One of the interesting things about Aortic surgery and Aortic disease management is the interplay between specialist involved in the care of these patients.  Patients with aortic aneurysms or aortic dissections can come in contact with numerous specialists such as emergency room physicians, cardiologists, interventional radiologists, vascular surgeons and cardiovascular surgeons.  Not to mention, the important role that family practice and internal medicine physicians play in helping coordinate the care of patients.

Research poster presented at The Society of Thoracic Surgeons Annual Meeting, January 2015

There are also many medical and surgical societies involved in helping understand the treatment of aortic diseases. Societies such as The Society of Thoracic Surgeons, Society For Vascular Surgery, American College of Cardiology and The American Association For Thoracic Surgery all include cutting-edge research into aortic disease diagnosis and new treatments.  Each of these societies have annual meetings were thousands of physicians come together to learn from each other and discuss new treatments.

The 51st Annual Meeting of The Society of Thoracic Surgeons was held recently.  There were some excellent presentations regarding aortic surgery that helped all of us see things in a new light.  We presented a research poster entitled “Cardiothoracic Surgeon Involvement in the Management of Aortic Dissections: Impact of Endovascular Technologies and Implications for Training”.  We evaluated the changing trends in the management of aortic dissections and looked at the impact the endovascular technologies (aortic stent-grafts) played in affecting the care of patients.

“We have seen a change in the management of patients with aortic dissection. It is not uncommon now to have multiple specialists, such as cardiothoracic and vascular surgeons, involved in the care of patients with aortic dissections, which I believe benefits patient care.”

— Grayson H. Wheatley, MD, FACS

Teamwork is critical, and working together not only on the physician level, but on the national society level will significantly advance the progress we are making in understanding this complex disease and its treatments.  A key factor in all of this is the evolving role that endovascular aortic stent-grafts are playing into the improved patient outcomes, particularly with Type B aortic dissections.

Endovascular and catheter-based training is a relatively new addition to cardiothoracic and vascular surgeons.  Residency training programs include varying degrees of experience in these techniques, but more work is needed to be done to ensure that current and future generations of cardiothoracic and vascular surgeons have the training and understanding on how to treat patients with aortic dissections.

Seeing that the next generation of surgeons is adequately prepared is paramount to improving patient care.

— Larry R. Kaiser, MD, FACS, Dean of Temple University School of Medicine, President/CEO of Temple University Health System

As a result, new training paradigms which emphasize catheter-based training along with fundamental surgical principles are needed.  Physicians in practice also need new updates and training because many physicians trained 5-10 years ago didn’t get much experience with endovascular techniques.

Bottom line: Endovascular aortic stents are having a significant impact on the care of patients with aortic dissections.  As we continue to explore aortic dissections, we will expand more on this.  Companies such as Medtronic, W. L. GORE & Associates and COOK Medical are partnering with physicians and hospitals to offer the most up-to-date technologies.  As the next generation of technologies are developed, increased endovascular skills and techniques will be need to safely use these new medical devices.