The Surgeons Who Care for Your Aorta

Podcast Transcript

Announcer:

Welcome to Love Your Heart, brought to you by Cleveland Clinic's Sydell and Arnold Miller Family, Heart, Vascular and Thoracic Institute. These podcasts will help you learn more about your heart, thoracic and vascular systems, ways to stay healthy, and information about diseases and treatment options. Enjoy.

Francis Caputo, MD:

Hi, my name is Frank Caputo. I'm the Vascular Surgery Director of the Aortic Center here at the Cleveland Clinic, as well as the Program Director here for the training programs in vascular surgery. And I'm here with Dr. Vargo.

Patrick Vargo, MD:

My name's Patrick Vargo. I'm one of the heart surgeons and aorta surgeons here at Cleveland Clinic. I work in the Aortic Center as well, from the cardiac surgery side of things. I'm in the training program for the thoracic surgery residents as the Associate Program Director, and together with Dr. Caputo and myself, we operate and take care of a lot of patients with aneurysms of their thoracic aorta and abdominal aorta.

Francis Caputo, MD:

So many of you may be wondering why a cardiac surgeon and a vascular surgeon are sitting next to each other. We're taking care of your aorta. As you know, we're both experts in aortic surgery, but there tends to be boundaries. Dr. Vargo tends to be an expert in those patients above the diaphragm. I tend to be below the diaphragm. And sometimes these aneurysms cross the diaphragm or sometimes there's a mixture of endovascular and open techniques, and we find that working collaboratively and together we have the best outcomes.

Patrick Vargo, MD:

So here at the Cleveland Clinic, as you mentioned, we both work in the Aorta Center. What that means is that there's a group of us who specialize in treating aortic disease, which could be aneurysms, dissections, and different pathologies that affect the aorta, which is the large artery that comes out of your heart and travels the whole length of the body to give blood to all your organs. In this center, there's cardiac surgeons like myself, vascular surgeons like Dr. Caputo and also cardiologists that are experts in medically managing these aortic diseases. And you'll often see all of us and some of us at different appointments as well. As these aneurysms grow, they become more of a surgical disease. And that's when we start talking about surgical planning. When they remain on the smaller side, you may be evaluated by us and then follow with cardiology and then receive optimal medical treatment at that time.

Francis Caputo, MD:

And remember, once you have a diseased aorta, whether your aneurysm is limited to one section or not, your entire aorta is at risk for developing over time. That's why it's all about lifelong surveillance. And we have to monitor these aortas to see if there's any aneurysmal growth or any development of high-risk features that may warrant surgical intervention. Up to a certain point, it is perfectly safe to medically manage these aneurysms.

Patrick Vargo, MD:

When it is time to treat a portion of the aorta, replace it or repair the aneurysm or dissection or whatever the pathology may be, there's different ways to go about it. A couple of generations ago, it used to always be an open surgical incision, and oftentimes that is still necessary, but this is a highly evolving, rapidly evolving field where new devices come out, that can treat these aortas minimally invasive. Oftentimes, we can use stents or a hybrid approach of stents and some smaller incisions to treat it. And in some cases, we still do need the open surgical approach to replace the aorta that's diseased. Here at Cleveland Clinic, we're one of the biggest centers in the country that treats this disease, and we have a lot of new devices that are a part of trials as well as many different devices available to us, and the support to do the operations necessary to repair your aorta.

Francis Caputo, MD:

And that's the benefit of having experts in these fields work together because we discuss all these options, whether it's like Dr. Vargo mentioned, endovascular only, whether it's open only, or whether we do some form of combination to minimize the stress on your body between endovascular and open, creating a hybrid solution to your aortic issues. We tend to work in teams in order to really bring all the various aspects from different fields together.

Patrick Vargo, MD:

And I think one other thing that's important for patients with aneurysm disease of aorta is they often may be part of a syndrome. Things like Marfan syndrome, Loeys-Dietz syndrome, or some of these other connective tissue disorders that are heritable. If you are a patient that does have something like this, we have big centers that manage the treatment of these patients, both the aortic portion of those syndromes as well as extra-aortic things. Sometimes these patients have issues with their musculoskeletal systems, eye issues, and different parts of the body. So, it's really a multidisciplinary center here, and we like to get you plugged in and treated completely as a patient.

Francis Caputo, MD:

In addition, with these genetic components, we help to identify members of family that carry these conditions to not only help treat patients that may not realize that they also have the condition, but also to help counsel on what the genetic ramifications for these are for the generations to come. But again, I'm happy that you guys are listening to us and getting educated about your aorta and its health. If you guys have any further questions or any need for seeing us in consult, we'd be more than happy to see you, Dr. Vargo and myself. And we at the Cleveland Clinic believe that every life deserves world-class care.

Patrick Vargo, MD:

Thank you for joining us today.

Announcer:

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