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
• Nonsyndromic heritable thoracic aortic disease (HTAD) or familial thoracic aortic aneurysm and dissection disease (FTAA/D)
• Turner syndrome
• Aortic dissection
• Unexplained thoracic aortic aneurysm

Washington University and Barnes-Jewish Hospital have a longstanding history of excellence in the care of patients with Marfan syndrome and related aortopathy conditions. Individuals 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 condition, 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, vascular surgery, orthopedic surgery, maternal-fetal medicine, and thoracic surgery may also be arranged as required.

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)
• Puja Kachroo, MD, (Cardiothoracic surgeon)
• Kevin Blinder, MD (Ophthalmology and the Retina Institute)
• Munish Gupta, MD(Orthopedics/Spine specialist)
• Marcia Willing, MD(Medical geneticist)

• Dana Gima, RN (Nurse Coordinator)
• Barbara Stehman, RN (Nurse Coordinator)
• Washington University Vascular Surgery; Maternal Fetal Medicine Division

 Clinical expertise

• Evaluation and management of heritable thoracic aortic disease and genetically triggered aortic aneurysm syndromes including:
  • Marfan syndrome
  • Loeys-Dietz syndrome
  • Nonsyndromic heritable thoracic aortic disease (HTAD) or Familial thoracic aortic aneurysm and dissection diseases
  • Bicuspid aortic valve with ascending aortic aneurysm
  • Vascular Ehlers-Danlos syndrome
  • Turner syndrome with aortic disease
• One of the largest clinics in the country dedicated to the care of patients with Marfan syndrome and Aortopathy conditions
• Evaluation and management of individuals with aortic dissection
• Evaluation and management of individuals with thoracic aortic aneurysm
• Evaluation of the individual with a family history of thoracic aortic aneurysm and/or aortic dissection
• Multidisciplinary evaluation when appropriate including evaluation by:
  • Cardiology
  • Cardiothoracic surgery
  • Medical genetics and genetic counseling
  • Ophthalmology
  • Orthopedic surgery
  • High-risk obstetrics (maternal-fetal medicine)
  • Vascular surgery
  • Thoracic surgery
• Determination as to whether patients are candidates for open surgery or endovascular repair

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 aortopathy conditions

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 or heritable vascular and aortic disease.

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

Clinical affiliations

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