For patients with aortic disease, such as aortic aneurysm or dissection, the best time to add a surgeon to their care team is soon after diagnosis—even if they’re unlikely to need surgery immediately.

“Often, when cardiologists see patients with a non-life-threatening issue, such as an ascending aortic aneurysm that’s only a few centimeters in diameter, there can be a perception that surgeons don’t want to see those patients,” said Michael Bowdish, MD, vice chair of quality and research in the Department of Cardiac Surgery at the Smidt Heart Institute at Cedars-Sinai.

“We think it’s important to start discussing surgical options with patients soon after their diagnosis to form a relationship with them, and also to work with their cardiologist as part of their care team—even if a surgical intervention might be several years off,” he explained.

Bowdish stresses the importance of surgeons establishing a relationship with referring physicians so they can be partners in care and collaborate on comprehensive treatment plans for their patients. “We’re invested in this continuity of care to ensure patients have a smooth transition from surgery back to their referring physician for follow-up care,” he said.

With a multidisciplinary team that includes cardiac surgeons, vascular surgeons, cardiologists, genetic counselors and research scientists, the Smidt Heart Institute’s Aortic Program is one of the largest in the western U.S. for aortic procedures, offering a range of open, endovascular and hybrid techniques. It is also a leader in innovation and research into treatments and prevention.

Looking beyond emergency surgery

For more than a decade, the Smidt Heart Institute’s Aortic Program team has been referred some of the most complex cases from other leading centers, which provides an opportunity to innovate and offer the latest and most promising techniques.

“We can treat all aortic conditions and pathologies using the full spectrum of treatment modalities available,” said Ali Azizzadeh, MD, professor of Surgery, director of the Division of Vascular Surgery and co-director of the Aortic Program in the Smidt Heart Institute. “Our patients also often have access to clinical trials and investigational devices, which significantly expands the treatment options available to them.”

The Cedars-Sinai Aortic Program goes beyond the expertise of the individual cardiovascular surgeons who provide the dedicated on-call rotation for aortic dissection. The program team comprises highly specialized anesthesiologists, perfusionists, intensivists, cardiologists and surgeons.

The service has the capacity to look beyond the immediate situation. Improved early and long-term outcomes for type A aortic dissection are proven, with continued selective cerebral perfusion, aortic valve-sparing root replacement, and extension of the aortic repair distally into the arch with a frozen elephant trunk or other endovascular stent.

A gentle approach for the best outcomes

“We take an advanced and gentle approach with patients. We match the most progressive techniques and technologies with a thorough risk assessment for each patient, resulting in some of the best patient outcomes in the nation,” said Pedro Catarino, MD, professor of Cardiac Surgery, director of Aortic Surgery and co-director of the Aortic Program in the Smidt Heart Institute. “Our close relationships with referring physicians are important to formulating the best treatment plans for our patients, and we’re committed to that collaboration.” 

The Cedars-Sinai Aortic Program is available 24/7. For physician referrals and patient appointments, call 310-423-3851. You can reach the urgent line at 888-AORTA11.