About

Pamela C Hess, OTD, OTR, DipACLM, PMH-C, CEAS II, is a professional associated with UF Health. Her credentials include a Doctor of Occupational Therapy, certification as an Occupational Therapist, and additional certifications in lifestyle medicine, mental health, and advanced ergonomics. Her professional focus encompasses occupational therapy with an emphasis on mental health, lifestyle medicine, and ergonomics, contributing to the interdisciplinary healthcare efforts at UF Health. Her background reflects a comprehensive expertise in occupational therapy, with a particular interest in mental health and lifestyle medicine, supporting her role in advancing patient care and education within her field. As a member of the UF Health community, she is involved in teaching, research, and clinical practice, contributing to the development of innovative approaches in her areas of specialization.

Research topics

• Surgery
• Intensive care medicine
• Emergency medicine
• Medicine
• Internal medicine

Selected publications

• Expanding Candidacy for Gore Thoracic Branch Endoprosthesis With Left Subclavian-Carotid Bypass and Common Carotid Ligation

  Journal of Vascular Surgery · 2026-04-15

  article
  PublisherDOI

• Comparative outcomes of first-time versus redo aortic root replacement in patients with prior sternotomy: A single-center retrospective analysis

  JTCVS Techniques · 2025-10-15

  articleOpen access

  Background: Aortic root replacement (ARR) is a challenging procedure that requires aortic root implantation, coronary reimplantation, and concomitant aortic and valve surgery. Prior sternotomy (PS) increases case complexity for patients requiring ARR. We aimed to compare outcomes in PS patients undergoing primary ARR and patients undergoing true redo ARR. Methods: value < .05 considered significant. Results: = .82). Conclusions: ARR in PS patients can be performed safely with good short- and long-term outcomes. Despite the challenges associated with reoperative aortic root surgery, there was no increase in adverse outcomes for primary ARR compared with true redo ARR.

  PublisherDOI

• Biomarkers to predict the outcomes of surgical intervention for aortic dissection

  Journal of Cardiothoracic Surgery · 2025-02-05 · 11 citations

  reviewOpen accessSenior author

  PURPOSE: Aortic dissections and repairs are associated with high rates of mortality. The aim of this review is to summarize the literature concerning the prognostic ability of various preoperative biomarkers for patients undergoing surgical repair of the thoracic and abdominal aorta to elucidate whether these biomarkers could improve the selection of surgical candidates. METHODS: Relevant biomarkers were selected if they had predictive value in inflammatory disease processes and/or cardiovascular disease. Full-text articles available in English on PubMed that related these biomarkers to the prognosis of aortic repair following aortic dissection were examined. RESULTS: For patients who underwent repair for type A dissection, a preoperative elevated SII was associated with inferior 30-day survival (hazard ratio: 3.532, 95% confidence interval: 1.719-7.255, p = 0.001) and increased rates of adverse cardiovascular events. Elevated preoperative IL-6 and D-dimer levels were independently associated with single-organ dysfunction, multiorgan dysfunction, and death. The use of a combination of markers was a stronger predictor. The areas under the curve (AUCs) for the specified IL-6 and D-dimer cutoff values were 0.901 and 0.817, respectively, whereas the AUC reached 0.936 when IL-6 was combined with D-dimer. For patients who underwent thoracic endovascular aortic repair (TEVAR) for type B dissection, an elevated postoperative systemic immune-inflammation index (SII) was an independent risk factor for aorta-related complications, graft failure, and significantly inferior freedom from aortic-related mortality. A combination of elevated preoperative and postoperative SII values was again predictive of in-hospital adverse outcomes and follow-up complications, including endoleaks, branch artery stenosis, distal aortic expansion, aortic rupture, and death (p = 0.0016). An elevated preoperative neutrophil‒leukocyte ratio (NLR) is associated with an increased incidence of early postoperative adverse events and poor survival. CONCLUSIONS: Inflammatory markers seem to have predictive ability for postoperative outcomes after aortic repair in type A dissections. Further studies should compare these biomarkers to determine the best predictive marker for individual disease states and surgeries.

