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Aortic Aneurysm Surgery

Westchester Heart and Vascular's Aortic Aneurysm team has performed over 250 cases of aortic surgery, spanning the spectrum of aortic procedures, including valve-sparing root replacements, full aortic arch replacements, using hypothermic circulatory arrest, thoracoabdominal replacements and many re-operative procedures. We are rapidly becoming a referral center for acute aortic dissections for the entire Hudson Valley and northern metropolitan New York City region.

The aorta is the main blood vessel in the human body. As blood is pumped from the heart, it passes across the aortic valve, and then through the aorta, where it is then distributed through a system of smaller arteries. As the aorta travels through the body, each portion has a different name based on its location and each section supplies different organ systems or areas of the body. The aorta first leaves the heart and brings blood towards the head as the ascending aorta. As the aorta turns towards the left side of the body, it gives off branches to the upper body and the brain as the aortic arch. The aorta next travels down the chest, where it is called the descending aorta. The descending aorta continues through the abdomen as the abdominal aorta, where it supplies the abdominal organs before dividing to provide arteries for each leg (the iliac arteries).

The wall of the aorta is made up of three layers, the thin adventitia on the outside, the media, which is thicker and more elastic, and the delicate intima on the inside. The elastic nature of the vessel wall helps the aorta respond to the high pressures produced as blood is ejected from the heart.

Aortic Aneurysm Surgery Team at Westchester Medical Center We have performed over 250 cases of Aortic Aneurysm Surgery, spanning the spectrum of aortic procedures, including valve-sparing root replacements; full arch replacements, using hypothermic circulatory arrest; thoracoabdominal replacements, using somatosensory and motor evoked potential monitoring; and many re-operative procedures. We are rapidly becoming a referral center for acute aortic dissections for the entire region and have performed 86 repairs for acute dissection, with 1.2% mortality. The overall mortality, for all aneurysm procedures, is 2.4%. When appropriate, we are employing a less invasive, endovascular stent approach.

Dr. Spielvogel has lectured at national and international meetings on his method of aortic arch replacement, the trifurcated graft technique (below), which is becoming adopted internationally. For preoperative and postoperative aneurysm patients, we inaugurated an Aortic Aneurysm Follow-up Program that includes a nurse practitioner and a custom-developed database to implement surveillance protocols for these patients.

An aneurysm is a localized dilatation of a blood vessel. Aneurysms may occur in any artery in the body, and in the aorta they may occur in any segment, whether in the chest (the ascending aorta, the aortic arch, or the descending aorta) or in the abdomen (the abdominal aorta). In a true aneurysm, the dilation involves all the walls of the aorta, in contrast to a pseudoaneurysm, or “false” aneurysm. In a pseudoaneurysm, the dilation does not involve all the layers of the aortic wall, but instead is usually contained by only the thin layer of adventitia.

There are many ways that doctors diagnose and follow aortic aneurysms. These different tests help to identify the presence of aneurysm as well as help determine treatment plans and follow up.

Chest X-ray

Often chest x-rays may suggest the presence of an aortic aneurysm. While they are not definitive studies, they may alert doctors of aortic pathology and suggest further tests.

CT Scan

CT scan of the chest (often referred to as “CAT Scan”) is the preferred means of imaging aortic aneurysms, both at initial presentation and during follow-up. CT scans that focus on the aorta do require intravenous contrast, which may be contraindicated in some patients with allergies or kidney problems.

Echocardiography

Echocardiograms, whether transthoracic or transesophageal, may also help to provide further information about the aorta. Echocardiograms are of particular use when evaluating the ascending aorta, aortic valve and the heart.

MRI

Magnetic resonance imaging (MRI) is another useful tool for examining the aorta. The images obtained are similar to those provided by CT, but the intravenous contrast used is better tolerated by patients.

For additional information please call 914.493.8793

Westchester Medical Center
100 Woods Road
Valhalla, NY 10595

By Car

Train

Westchester Medical Center is served by Metro North's Harlem line via two stations:

  • White Plains - Bus transfer options available
  • Hawthorne - Taxi service available

For train fare and schedule information, call 1-800-METRO-INFO or go to www.mta.info/mnr .

Bus

There are three bus lines (Westchester Bee Line) you can take to our campus. Please call 914-813-7777 for bus routes and fares

Campus Map

The Westchester Medical Center campus includes the Maria Fareri Children's Hospital and the Behavioral Health Center.

Lansman, Steven L.
Lansman, Steven L.
Chief, Cardiothoracic Surgery
Professor of Surgery
Cardiothoracic Surgery
Thoracic Surgery
Spielvogel, David
Spielvogel, David
Associate Chief Cardiothoracic Surgery
Director Heart Transplantation
Professor Cardiothoracic Surgery
Cardiothoracic Surgery
Goldberg, Joshua Benjamin
Goldberg, Joshua Benjamin
Assistant Professor of Surgery
Cardiothoracic Surgery
Kai, Masashi
Kai, Masashi
Assistant Professor of Medicine
Cardiothoracic Surgery
Thoracic Surgery
Malekan, Ramin
Malekan, Ramin
Assistant Professor of Surgery
Cardiovascular Disease
Thoracic Surgery
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