Aortic Dissections, Aortic Aneurysms & Genetic Conditions

Cardiothoracic surgeons and vascular surgeons care for patients with diseases of the thoracic aorta. This includes acute aortic disease like Type A and Type B dissections, ascending arch and descending thoracic aortic aneurysms as well as genetic conditions affecting the aorta like Marfans Syndrome and Loeys-Dietz Syndrome.

 

Multidisciplinary Approach

Cardiac surgery, vascular surgery and cardiology are involved in the initial assessment of a patient. Preoperative evaluation of these patients include:

  1. Detailed history and physical exam.
  2. Evaluation of imaging studies which led to the diagnosis of the disease.
  3. Cardiac evaluation includes echocardigram, stress test and cardiac catherization.
  4. Pulmonary function assessment.

 

Imaging Modalities

Prior to surgical intervention, we believe that a sound and clear road map of the disease is available to us for which we use CT angiography /high resolution CT scan with 3 D reconstruction or MR angiography.

This is followed by formulating plan of care for the patient which is discussed with both the patient and the family. Detailed discussions regarding risks and complications are covered, so that patient and families understand the extensive nature of the surgery.

In addition to open surgical repair of the aortic root, ascending aorta and arch aneurysms, we use minimally invasive stent graft repair of the descending thoracic aneurysms, and also hybrid approaches to more complex Arch aneurysms with use of both open and stent graft repair to achieve lower morbidity and mortality and greatly improved outcomes.

 

Follow up care

Patients with aortic disease who have aneurismal disease which do not meet criteria for surgical intervention are followed with imaging on a yearly basis till their aneurysm reaches the critical size for operative intervention.