  PublisherOA PDFDOI

• Open repair of chronic type B aortic dissection

  Journal of Visualized Surgery · 2021-06-16

  articleOpen access

  Open repair of descending thoracic and thoracoabdominal aortic aneurysms in the setting of chronic aortic dissection is a complex procedure that requires a thorough understanding of the physiology of aortic dissection and cardiopulmonary bypass, efficient reperfusion of vital organs and meticulous surgical technique. Open surgery on the descending thoracic or thoracoabdominal aorta is high risk and has been associated with significant morbidity and mortality. Alternatively, endovascular repair of chronic distal aortic dissection using the currently available thoracic endovascular devices is less invasive and can have low mortality. However, reintervention is quite common, the durability of the repair is questionable and aortic remodeling is uncommon in the abdominal aorta. Endovascular repair is not likely to be durable in the young patient with a genetically triggered or familial aortopathy. For these reasons, we believe that open repair of chronic distal aortic dissection is the definitive and durable solution in the appropriately selected patient. We have a greater than 20-year experience using deep hypothermia and circulatory arrest for repair of complex thoracic and thoracoabdominal aortic aneurysms. Morbidity and mortality in our hands using this perfusion technique in chronic distal aortic dissection is comparable to endovascular procedures with rates of mortality 3.6%, permanent neurological deficit 2.6%, permanent requirement for hemodialysis 0% and cerebrovascular accident 1%. The following article describes, in detail, the intraoperative technique and postoperative management of patients who are suitable for descending thoracic or thoracoabdominal aortic aneurysm repair of chronic distal aortic dissection with deep hypothermia and circulatory arrest.

  PublisherOA PDFDOI

• A video-graphic presentation of open repair of thoracoabdominal aortic aneurysms using deep hypothermia and circulatory arrest

  ASVIDE · 2021-10-01

  article
  PublisherDOI

• Outcomes of Surgical Coronary Revascularization Performed Before Solid Abdominal Organ Transplants

  The Annals of Thoracic Surgery · 2020-07-08 · 6 citations

  articleOpen access
  PublisherOA PDFDOI

• Impact of troponin I level on coronary artery bypass grafting outcomes

  Journal of Cardiac Surgery · 2020-07-27 · 3 citations

  article

  PURPOSE: The effect of preoperative cardiac troponin level on outcomes after coronary artery bypass grafting (CABG) is unclear. We investigated the impact of preoperative cardiac troponin I (cTnI) level as well as the time interval between maximum cTnI and surgery on CABG outcomes. METHODS: All patients who underwent isolated CABG at our institution between 2009 and 2016 and had preoperative cTnI level available were identified using our Society of Thoracic Surgeons registry. Receiver operating characteristic (ROC) analysis was performed to identify a cTnI threshold level. Subjects were divided into groups based on this value and outcomes compared. RESULTS: A total of 608 patients were included. ROC analysis identified 5.74 µg/dL as the threshold value associated with worse postoperative outcomes. Patients with peak cTnI >5.74 µg/dL underwent CABG approximately 1 day later, had twice the risk of adverse postoperative events, and had 2.8 day longer postoperative length of stay than those with peak cTnI ≤5.74 µg/dL. cTnI level was not associated with mortality or 30-day readmission. Time interval between peak cTnI and surgery did not affect outcomes. CONCLUSION: Elevated preoperative cTnI level beyond a certain threshold value is associated with adverse postoperative outcomes but is not a marker for increased mortality. Time from peak cTnI does not affect postoperative outcomes or mortality and may not need to be considered when deciding timing of CABG.

