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Specialists at the Massachusetts General Hospital Thoracic Aortic Center care for patients with conditions of the thoracic aorta, including acute and chronic aortic dissections, thoracic and thoracoabdominal aortic aneurysms, coarctation of the aorta and Marfan Syndrome and related conditions.
The collaborative environment in the Thoracic Aortic Center results in a focused approach to a patient’s condition and treatment. While our sophisticated technologies may drive the treatment, it is the entire team of specialists who implement the plan. The composition of the team at the Thoracic Aortic Center builds and grows depending on each patient’s needs. Specialists begin with a thorough evaluation, which details the patient’s history of prior cardiovascular disease and hypertension as well as the history of the aortic condition itself. Patients bring any previous studies with them and, when necessary, additional tests are ordered. Support services, including interpreters, social workers and other medical specialists are available to patients as needed.Once we have excellent definition of the relevant anatomy, our cardiologists, cardiac surgeons and vascular/endovascular surgeons collaborate in a discussion of the findings. By carefully studying the results of imaging studies and considering the patient’s past medical history, the team considers the benefits of various treatments and recommends a course of optimal management to the patient, family and referring physician. All of this happens quickly, with the patient typically having a treatment plan established at the end of the first visit.
The Center’s multidisciplinary approach enhances the quality of care by fostering close communication among the team involved in the patient’s treatment. Visits are coordinated with the goal that, when possible, patients have any necessary testing and visits with one or more appropriate physicians on the same day. Team conferences and electronic medical records facilitate collaboration among specialists, resulting in well-integrated, consistent treatment approaches that help achieve the best outcomes possible.
The attending physician is the leader of the team. Patients and their families are encouraged to be partners with us on the treatment team and to be involved in every decision along the way. In order for patients to make informed decisions, education is a cornerstone of our care.
The initial medical evaluation of a patient includes:
Our specialists may use one or more imaging techniques to fully reveal the aortic anatomy, including:
In addition to standard therapies, specialists offer innovative strategies for managing thoracic aortic diseases, including:
Surgical repair of thoracic aortic aneurysms is usually carried out when the aneurysm is large enough in size to carry a significant risk of rupture or dissection, or when aneurysms cause symptoms. Aneurysms of smaller size are usually managed medically with blood pressure control and periodic follow-up imaging.
Patients with aortic disease who are diagnosed and managed appropriately can expect to lead relatively normal lives, but lifelong management of the disease is required.
Patients need to have control of their blood pressure over their lifetimes to avoid hypertension (high blood pressure) and limit the stress on the weakened wall of the aorta. We typically recommend that patients buy an automatic blood pressure cuff to monitor blood pressure at home. Target blood pressure goals are recommended and patients are encouraged to monitor their own blood pressure and contact their Thoracic Aortic Center provider if their blood pressure drifts consistently out of range.
Patients also undergo periodic imaging studies to look for changes in the size of the involved portions for the aorta. Most of the time follow-up imaging studies are either an echocardiogram (ultrasound of the heart), a contrast-enhanced CT scan (CT angiogram or CTA) or a gadolinium-enhanced MRI (MR angiogram or MRA).
The Thoracic Aortic Center follows patients after initial diagnosis and treatment to ensure that the patients and their doctors are doing everything possible to manage their aortic disease. The Thoracic Aortic Center also ensures that primary doctors are kept informed every step of the way.
This program's approach streamlines the care of patients with complex aortic disease so that they receive input from multiple specialists.
Established in 1999, the Thoracic Aortic Center strives to provide the best-possible patient care, educate both patients and physicians about lifelong management of thoracic aortic disease and develop new treatment options. Treatment combines advanced resources and the specialized expertise of cardiologists, cardiac surgeons, vascular/endovascular surgeons and vascular radiologists. A collaborative approach to care allows our specialists to optimally manage conditions such as:
Thoracic aortic diseases are complicated conditions requiring complex solutions. The Thoracic Aortic Center is a complete, interdisciplinary resource for patients and offers the most advanced treatments available for the full spectrum of thoracic aortic disease.
