Thoracic Aortic Disease

The Center for Thoracic Aortic Disease, along with the Marfan Syndrome Clinic, are multidisciplinary clinics providing evaluation and management of diseases which involve the thoracic aorta.

Many of these disorders have an underlying genetic basis, including:

• Marfan syndrome
• Loeys-Dietz syndrome
• Bicuspid aortic valve associated with ascending aortic aneurysm
• Vascular Ehlers-Danlos syndrome
• Familial thoracic aortic aneurysm syndrome
• Turner syndrome

Washington University and Barnes-Jewish Hospital have a longstanding history of excellence in the care of patients with Marfan syndrome and related disorders. Patients with these conditions as well as those with thoracic aortic aneurysm and aortic dissection may be evaluated by a group of experts to determine the underlying disease, screen for genetic mutations when appropriate, and determine medical and surgical therapy. Full day evaluations including examinations by cardiology, medical genetics, ophthalmology, and an echocardiogram may be arranged as needed. Consultations with subspecialists including cardiac surgery and orthopedic surgery may also be prearranged.

Our team

Our multidisciplinary team of expert physicians and nurses includes:

• Alan C. Braverman MD, Director (Cardiology)
• Marc Moon, MD, Surgical Director (Thoracic Aortic Diseases Center)

• Kevin Blinder, MD (Ophthalmology and the Retina Institute)
• Keith Bridwell, MD (Orthopedics/Spine)
• Patrick Geraghty, MD (Vascular Surgery)
• Dana Gima, RN (Nurse Coordinator)
• Jeffrey Jim, MD (Vascular Surgery)
• Brian Rubin, MD (Vascular Surgery)
• Louis Sanchez, MD (Vascular Surgery)
• Barbara Stehman, RN (Nurse Coordinator)
• Marcia Willing, MD (Medical Genetics)

• Washington University Maternal Fetal Medicine Division

 Clinical expertise

• Evaluation and management of genetically triggered aortic aneurysm syndromes including:
  • Marfan syndrome
  • Loeys-Dietz syndrome
  • Familial thoracic aortic aneurysm or dissection syndrome
  • Bicuspid aortic valve with aneurysm
  • Vascular Ehlers-Danlos syndrome
  • Turner syndrome
• One of the largest clinics in the country dedicated to the care of patients with Marfan syndrome and related disorders
• Evaluation and management of patients with unexplained thoracic aortic aneurysm or aortic dissection
• Multidisciplinary evaluation when appropriate including evaluation by:
  • Cardiology
  • Cardiothoracic surgery
  • Medical genetics and genetic counseling
  • Ophthalmology
  • Orthopedic surgery
  • High-risk obstetrics
  • Vascular surgery
  • Cardiac radiology
• Close ties to pediatric services at St. Louis Children’s Hospital
• Determination as to whether patients are candidates for open surgery or endovascular surgery 

Surgical expertise

• Experienced cardiothoracic and vascular surgery for management of thoracic aortic aneurysm and aortic dissection
• Valve-sparing aortic root replacement, composite aortic valve and root replacement, open thoracic surgery on descending aortic aneurysms, hybrid procedures, endovascular repair of thoracic aortic aneurysms and for complications of aortic dissections
• Experience in valve-sparing aortic root replacement in Marfan syndrome and related disorder

Imaging capabilities

Washington University and Barnes-Jewish Hospital have expertise in all aspects of imaging of the aorta and its branches in the evaluation and management of diseases of thoracic aorta and genetically triggered vascular and aortic disease.

Long-term management of aortic aneurysm and dissection involves serial imaging studies utilizing MR angiography and CT angiography and echocardiography.

Clinical affiliations

• Cardiovascular Genetics
• Mallinckrodt Radiology Institute
• Genomics and Pathology Services
• The Marfan Foundation