Aortopathy

Patient-Centered, Multidisciplinary Approach to Aortopathy

The University of Chicago Medicine Aortopathy Program has a fully integrated team of adult and pediatric vascular surgeons, cardiac surgeons, cardiologists and nurses that collaborate to deliver comprehensive care to our patients from the initial meeting through long-term maintenance. At UChicago Medicine, we treat adults and children of all ages, including high-risk patients that have been turned away from other hospitals, and are committed to providing the best and safest solution(s) that are unique to our patients’ personalized healthcare and lifestyle goals.

Because we meet regularly to discuss new and current patients, our multidisciplinary team works together to create a plan that is tailored to each patient’s individual diagnosis, symptoms, risk factors and existing cardiovascular conditions. By maximizing the combined expertise, experiences and strengths of each team member, we offer a truly innovative, patient-centric approach to care that puts our patients at the forefront of aortopathy treatment.

What is aortopathy?

Aortopathy is a type of heart disease that affects the aorta, which carries oxygen-rich blood to critical organs and the rest of the body. With aortopathy, proper blood flow becomes limited or decreased in the body due to a weakened aortic wall and/or tear or rupture of the aorta. If this remains untreated, aortopathy can ultimately result in serious, and even life-threatening, conditions.

Types of Aortopathy

Aortopathy is characterized by a group of aortic conditions, so they are several types of aortopathy you could experience, with the most common types including:

• Adnominal aortic aneurysm: An abdominal aortic aneurysm (AAA) is a condition that occurs when the lower part of the aorta becomes enlarged and could rupture.
• Iliac aortic aneurysm: With an iliac aneurysm (IAA), the wall of the iliac artery that directs blood flow to the legs can expand and weaken, which puts the artery at risk for bursting.
• Thoracic aortic aneurysm: A thoracic aortic aneurysm (TAA) is a widening or ballooning of the ascending aorta, aortic arch and/or descending aorta located in the chest.
• Aortic root aneurysm: Aortic root aneurysms are aneurysms that occur in the aorta closest to the heart and can cause aortic valve insufficiency (“leaky valve”) and other problems.
• Aortic dissection: An aortic dissection is a tear or rip in the aortic wall, allowing blood to escape from the artery and deprive organs from oxygen-rich blood.
• Residual arch dissection: Patients who have undergone type A aortic dissection repair are often left with a difficult problem of residual aortic arch dissection and aneurysmal degeneration of the thoracic aorta, which can lead to stroke or rupture.
• Bicuspid aortic valve disease: Normally, the aortic valve has three leaflets, but there are cases in which the aortic valve is congenitally two leaflets, which is called a bicuspid aortic valve. It may cause abnormalities of the aortic valve (leak or narrowing) or enlargement of the ascending aorta over time.
• Connective tissue disorders: The body needs tissues to connect all the structures and muscles in the body, including the heart. With connective tissue disorders, the proteins needed for connective tissues are inflamed or damaged, which can weaken the aorta overtime.

Diagnosing Aortopathy

To ensure we have an accurate diagnosis and treatment plan, we use imaging, specifically CTs and MRIs, and advanced computer tools that show the exact anatomy of a patient’s aorta to collect highly personalized anatomic details unique to every patient. Additionally, our team is focused on National Institutes of Health (NIH)-funded research that allows us to develop algorithms to help doctors select the treatment option (open surgery, total endovascular or hybrid aortic procedures) best suited to each individual patient. Our goal is to optimize the initial surgical success as well as provide long-term aortic stability and freedom from reintervention.

Prevention for Aortopathy

Once you know that you are at risk of aortopathy, prevention is one of the most important and effective ways to lower your chances of having severe aortic disease. Depending on your specific risk factors, prevention could include:

Lifestyle Management

Taking steps early to improve your healthy lifestyle can significantly reduce your risk of aortopathy. Maintaining a normal weight and scheduling regular appointments to monitoring your cholesterol, blood pressure and glucose can help you avoid long-term aortic issues.

Additionally, because smoking damages the aorta, making a dedicated effort to stop smoking can prevent aneurysm, dissections and other aortic issues in the long run. For additional support, consider joining our smoking cessation group designed to help at-risk patients who are struggling with quitting.

Genetic Testing

If you have an inherited cardiovascular disease that can increase your chances of aortic disease, our Cardiovascular Genetics Clinic has an expert team of counselors who perform genetic testing to identify if you or your family are at risk for Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome and more. We can help you navigate any genetic-related risks in order to prevent or minimize the impact the inherited condition can have on your aorta.

Routine Imaging/Scans

Because not all diagnosed aneurysms require immediate surgical intervention, we can use painless, noninvasive testing to monitor the shape and size of your aneurysm regularly. This allows us to hold off on surgery while preventing any additional aortic complications.

Treatment Options

UChicago Medicine offers a full range of medical and surgical therapies to treat aortopathy using customized treatment plans that address each patient’s symptoms, risk factors, comorbidities to deliver the best, most effective solutions for long-term success and quality of life. Personalized treatments may include one or more of the following:

• Controlling or modifying risk factors: Quit smoking, control blood pressure and/or cholesterol, manage blood sugar to prevent/control diabetes can all prevent or slow aortic disease
• Observation: For diagnosed aneurysms, having routine scans can monitor the size and rate of growth of an aneurysm and recommend additional treatments if/when necessary
• Medication: Decrease factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure
• Open Aneurysm Repair: Replacement of the diseased area of the aorta with a fabric graft
• Endovascular Aneurysm Repair: A minimally invasive alternative to the open repair
• Hybrid Aneurysm Repair: Combination of open surgery and endovascular to repair the aorta
• Access to Clinical Trials and Novel Devices: New therapies and innovative devices allow us to revolutionize treatment for aortopathy patients before the solutions become widely available.