Our team teaches patients about their aortic disease, its causes, treatment options and the follow-up care that we provide. Patients learn the importance of monitoring their own blood pressure, understanding their physical restrictions, identifying high risk activities as well as recognizing symptoms that require attention in an emergency department.
Many of our physicians are also on the faculty of Harvard Medical School, which means they not only have a mission to provide the best possible patient care, but also a commitment to educate the next generation of medical professionals.
The care team at the Thoracic Aortic Center encourages all patients and family members to learn more about conditions and diseases that affect the heart and overall cardiovascular system. The links below provide more information about heart conditions and diseases that might be treated within this program.
Definitions of Thoracic Aortic TerminologyMedical staff at the Thoracic Aortic Center make sure all patients fully understand their conditions and treatment options. Read about commonly used medical terms to describe thoracic aortic conditions.
Aortic Anatomy: Descriptions with Images Learn about the aorta, the largest artery in the body that carries oxygen rich blood from the heart to all major organs and limbs.
A thoracic aortic aneurysm, also called TAA, is a bulging, weakened area in the wall of the thoracic aorta (the largest artery in the body), resulting in an abnormal widening or ballooning.
Learn what to expect before, during and after
your surgery at the Massachusetts General Hospital Heart Center by downloading and printing our patient guide to cardiac surgery.
As you prepare for your catheterization, Massachusetts General Hospital clinicians want you to feel as comfortable as possible. To help you understand what to expect during your visit, this booklet describes key steps of your catheterization procedure.
The Massachusetts General Hospital Heart Center offers a patient guide to cardiac anesthesia. Our dedicated clinicians believe it is important for you to know what to expect before, during and after a cardiac anesthesia.
Learn how physicians at the Massachusetts General Hospital Thoracic Aortic Center diagnose and treat thoracic aortic disease, a condition that affects the portion of the aorta that is in the chest and requires treatment from both cardiac and vascular specialists.
Cardiac nurses at the Massachusetts General Hospital Heart Center offer support and guidance during a family member's open-heart surgery or transplantation.
Since childhood, Keith and Kevin Mullen have shared many life experiences, but the twin brothers never thought open-heart surgery would be on that list.
Late last year, the Coronary Artery Bypass Graft Care Redesign team – made up of anesthesiologists, perfusionists and surgeons – formed a subgroup focused specifically on the practice of CPB. They began to investigate different ways they could strengthen not only how care was administered, but also how they could work more collaboratively on a daily basis.
Richard Cambria, MD, chief of the MGH Division of Vascular and Endovascular Surgery and co-director of the Thoracic Aortic Center, is the first incumbent to the Robert R. Linton, MD, Professorship in Surgery in the Field of Vascular and Endovascular Surgery at Harvard Medical School.
Richard P. Cambria, MD, is the fourth Mass General surgeon to lead the Society for Vascular Surgery, the largest medical society of vascular surgeons.
A leader in the field of cardiothoracic surgery, Alan D. Hilgenberg, MD, was an expert in the surgical management of thoracic aortic aneurysms. In 1999, he was named co-director of the newly created Mass General Center for Thoracic Aortic Surgery.
Thoracic Aortic Center
Patient referrals can be made to the Thoracic Aortic Center at 617-724-4747 or directly to any of the participating physicians. Coverage is available 24 hours per day, seven days per week to receive emergency referrals from any regional physician or emergency department if an acute syndrome related to the thoracic aorta is suspected. A phone call to the Thoracic Aortic Center will set in motion the assembly of a team for emergency evaluation and management of the patient.
Outpatient referrals of patients with thoracic aortic aneurysms will result in multidisciplinary evaluation by appropriate physicians from cardiology, vascular radiology, cardiac and vascular surgery. Patients can be seen by multiple physicians on the same day, and the appointments are made with a single phone call to the Thoracic Aortic Center number.
Evaluation will result in a recommendation for either intervention or follow-up. Follow-up for the aortic problem will be arranged at the Center. General cardiac and pulmonary evaluation may also be done.
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