Cardiac surgeons at the Brigham and Women’s Hospital (BWH) Thoracic Aortic Center offer expert screening, evaluation, surveillance, and treatment for diseases of the ascending, arch, descending and thoracoabdominal segments of the aorta. They treat aortic emergencies including dissection, transsection, and rupture, as well aneurysmal disease, coarctation, and aortic disease associated with valvular disease. In 2006, there were 158 aortic procedures performed for aortic dissections and for thoracic aortic aneurysms.

R. Morton Bolman, III, MD, Chief, Cardiac Surgery, says, “At the Thoracic Aortic Center, we offer a multidisciplinary, patient-centered approach to aortic disease.” He continues, “We work in close collaboration with our colleagues in vascular and endovascular surgery, anesthesiology, cardiology, and interventional radiology to provide the full spectrum of open, endovascular, and hybrid approaches and treat each individual patient in the most effective and appropriate manner.”

Acute Aortic Response Team

One result of this collaborative approach to patient care is the anticipated launch of the Acute Aortic Response Team in the summer of 2007. Teams of multidisciplinary experts will be on-call 24 hours-a-day to bring resources and customized therapies to the management of patients with acute aortic syndromes including aneurysms, dissections, and traumatic disruptions.

Dr. Bolman notes, “Although such teams are commonly involved in non-emergent care of aortic disease, ours will be one of the few centers in the country to provide a multi-specialty approach to patients with acute aortic emergencies.”

Building a comprehensive database

The collaborative treatment approach also enhances the capacity to capture data and to build a more comprehensive aortic disease management database. Dr. Bolman says, “For all patients we follow or treat, we collect data including natural history, imaging findings, procedures, outcomes, complications, and quality-of-life in order to better understand aortic disease and determine the best treatment for each individual patient.”

Advanced treatment for aortic disease

Cardiac, vascular, and endovascular surgeons working together in the Thoracic Aortic Center offer advanced treatment approaches tailored to the requirements of each individual patient. Treatment approaches include:

• Repair and reconstruction of all aortic segments,
• Conventional and endovascular treatment for thoracic and abdominal aneurysms,
• Treatment for patients with connective tissue disease, including Marfan, Ehlers Danlos, and other syndromes that affect the aorta,
• Aortic valve-sparing root replacement surgery,
• Composite aortic root replacement,
• Homograft aortic root replacement.

Cardiac anesthesia specialists work closely with our surgeons to offer stateof-the-art techniques of myocardial, cerebral, and spinal protection to make these procedures as safe as possible and reduce the risk of complications.

Clinical trials enhance patient care

Research efforts at the Thoracic Aortic Center comprise basic, translational, and clinical studies to develop better ways of preventing complications of current procedures, to develop safe and effective new devices and procedures, as well as less invasive techniques for treating thoracic aortic disease. Appropriately selected patients have access to the latest clinical trials, including:

• A multi-center national trial comparing surgical repair and stent graft treatment for thoracic aortic dissection and traumatic injuries,
• A trial comparing surgical versus endovascular treatment for descending aortic dissection,
• A trial of a percutaneous aortic valve replacement device,
• Trials of a variety of endovascular stent graft devices to treat abdominal and thoracic aneurysms,
• A trial of a new drug that may prevent the development of aneurysms in patients with Marfan syndrome.

In addition, the Center is currently a site for a multi-center National Institutes of Health study investigating methods of cerebral protection during aortic arch surgery.

Referrals and Information

The Division of Cardiac Surgery welcomes physician inquiries and referrals. Call our Physician Referral Service at 1-800-MD-TO-BWH.