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Center for Vascular Disease

Thoracic Aortic Surgery
A thoracic aortic aneurysm is a widening or bulging of part of the wall of the aorta. The aorta is the major artery that arises from and carries blood away from your heart to all the parts of your body. Thoracic aortic aneurysms can dissect or rupture, which represents a life-threatening emergency due to severe internal bleeding. Ruptured thoracic aortic aneurysms are typically treated with emergency surgery. Thoracic aortic aneurysms affect approximately 15,000 people in the United States each year.

Thoracic aortic diseases include aneurysms, penetrating atherosclerotic ulcers, acute and chronic dissections, atherosclerotic disease, traumatic injury, and certain infections. The Thoracic Aortic Surgery program at the Bluhm Cardiovascular Institute is designed to manage all aspects of thoracic aortic disease from the level of the aortic valve through the ascending aorta, the aortic arch, the descending thoracic aorta, and thoraco-abdominal aorta in concert with other cardiovascular diseases.

Co-directors of the Thoracic Aortic Surgery program, Mark D. Morasch, MD, and S. Chris Malaisrie, MD, have established a comprehensive system of care to treat thoracic aortic diseases that relies heavily on an integrated, team approach. The Thoracic Aortic Surgery program team includes Mark K. Eskandari, MD, Jon S. Matsumura, MD, Edwin C. McGee, MD, and specialized nurses, anesthesiologists, cardiologists, radiologists, and neurologists, working together to customize and ensure state-of-the-art patient care.

The principal goals of the Thoracic Aortic Surgery program include:

  • utilizing the most advanced therapies available
  • practicing the safest techniques of circulation management using specialized perfusion techniques during the complex surgeries required to treat thoracic aortic diseases
  • relying on a comprehensive system of monitoring heart, brain, and spinal cord function during the complex surgeries required to treat thoracic aortic diseases
  • achieving the best long-term clinical outcomes possible for each patient

To establish accurate diagnoses, the Thoracic Aortic Surgery program uses a combination of advanced cross-sectional and three dimensional (3-D) imaging techniques including dual source 64 slice Computed Tomography Angiography CTA, magnetic resonance angiography (MRA), and echocardiography. Physicians then thoroughly evaluate each patient for coexisting diseases involving other organ systems so that any required surgeries can be carefully planned and executed in a manner that minimizes patient risk.

The Thoracic Aortic Surgery program offers the entire range of currently available techniques within the field of thoracic aortic surgery allowing optimally tailored management for every patient. Surgeries performed include:

  • replacement of any part of the thoracic aorta
  • valve-sparing aortic root replacement using the "reimplantation" (David) technique and other root replacement techniques
  • aortic arch replacement using antegrade cerebral perfusion strategies for brain protection
  • thoracoabdominal aortic replacement using deep hypothermia to protect the spinal cord
  • minimally-invasive, endovascular repair of aneurysms using thoracic aortic stent-grafts

Patients with heritable conditions such as the Marfan syndrome and the Loeys-Dietz syndrome are at particular risk of death secondary to aortic dissection or rupture. Serial (routinely repeated) imaging of the aortic root and ascending aorta with timely surgical replacement can prevent these catastrophic events.

Several clinical research trials are currently under at the Center for Vascular Disease to investigate and improve the care of the patient with thoracic aortic diseases. These ongoing clinical research trials help to ensure that our patients continue to receive the most innovative care for thoracic aortic disease in the country.

Contact
For more information regarding thoracic aortic surgery and the treatments available through the Center for Vascular Disease, call the Bluhm Cardiovascular Institute at (866) 662-8467, or request an appointment online.

Review Date: 11/07