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Aortic Center of Excellence
Physicians affiliated with the Aortic Center of Excellence at Memorial Hermann Heart & Vascular Institute-Texas Medical Center were the first in the world to perform robotic reconstructive aortic surgery, and they continue to pave the way in the area of aortic aneurysm repair. The Aortic Center of Excellence is fully staffed by surgeons from the Department of Cardiothoracic & Vascular Surgery at The University of Texas Medical School at Houston. Traditional surgery to repair aortic aneurysms is done in stages, requiring multiple procedures. Thanks to innovative techniques developed by surgeons at the Heart & Vascular Institute-Texas Medical Center and The University of Texas Medical School at Houston, the repair can now be completed with minimally invasive surgical techniques which means patients have lower morbidity rates, shorter recovery times and can usually resume normal activity a week after surgery. No one in the world is more experienced in this life-saving technique than the team at Memorial Hermann. Affiliated physicians provide preoperative, operative, and critical care for all diseases of the aorta including: The Aortic Center of Excellence is one of the world’s largest aortic surgery practices and as such is a major center for device development research. The clinical research team has been a leader in the field of complex aortic surgery research, with over 200 peer-reviewed publications. The group has published in major subspecialty journals and general medical journals such as the Journal of Vascular Surgery, the Journal of Cardiovascular and Thoracic Surgery, the New England Journal of Medicine, Lancet and Nature Genetics. Research studies and clinical trials are underway to explore new treatment options for individuals with aortic aneurysms. Learn about current research studies related to this condition and information on enrollment as a study participant.
UT Cardiothoracic and Vascular Surgery
6400 Fannin, Suite 2850
Houston, TX 77030
Phone: 713.486.5100
Fax: 713.383.3727
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The aorta is the main vessel of the human body providing blood to all organs. Starting at the root of the heart, attached to the aortic valve, branches to heart, brain, arms, spinal cord, visceral organs (intestines, liver, stomach), kidneys, and legs originate from the aorta. An aortic aneurysm is a “ballooning” in this main blood vessel that can lead to rupture or dissection. Aortic dissection occurs when the middle layer of the aortic wall splits creating a “false” channel for blood flow. This dissecting process weakens the aortic wall making it more prone to rupture. When rupture occurs, survival is often less than 10%. Aortic dissection can also lead to obstruction of any of the branches of the aorta and ultimate organ death.Each year, 15,000 Americans die due to ruptures of these aneurysms, often without ever having symptoms. Another 100,000 are diagnosed before rupture, typically as the result of an incidental imaging procedure. The incidence of abdominal aortic aneurysm (AAA) and thoracoabdominal aneurysm (TAA) has increased substantially in recent decades; surgery is the only effective treatment.
Although many risk factors for aortic aneurysms have been identified, the exact cause remains unknown. Risk factors for aortic aneurysms include: - High blood pressure
- Smoking
- High cholesterol
- Obesity
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Although most aortic aneurysms occur in the infrarenal abdominal aorta (the segment of the aorta below the renal arteries in the abdomen), many do occur above this area. Aortic aneurysms can be classified by anatomical location. The ascending aorta is located near the heart at the front of the chest giving branches to the heart (coronary arteries). This is the area most commonly affected by aortic dissection. The late actor John Ritter was afflicted with this disorder. The ascending aorta leads to the transverse aortic arch giving branches to the brain (innominate, and left common carotid arteries) and the arms (subclavian arteries). The transverse arch also directs blood to the back of the chest leading to the descending thoracic aorta. This segment of aorta now travels downward towards the abdomen giving branches to the spinal cord (intercostals arteries). Crossing through the chest and through the diaphragm, the aorta enters the abdomen. In the abdomen, the aorta gives off branches to the liver, stomach, spleen (celiac axis), the small intestines (superior and inferior mesenteric arteries), and kidneys (renal arteries). The infrarenal abdominal aorta then branches in the pelvis into the iliac arteries.
Diagnosis
The Memorial Hermann Heart & Vascular Institute-Texas Medical Center is equipped with the full range of technology for accurate, noninvasive assessment of a wide range of conditions.
