At NYU Langone’s Center for Complex Aortic Disease, our renowned cardiothoracic and vascular experts bring together their decades of surgical expertise to repair the hardest-to-treat types of aortic aneurysm, including aortic root, aortic arch, and thoracoabdominal aneurysms.
Our team is led by cardiac surgeon Dr. Aubrey C. Galloway, chair of NYU Langone’s Department of Cardiothoracic Surgery, and Dr. Thomas Maldonado, an international leader in aortic repair who pioneered the use of stents for treating thoracoabdominal aneurysm. Their unique partnership, supported by Dr. Deane E. Smith and Dr. Neal S. Cayne and other members of our cardiac and vascular surgery teams, allows us to provide aneurysm treatment for people who have been told elsewhere that they are not candidates for surgery.
Our expertise in the care of complex aortic aneurysms translates to treatment for all types of aneurysms as well as aortic dissection. We use minimally invasive endovascular approaches, open surgery, and a hybrid of the two to create treatment strategies that are customized to each person’s unique diagnosis.
The aorta is the body’s largest and most important vessel, supplying blood to the heart, head, neck, arms, chest, and abdominal organs. An aneurysm is a bulge in the aortic wall that can lead to serious and sometimes life-threatening aortic dissection or hemorrhage. There are three types of aortic aneurysms considered the most dangerous and difficult to treat: aortic root aneurysm, aortic arch aneurysm, and thoracoabdominal aneurysm.
The aortic root is closest to the heart and provides blood flow to the left and right coronary arteries. Aside from the risk of aortic dissection or hemorrhage, an aneurysm on the aortic root can also damage the aortic valve. In people who have Marfan syndrome or other genetic connective tissue disorders, the aorta is more sensitive to injury. These people are at heightened risk of complications from aortic root aneurysm. Our surgical team specializes in valve-sparing aortic root replacement, which replaces the aortic root while also preserving the aortic valve.
An aortic arch aneurysm occurs in the section where the artery curves up and away from the heart. The aortic arch connects to vessels that supply blood to the head and arms. Aortic arch aneurysms usually require surgery to replace the arch and vessels, or a hybrid procedure which includes open surgery followed by a stent graft, which is a fabric-covered mesh tube that seals and strengthens the wall of the aorta, allowing the aneurysm to shrink. This treatment requires team work by cardiac and vascular surgeons.
A thoracoabdominal aneurysm occurs in the region that spans the chest and abdomen, where numerous vessels supply blood to the liver, kidneys, intestines, and spine. Our cardiac surgeons have extensive experience in techniques used to create bypasses that maintain blood flow to these organs. Our vascular surgeons specialize in endovascular aneurysm repair (EVAR), a minimally invasive approach that uses a catheter in the femoral artery to place customized stents that shore up the aorta while also allowing blood to flow through its connected veins and to vital organs. Our team of cardiac and vascular surgeons evaluate all patients with thoracoabdominal aneurysms to determine the safest and most effective treatment approach.
Connective tissue disorders such as Marfan syndrome and Loeys-Dietz syndrome can contribute to aortic disease. They can also increase the risk of complications during surgery. For this reason, we provide full cardiology evaluation and genetic testing for patients before surgery. Many people are unaware that they have a connective tissue disorder until they receive testing. If someone is confirmed to have one of these disorders, we adapt our strategy to provide the treatment that is most likely to heal the aneurysm with the least risk of adverse effects.
NYU Langone continues to lead the way in research to find the best treatment for aortic aneurysms, as well as the role of growth factors, cellular mechanisms, genetics, and inflammation in causing the formation of aneurysms and other artery diseases. We are also one of a handful of centers involved in a number of clinical trials, including the Medtronic Valiant® thoracic stent graft and Cook Medical fenestrated thoracoabdominal device. These cutting edge technologies allow us to treat complex aortic aneurysm minimally invasively, by relining the aorta and preserving circulation to important vital organs.
Procedures take place at NYU Langone’s Kimmel Pavilion, where our surgeons perform the most complex types of open and endovascular procedures. During surgery, we collaborate closely with our cardiac anesthesiologist and neurointerventional radiologist to ensure that you are as safe as possible. After the procedure, you stay in one of our single-bedded patient rooms, which feature real-time patient monitoring and negative-pressure ventilation to ensure a safe environment during your recovery.
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