  PublisherDOI

• The Presence of a Dedicated Cardiac Surgical Intensive Care Service Impacts Clinical Outcomes in Adult Cardiac Surgery Patients

  Author eBooks · 2020-04-01

  book-chapterSenior author

  Background Postoperative critical care management is an integral part of cardiac surgery that contributes directly to clinical outcomes. In the United States there remains considerable variability in the critical care infrastructure for cardiac surgical programs. There is little published data investigating the impact of a dedicated cardiac surgical intensive care service. Methods A retrospective study examining postoperative outcomes in cardiac surgical patients before and after the implementation of a dedicated cardiac surgical intensive care service at a single academic institution. An institutional Society of Thoracic Surgeons database was queried for study variables. Primary endpoints were the postoperative length of stay, intensive care unit length of stay, and mechanical ventilation time. Secondary endpoints included mortality, readmission rates, and postoperative complications. The effect on outcomes based on procedure type was also analyzed. Results A total of 1703 patients were included in this study-914 in the control group (before dedicated intensive care service) and 789 in the study group (after dedicated intensive care service). Baseline demographics were similar between groups. Length of stay, mechanical ventilation hours, and renal failure rate were significantly reduced in the study group. Coronary artery bypass grafting patients observed the greatest improvement in outcomes. Conclusions Implementation of a dedicated cardiac surgical intensive care service leads to significant improvements in clinical outcomes. The greatest benefit is seen in patients undergoing coronary artery bypass, the most common cardiac surgical operation in the United States. Thus, developing a cardiac surgical intensive care service may be a worthwhile initiative for any cardiac surgical program.

  Publisher

• Outcomes of surgical coronary revascularization performed pre-solid abdominal organ transplant

  Author eBooks · 2020-01-01 · 1 citations

  book-chapter
  Publisher

• Outcomes of Florida Sleeve Procedure in Patients with Bicuspid Versus Tricuspid Aortic Valve

  Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery · 2020-07-01 · 7 citations

  article

  Objective Outcomes of the Florida Sleeve (FS) procedure in patients with bicuspid aortic valve (BAV) have not been reported before. We compared outcomes of the FS procedure between patients with BAV and those with tricuspid aortic valve (TAV). Methods From May 1, 2002 to January 1, 2016, 177 patients including 18 BAV and 159 TAV underwent the FS procedure. Baseline characteristics, perioperative outcomes, and echocardiographic measurements were compared between the 2 groups. Kaplan–Meier and life-table analyses were used to evaluate survival and freedom from reintervention rates. Results Mean ± standard deviation age and aortic root diameter were comparable in BAV and TAV groups, 47.83 ± 11.19 versus 49.59 ± 15.79 years ( P = 0.55) and 56.57 ± 6.18 versus 55.17 ± 8.84 mm ( P = 0.46), respectively. The 30-day mortality and stroke rates were zero in the BAV group and 1.88% ( n = 3) in the TAV group ( P = 1.00). One patient (5.55%) in the BAV group and 8 (5.03%) patients in the TAV group needed permanent pacemaker implantation ( P = 0.62). Freedom from reoperation was 93% in the BAV group and 99% in the TAV group at 8 years ( P = 0.041). Patient survival rate was 100% in the BAV group and 91% in the TAV group at 8 years ( P = 0.42). Freedom from aortic insufficiency greater than mild was 93% in the BAV group and 96.5% in the TAV group at 5 years ( P = 0.61). Conclusions This is the first study reporting outcomes of the FS procedure in patients with BAV. This technique is feasible, and the results appear to be durable when compared to patients with TAV.

  PublisherDOI

Frequent coauthors

• Tomas D. Martin

  127 shared

• Thomas M. Beaver

  89 shared

• Charles T. Klodell

  86 shared

• Joel S. Corvera

  Indiana University School of Medicine

  61 shared

• Robert J. Feezor

  61 shared

• Thomas S. Huber

  57 shared

• Jeffrey E. Everett

  Indiana University – Purdue University Indianapolis

  42 shared

• Lava Timsina

  Center for Outcomes Research in Liver Diseases

  41 shared