Advances in Managing Aortic Disease

Hiroo Takayama, MD, PhD, has been named Director of the nationally recognized Aortic Surgery Program and the Cardiovascular Institute at Columbia University Medical Center. 

The Aortic Program, which is growing rapidly, completed nearly 200 operations in the last year. It now offers a catheter-based, minimally invasive approach for various aortic diseases. Team members also collaborate with referring physicians in order to optimize the follow-up of patients with aortic diseases since a number of these patients suffer from recurrent aortic events. 

In addition, the Aortic Program actively participates in many clinical trials on new devices for novel transcatheter and surgical therapies for aortic diseases.  It is one of the first centers in the nation to use the Thoraflex hybrid device to treat extensive thoracic aortic aneurysms

Thoraflex uses the frozen elephant trunk (FET) technique, a modification of the elephant trunk method introduced in 1983. The new aortic prosthesis consists of a Dacron sheath, with or without branches, leading to the arterial vessels exiting the aortic arch, and a port for extracorporeal circulation with a self-expanding stent graft. View Thoraflex Hybrid Animation »

“This combination allows us to do a complete one-stage treatment of pathologies within the arch and the nearby segment of the descending aorta,” adds Dr. Takayama. “It also allows a two-stage treatment of extensive thoracic aortic aneurysms affecting a significant section of the descending aorta.”

Highlights of the Aortic Program include: 

Excellent outcomes

Columbia’s new comprehensive aortic database tracks long-term outcomes and helps physicians and surgeons to achieve the highest standards of patient care.  Data by procedure can be found here.  

Minimally-invasive approaches

 “All of our patients are assessed for an endovascular and minimally invasive surgical options,” says Dr. Takayama. “We are one of the few programs with advanced expertise in both endovascular and open approaches, and can offer endovascular procedures even for ascending, arch, and thoracoabdominal pathologies, previously considered contraindicated, with close collaboration with Dr. Isaac George, Surgical Director of the NYP/Columbia Heart Valve Center.”  Dr. George pioneered the use of neo-cord, an artificial cord for the repair of mitral valve regurgitation, using an off-pump approach.  

Dr. Virendra Patel will soon join the Aortic Program as chief of Vascular Surgery and co-Director of the Aortic Program after years of distinguished service at the Massachusetts General Hospital, adding to our expertise. 

Collaborative follow-up clinic

All patients with significant aortic pathology―those who have had surgery and those who don’t yet require intervention―need careful follow-up with imaging studies.

“We have developed a comprehensive aortic database that helps determine the timing for these studies, using set guidelines and individualized risk assessment,” says Dr. Takayama.  “Imaging studies can be scheduled at a local facility or at NYP/Columbia.  Our team will discuss the results with referring physicians and their patients and prepare a management plan.”

Comprehensive patient-centered care

With the extensive resources of a leading medical center, the Columbia Aortic Program offers the most comprehensive approach available.  The team consists of dedicated specialists in cardiac and vascular surgery, cardiology, radiology and, genetics.  Treatment is tailored to the needs of every patient and the role of family members in the caregiving process is considered as well.

Instant accessibility

Columbia’s aortic team is available on a 24/7 basis. For consultation, please call 2844.792.6782 (844.RX.AORTA) or visit our online referral center.