09-01

  articleSenior author

  Introduction: We present a case study of a pediatric patient who developed differential hypoxemia after Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation via the right femoral artery and right femoral vein, monitored by right upper extremity arterial blood gases. The patient was converted to Veno-arterial-venous (VAV) ECMO with an additional return cannula via the right internal jugular vein. Post conversion, the patient was monitored by frequency domain diffuse optic spectroscopy (FD-DOS) and diffuse correlation spectroscopy (DCS) to assess cerebral and peripheral hemodynamic and metabolism changes. Aim: Characterize changes in cerebral and peripheral oxygenation and blood flow after VAV conversion in the setting of differential hypoxemia. Method: The subject was monitored for an eight-hour window post conversion using two optical sensors placed on the forehead and right/left thigh. FD-DOS monitored specific tissue optical properties and physiologic parameters including tissue oxygen saturation (StO2, %), while DCS monitored blood flow index (BFI). Results: Monitoring revealed increases over the eight-hour period in blood flow (cerebral, +109%; peripheral, +298%) and oxygenation (cerebral, +5%; peripheral +16%) correlating with increased mean arterial pressure from 59 to 67mmHg (+12%). ECMO flow remained stable through the additional venous cannula (+0.5%) with a small increase through the arterial cannula (+6%). Peripheral oxygen saturation (96-99%) remained stable, while partial pressure of oxygen decreased (-8%) and partial pressure of carbon dioxide increased (30%). Conclusion: This preliminary study utilized FD-DOS/DCS to provide new insights into cerebral and peripheral hemodynamic and metabolism changes, not reflected in routine bedside monitoring tools.

  PublisherDOI

• Complex pediatric neoplasms: The role of congenital cardiothoracic surgery

  JTCVS Techniques · 2025-02-08

  articleOpen access

  Background: Surgery for pediatric solid neoplasms is often complicated by local tumor invasion. Cardiac surgeons can provide expertise in the chest and facilitate potentially aggressive management of tumors invading vasculature, pericardiac, or diaphragmatic spaces. Here we present 4 complex cases. Methods: This descriptive retrospective chart review study included 4 surgical patients with locally invasive solid tumors. Results: Case 1: 16 × 15.5 × 11 cm right chest synovial sarcoma in a male patient status post-neoadjuvant chemoradiation. Imaging revealed invasion of the right-sided subclavian vein, subclavian artery, phrenic nerve, and vagus nerve. The surgical approach via hemi-clamshell allowed for R0 resection. Case 2: Resection of a 17.6 × 10.5 × 8.1 cm sclerosing epithelioid fibrosarcoma originating from the vertebral body but causing aortic arch, right and left pulmonary artery, tracheal, and esophageal displacement. The surgeons preserved nearly all thoracic anatomy despite extensive periaortic and posterior mediastinal dissection. Case 3: Synchronous removal of a 11.5 × 9 × 5.5 cm pleuropulmonary blastoma at the time of tetralogy of Fallot repair. Case 4: Resection of a 12 × 0.5 × 0.3 cm nonviable Wilms tumor traversing from the right renal vein to the level of the Eustachian valve. All patients were extubated in the operating room and had an uneventful hospital course, with length of stay ranging from 5 to 10 days. Conclusions: Pediatric patients may present with locally advanced heterogenous neoplasms. The added anatomic familiarity with the mediastinum, thoracic hilum, and great vessels in particular ensured safe resection in all cases. Thus, cardiothoracic surgery consultation is valuable when managing complex thoracic oncologic tumor resection.

  PublisherOA PDFDOI

Frequent coauthors

• John W. MacArthur

  36 shared

• Jeffrey Е. Cohen

  Fordham University

  31 shared

• Pavan Atluri

  University of Pennsylvania

  30 shared

• Yasuhiro Shudo

  Stanford University

  28 shared

• Y. Joseph Woo

  Stanford University

  26 shared

• Alen Trubelja

  Rice University

  24 shared

• Jay Patel

  MedStar Washington Hospital Center

  22 shared

• Bryan B. Edwards

  Stanford University

  19 shared

Labs

• Vascular Surgery at the Hospital of the University of PennsylvaniaPI

Education

• B.A.

  University of Pennsylvania

  2009

• M.D.

  Perelman School of Medicine, University of Pennsylvania

  2017

• Other

  Georgetown University

  2007