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We specialize in the assessment, follow-up and management of patients requiring surgery for aortic disease. Patients referred to this clinic include those with aneurysms and/or dissections involving the thoracic and thoracoabdominal aorta. With expertise in state-of-the-art open, endovascular and hybrid repair techniques, our team tailors the plan for each patient using a multi-disciplinary approach.
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what you can expect when you have a clinic appointment.
The Patient & Family Education Program at UHN offers valuable resources to help you understand your condition.
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Blood vessels are the channels or tubes that distribute blood to body tissues. The aorta is the largest blood vessel in your body. It carries blood from the heart to all other parts of the body.
The aorta is made up of these parts:
An aortic aneurysm is a balloon-like bulge that can happen in weaker parts of the aorta. Aneurysms can happen anywhere in the aorta. For example, an aneurysm in the chest is called a thoracic aortic aneurysm.
Risk factors that can raise your chances of developing an aortic aneurysm over time include:
Having an aortic aneurysm means the layers of the aorta may get so weak or thin that they can cause:
A rupture or dissection can cause death if not treated urgently with surgery.
Your doctor may recommend taking medicine and making lifestyle changes to help slow the growth of an aortic aneurysm. For example:
Your doctor may recommend surgery if the aneurysm reaches a certain size and depending on other factors (such as age, medical history, and health condition).
Open surgery replaces the section of the aorta affected by the aneurysm with a durable fabric tube (graft) connecting the healthy ends of the aorta.
Endovascular stent graft
A device called a stent graft is put inside the aorta to divert the flow of blood away from the aneurysm.
What is aortic dissection?
An aortic dissection is a tear in the inner wall of the aorta, causing separation of the layers of the aortic wall. There are two types of dissections depending on which part of the aorta is affected:
Who is at risk?
Risk factors that can raise your chances of developing an aortic dissection over time include:
What are the symptoms?
Treatment for Type A aortic dissection
Acute Type A aortic dissection is a dangerous, life-threatening condition. It’s important to get medical attention right away.
Your doctor may prescribe medications to lower your blood pressure before surgery to prevent the dissection from getting worse.
Type A aortic dissection is treated with open surgery:
Treatment for Type B aortic dissection
Your doctor can usually treat acute Type B aortic dissection with medication.
Surgery may be needed for complicated cases:
What are the long-term health issues?
After receiving urgent treatment for an aortic dissection, you may need to:
You will need life-long follow up with CT scans, MRIs and/or echocardiograms for monitoring.
You may need open surgery or endovascular stent graft if the aorta continues to grow over time.
Where can I get more information?
UHN Patient Education and Engagement for reliable health information or to request a tailored consumer health search.
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People diagnosed with aortic aneurysm might wonder what happens next. There are many possible treatment options for aortic aneurysm. If surgery is the best option for you, our multidisciplinary team of aortic experts can guide and prepare you through your surgical journey.
Please choose one of the following options to read more about surgery to treat aortic disease.
The aortic root contains the aortic valve and the coronary arteries. Your doctor may recommend surgery if an aneurysm in the aortic root is causing the aortic valve not to open and close properly.
What is the Bentall procedure?
What is valve-sparing root replacement?
What is the Ross procedure?
The aortic arch is the curved part of the aorta that carries blood to your head, neck, brain and arms.We offer the open, hybrid and endovascular repair of the aortic arch.
What is open surgery?
What is endovascular surgery?
What is hybrid surgery?
An aortic aneurysm that involves your chest and continues down into your abdomen is called a thoraco-abdominal aortic aneurysm or TAAA.
TAAA repair is a very complex procedure. There are different ways to do the surgery (open surgery or endovascular repair) depending on the type of aneurysm.
The surgeon makes a long incision (cut) along the left side of the chest, between the ribs and down towards the belly button (umbilicus) in the lower abdomen. The weakened part of your aorta is replaced with a fabric tube called a graft.
What is Endovascular Aneurysm Repair (EVAR)?
This is a less invasive way to manage your aneurysm. A catheter is inserted into an artery in your groin and a device called a stent graft (fabric tube) is put into your aorta to seal off the aneurysm from the inside.
To repair a thoracoabdominal aortic aneurysm, or one close to the kidney arteries, a surgeon will often use a custom-made graft with branches or openings to re-attach important arteries of the abdominal aorta.
What is lumbar or spinal drain?
