Aortic Disease Program

The hybrid operating room has been instrumental in the care of patients with complex aortic and structural heart conditions requiring both open surgical and endovascular techniques.

The Brigham and Women’s Hospital (BWH) Aortic Disease Program, within the Carl J. and Ruth Shapiro Cardiovascular Center, features experts in cardiac surgery, vascular and endovascular surgery, cardiology, vascular medicine, cardiovascular imaging, and cardiac and vascular anesthesia who provide expert multidisciplinary evaluation and treatment for all complex aortic diseases and acute aortic emergencies.

The hybrid operating room has been instrumental in the care of patients with complex aortic and structural heart conditions requiring both open surgical and endovascular techniques.

Advanced Approaches to
Aortic Disease Care

Cardiovascular specialists at BWH have pioneered interdisciplinary approaches to the treatment of cardiovascular disease and routinely perform procedures combining cardiac and vascular surgery and interventional cardiology for the treatment of many conditions, including complex aortic and thoracoabdominal disease.

Advanced procedures include:

• Innovative hybrid procedures performed in the hybrid operating room at the Shapiro Cardiovascular Center combine multiple treatment approaches, including endovascular techniques, minimally invasive cardiac procedures and open procedures, for patients with complex aortic disease.
• Repair and reconstruction of all five aortic segments/sections.
• Valve-sparing aortic root replacement - replacing the aortic root, located at the junction of the heart and the aorta, without replacing the aortic valve.
• Composite aortic root replacement – repair of the aortic root and aortic valve with artificial materials
• Homograft aortic root replacement – repair of the aortic root and aortic valve with a donated human aortic root and aortic valve
• Minimally invasive endovascular thoracic and abdominal aortic repair – inserting a stent graft, made of a polyester tube inside a metal cylinder, through an artery in the leg and then placing it against the weakened portion of the aorta.
• Hybrid aneurysm repair - combining open and endovascular techniques.

Specialists in the Aortic Disease Program evaluate and treat all forms of aortic disease, including:

• Dissections (tears) or aneurysms (bulges) of the aortic root, ascending aorta, descending aorta, aortic arch and thoracoabdominal aorta.
• Acute aortic emergencies, such as a tear or rupture affecting any segment of the thoracic and/or abdominal aorta.
• Abdominal aortic aneurysms.
• Connective tissue diseases, such as Marfan Syndrome.
• Aortic occlusive disease – narrowing of abdominal aorta.
• Visceral ischemic syndromes – caused by the blockage of one or more of the three major abdominal blood vessels.
• Infected aortic grafts.
• Aortitis – inflammation of the aorta.

State-of-the-Art Imaging and Anesthesia Services

Specialized evaluation, treatment and management of aortic diseases is performed by using state-of-the-art imaging techniques, including computed tomography (CT) with 3D reconstruction; ultrasound, including intravascular ultrasound (IVUS); and magnetic resonance aortography.

Patients at the Center also benefit from dedicated cardiac and vascular anesthesia teams. The Cardiac Anesthesia Service and Vascular Anesthesia Service at Brigham and Women’s Hospital provide specialized care for patients with complex cardiac conditions, often with severe coexisting disease, by using state-of-the-art resources, including our own intraoperative Transesophageal Echocardiography (TEE) Service and innovative myocardial, cerebral and spinal protection techniques.

Our Aortic Disease Program Team

Aortic Disease Clinical Trials

The Aortic Disease Program is one of few centers in New England to offer the following trials investigating new treatment approaches for aortic disease:

• Pythagoras – This trial of a new abdominal stent graft, an artificial tube made of fabric and metal, is designed for patients with highly-angulated infrarenal aortic aneurysms, who are not eligible for current FDA-approved devices.
• Thrive – Multi-center trial for stent grafting of thoracic aortic aneurysms.
• Vitality – Multi-center trial for stent grafting of abdominal aortic aneurysms.
• Unite – Multi-center trial of aortouni-iliac stent grafting (extending from the aorta to the iliac arteries) for complex aortic aneurysms
• Cardiomems – This trial is evaluating the implantation of pressure-sensing monitors into aortic aneurysms for long-term monitoring following endovascular aneurysm repair.

For information regarding any of the above trials, please contact Michael Belkin, MD, or Edwin Gravereaux, MD, at (857) 307-1930.

Refer a Patient to the Aortic Disease Program

To refer a patient to the Aortic Disease Program, or to get assistance with transfers or consultations, please call Cardiovascular Access Managers Lisa Downey, RN, BSN or Brian Laneau, RN, BSN at (617) 543-4170.