Abdominal aortic aneurysm may be diagnosed with the following exams: Most non-leaking thoracic aortic aneurysms are detected by tests -- usually a chest x-ray or a chest CT scan -- run for other reasons. A chest x-ray and chest CT scan show if the aorta is enlarged. A chest CT scan shows the size of the aorta and the exact location of the aneurysm.Our Women’s Heart Healthy Program offers exams that can detect aortic aneurysms. This program is designed specifically for women who want to make a healthy living – and a healthy heart – a personal priority. This new program incorporates leading-edge technology in a private setting, offering personalized, hands-on care provided by board-certified cardiologists and cardiovascular surgeons affiliated with Memorial Hermann Heart & Vascular Institute-Texas Medical Center. Call 713.704.1000 to schedule your appointment for a Heart & Vascular Package.
Treatment
Surgeons affiliated with the Aortic Center of Excellence at Memorial Hermann Heart & Vascular Institute-Texas Medical Center are world leaders in the reconstruction of aortic aneurysms. Their ground-breaking techniques have resulted in critical advancements in the repair of these ballooning blood vessels helping to prevent ruptures and significantly improving outcomes.
The surgeons are leaders in innovation for aortic surgery performing procedures including: - Complex valve sparing aortic replacement procedures
- Hybrid arch and thoracoabdominal aortic aneurysm repair
- Percutaneous interventions for aortic dissection
- Thoracic endovascular aortic repair (TEVAR)
- Endovascular repair of throacoabdominal aortic aneurysms
Aneurysms that involve the thoracic and abdominal aorta are called thoracoabdominal aneurysms. During open aneurysm repair, your surgeon makes an incision in your chest and replaces the weakened portion of your aorta with a fabric tube, called a graft. The graft is stronger than the weakened aorta and allows blood to pass through it without causing a bulge. A catheter, inserted at the start of the procedure to drain spinal fluid, relieves pressure created during surgery and reduces the risk of postsurgical paralysis. TAA repair is a very complex procedure and requires a team of highly skilled and experienced surgeons. Surgical methods used by the Memorial Hermann Heart & Vascular Institute-TMC team have resulted in a significant reduction of the risks commonly associated with this procedure. Since 1992, incidence of paralysis has decreased from 15 percent to less than 3 percent.
A minimally invasive alternative to open surgical repair of diseases of the thoracic aorta, TEVAR is most commonly used to correct thoracic aneurysmal disease. Using the TEVAR procedure, the vascular surgeon inserts an endograft into the aneurysm as a replacement for the diseased segment of the aorta. Patients benefit from reduced mortality and morbidity, shorter hospitalizations and more rapid recovery.
The minimally invasive endovascular abdominal aneurysm repair (EVAR) procedure involves making small incisions in the groin and threading catheter tubes through the femoral arteries and into the aorta. A fabric covered metal stent is introduced through the artery and fixed in place, relieving pressure on the artery to prevent rupture. Patients remain conscious under local anesthesia during the procedure. Patients who undergo EVAR have lower morbidity rates and shorter recovery times and can usually resume normal activity a week after surgery.
Physicians
 The Aortic Center of Excellence is fully staffed by surgeons from The University of Texas Medical School at Houston, under the leadership of Hazim Safi,M.D.
Hazim J. Safi, MD
Ali Azizzadeh, MD
Sheila M. Coogan, MD
Anthony L. Estrera, MD
Kamal Khalil, MD
Charles C. Miller, III, Ph.D.
Eyal E. Porat, MD
Jon-Cecil M. Walkes, MD
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Patient Stories
We believe that our patients are the best advocates for what we do. We are sharing a few of our aortic aneurysm patient stories to provide a learning opportunity for others. Thank you to our patients for sharing their stories. | Our Patients |  |
Heart & Vascular Institute-Texas Medical Center
Debbie celebrates a new birthday after a thoracic aortic aneurysm nearly takes her life.
Read Debbie’s Story
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Heart & Vascular Institute-Texas Medical Center
Surgeons combine techniques to treat extensive aortic aneurysms. An innovative physician team at Memorial Hermann-TMC successfully treated Janice with a single operation.
Read Janice's Story
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