The lumbar or spinal drain collects cerebrospinal fluid (CSF) during and after surgery. CSF is the clear fluid that surrounds and protects your spinal cord and brain. Too much pressure in the fluid around the spinal cord can cause damage to the cord leading to paralysis of the legs and lower part of the body.
Before the surgery, a drain catheter is put into the fluid surrounding your spinal to reduce the pressure in your spinal cord and lower the risk of paralysis.
You can find more information on TAAA :
Administrative Team: Liza Fabian, Victoria de Melo, Leah Gabriel
Medical Imaging Consultant: Dr. Kong Teng Tan
Nurse Practitioner: Connie Xu
Research Coordinators: Karamvir Deol, Rifat Islam
At the Thoracic Aortic Surgery Clinic (TASC), we aim to improve the clinical outcomes of not only our current patients but also our future patients with aortic disease. This drives us to be involved in a wide range of clinical and basic science research to better understand what factors lead to life-threatening aortic complications and how to identify and treat patients at risk. We also explore the role of novel cutting-edge technologies in the surgical treatment of aortic disease.
The current research projects at TASC are:
Aorta BiomechanicsThis study examines the material properties of aortic tissue, characterizing it and testing it for vulnerability to dissection and rupture. This study has improved our understanding of how aortic tissue behaves and aims to identify a mechanics-based marker for aneurysm risk prediction.
Biomechanical and Metabolic Properties of Proximal Aortic Aneurysms in Patients with Bicuspid Aortic Valves (BAV_MRPET)This study evaluates the role of an innovative hybrid imaging modality, combined Positron Emission Tomography and Magnetic Resonance Imaging (PET/MR), in predicting areas of aneurysms that may be unstable and prone to rupture and/or dissection.
Treatment In Thoracic Aortic Aneurysm Surgery versus Surveillance (TITAN: SvS)This multicentre study is the first randomized controlled trial that compares two strategies for ascending aortic aneurysms that are not yet at the traditional size threshold for surgery: early surgery or ongoing surveillance.
The International Registry of Aortic Dissection (IRAD)We participate in the largest international multicentre registry for acute dissections (Type A and Type B). This registry has provided us with foundational knowledge on the outcomes following aortic dissection.
Montalcino Aortic Consortium (MAC): Precision Medicine for Heritable Thoracic Aortic DiseaseWe participate in this multicentre registry to better characterize the known causative gene mutations for heritable thoracic aortic disease and to identify novel genes that lead to heritable thoracic aortic disease.
DARTS: A Postmarket StudyThis study investigates the performance and clinical benefits of the innovative Ascyrus™ Medical Dissection Stent (AMDS) to treat patients with certain types of aortic dissection.
Thoraflex Hybrid Post-Market Study (THOR)The purpose of this study is to follow patients who have received a Thoraflex™ Hybrid device in treatment of aortic arch aneurysms and dissections.
For more information on any of the above studies, please contact our research coordinator,
You will be contacted with information about your first appointment.
Please bring the following to your appointment. Not all of these items may be needed for your appointment. Our clinic or your referring doctor will let you know what you must bring.
Please arrive 15 minutes before your appointment.
When you arrive, you will sign in with the receptionist. You will need your health card (OHIP card) to sign-in. If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver’s license or passport.
You may be given a Measuring Health Equity Questionnaire to fill out. This form contains questions about your background. We collect this information to find out who we serve and what unique needs you may have. The form is voluntary and you can choose ‘prefer not to answer’ to any or all questions. However, the information you choose to give us will help us improve the quality of care for you and others.
First appointments take longer than follow-up appointments. Your first appointment can take 2 hours or more. Follow-up appointments usually take 15 to 30 minutes. We do everything we can to stay on time but sometimes unforeseen circumstances may delay your appointment.
At the end of your first appointment, the nurse or doctor will give you a contact list for your health care team. If you don’t get a contact list, feel free to ask for it.
After every appointment, a member of your health care team will tell you about your next visit. Be sure you understand what is going to happen next. For example, know the time and place of your next visit or if someone will call you with this information.
If you are unsure about what your next steps are, don’t be afraid to ask a member of your team. We are here to help you.
We understand that reaching us by phone can sometimes be difficult. Often our phone lines are busy or are turned over to the message centre so our staff can prepare for clinic visits or help other patients. We make every effort to return your call within 24 hours. Our staff will try to reach you 2 times. If we are not able to reach you directly you may need to call us again.