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The body's largest artery, the aorta, is the path through which oxygenated blood leaves the heart for the rest of the body. When this important pathway is damaged, the artery can split or bulge, leading to life-threatening consequences. Aortic disease includes:
- Aortic Aneurysm - an enlargement or bulge
- Aortic Dissection - a partial tear
Some of the conditions that lead to aortic disease — high blood pressure and cholesterol and fat build-up in the arteries — can be managed with medications and lifestyle change. Yet, the damage to the aorta still may need surgical repair.
At the University of Maryland Center for Aortic Disease, our surgical team works closely with our medical team to provide the advanced surgery you need with intensive follow-up care to keep your blood pressure under control.
The UM Center for Aortic Disease team is still seeing patients with urgent or emergent conditions. For all non-urgent medical concerns, virtual appointments are now available for aortic disease services. We strongly encourage patients to schedule video and/or phone consults for appointments. Please contact us at 410-328-4771 to find out if telehealth is available for your next visit.
Medical Management of Aortic Disease
Medications can help decrease the pressure on the vascular system and blood vessel walls, reducing the chance that an aneurysm will rupture.
Our dedicated blood pressure specialist has extensive experience treating patients who have not respond to standard medications. These therapies may include medications, procedures or clinical trials not available elsewhere.
Surgical Treatment of Aortic Disease
If your aorta is enlarged (more than two inches across) or is growing quickly, your doctor may recommend surgery.
The goal of surgery is to repair the aorta before it starts to leak or rupture (aortic dissection).
As the mid-Atlantic region’s leading aortic disease program, for Aortic Disease offers the complete spectrum of surgical options. Our team performs more surgeries to treat aortic disease than anywhere else in Maryland. These include:
Your doctor may recommend open surgery to repair your aorta. This open will vary depending on the location of your aorta. The open surgical option for treatment of an enlargement of the aorta in your abdomen is known as an abdominal aortic repair. The surgical option to treat an enlargement of the aorta in your chest is known as a thoracic aortic repair.
- Open abdominal aortic repair: a surgical procedure to treat abdominal aortic aneurysms. While the patient is under general anesthesia, a vascular surgeon makes an incision in the patient’s abdomen and removes the section of the aorta that has enlarged or has the aneurysm. The section of the aorta that had the aneurysm is replaced with a graft, or strong fabric tube, which is sewn in place.
- Open thoracic aortic repair: a surgical procedure to treat thoracic aortic aneurysms. While the patient is under general anesthesia (unconscious), a cardiovascular surgeon makes an incision along the side of the chest and removes the section of the aorta that has the aneurysm. This may require the patient to be attached to a heart-lung bypass machine during part of the surgery. The damaged part of the aorta is replaced with graft, or strong fabric tube, which is sewn in place. After the graft is sewn in place, the chest incision is closed.
Some patients are candidates for a minimally invasive surgical option. Endovascular surgery does not require an incision like open surgery does, allowing for a shorter hospital stay and quicker recovery as a result.
- Endovascular aortic repair (EVAR): This option is used to treat abdominal aortic aneurysms in some patients. The patient is under general anesthesia. A vascular surgeon makes a small, dime-sized incision in the patient’s groin area and threads a narrow tube called a catheter through the patient’s blood vessels and up to the abdominal section of the aorta. Next, the surgeon inserts a fabric-covered metal or plastic tube called a stent at the site of the aneurysm. Blood flows through the center of the stent, taking the pressure off the aneurysm and preventing it from growing larger or rupturing.
- Thoracic endovascular aortic repair (TEVAR): This option is used to treat thoracic aortic aneurysms in some patients. While the patient is under general anesthesia (unconscious), a cardiovascular surgeon makes a small, dime-sized incision in the patient’s groin area and threads a narrow tube called a catheter through the patient’s blood vessels and up to the thoracic section of the aorta. Next, the surgeon inserts a fabric-covered metal or plastic tube called a stent at the site of the aneurysm. Blood flows through the center of the stent, taking the pressure off the aneurysm and preventing it from growing larger or rupturing.
Hybrid Operating Room
The University of Maryland’s hybrid operating room incorporates equipment for both open and endovascular procedures, allowing for unparalleled flexibility to adapt to the patient and choose the best surgical option for the individual.
Our cardiac and vascular teams work together to design the best treatment plan with the needs of each individual patient in mind.
Due to having many surgical options our team works to ensure patients get the best long-term outcomes for their aortic disease.
In addition to surgical team, the University of Maryland’s Center for Aortic Disease offers specialists in hypertension management, cardiology, and genetic counseling to ensure the patients’ health is optimized after the surgical repair.
We offer a surveillance program as well for diligent monitoring to ensure your aorta remain stable after the repair by performing CT scans. Through this surveillance program, we follow patients carefully over the years and are able to build long-term relationships with our patients.
If you’ve been diagnosed with aortic disease and may need surgery, this information will help you know what to expect.
Aortic Disease Screening
Because most aortic conditions are treatable when detected early, we emphasize preventive care, early detection and ongoing medical management.
Screening and preventive measures include:
- Blood pressure screenings - Hypertension is one of the leading causes of aortic conditions. Get regular blood pressure screenings and use a digital blood pressure cuff at home.
- Lifestyle changes - If diagnosed with high blood pressure and aortic disease, we may recommend lifestyle changes, such as a low-sodium diet, lower levels of physical exertion and stress reduction. Learn more about high blood pressure.
- Pay attention to symptoms - Tell your doctor if you have any symptoms like chest pain, weakness, numbness or fainting.
- Genetic Testing - If your family has a history of aortic disease, genetic testing may be a screening option
To make an appointment with one of our specialists, call 410-328-4771.
We provide rapid, effective treatment for emergency cases via our emergency transport system, University of Maryland ExpressCare.
We are in constant contact with UM ExpressCare, so we are ready to begin treatment the minute the patient arrives, including gathering the necessary specialists. We also have a Critical Care Resuscitation Unit so patients get intensive care unit-level care right away.
To reach ExpressCare, call 410-328-1234.