Aortic Aneurysms

An aortic aneurysm is an abnormal bulge in the wall of the aorta, the body's largest artery. Aneurysms often cause no symptoms, but they can be life-threatening if they grow too large and rupture or burst.

Most people discover their aneurysms while being tested for another condition. A physician may spot the telltale bulge while studying a chest X-ray, performing an ultrasound to investigate a heart murmur or from a CT scan to evaluate a chronic cough, for example.

The Aortic Institute at Yale New Haven Hospital is a multidisciplinary specialty center dedicated to the care of patients with medical and surgical conditions that affect the aorta. One of the first and largest such institutes in the world providing clinical care of patients with aneurysms, the Aortic Institute at Yale New Haven Hospital is also one of the most active centers internationally for basic science and clinical research in aortic diseases.

Our multidisciplinary specialty center is dedicated to the care of patients with medical and surgical conditions that affect the aorta. Led by John Elefteriades, MD, Sandip Mukherjee, MD, and Prashanth Vallabhajosyula, MD, our team of cardiothoracic surgeons, geneticists, cardiologists, vascular surgeons, interventional and diagnostic radiologists monitor aneurysm activity, screen family members, and perform surgery and stent grafting for large aneurysms.

Our Institute has cared for nearly 5,000 patients and performs more than 150 aortic surgeries annually. Some of our clinical research findings have been groundbreaking. Our contributions in the field of genetics research and treatment options for aortic disease include development of the first general screening blood test for thoracic aortic aneurysm (“RNA signature” test), and identification of specific genetic mutations that underlie thoracic aortic disease. Among the milestones of the Aortic Institute:

• Identified inherited, genetic nature of thoracic aortic aneurysm and dissection.
• Developed first general screening blood test for thoracic aortic aneurysm.
• Identified benefit of using statin drugs in preventing progression and complications of thoracic aortic aneurysm. 
• Developed first routine genetic testing program for mutations leading to thoracic aortic aneurysm and dissection.
• Demonstrated the markedly increased (triple) risk of aortic dissection once a first dissection has occurred in a family.

Patient Care

The Aortic Institute provides comprehensive management for patients with an aneurysm or aortic dissection. Services offered include clinical and genetic screening of family members and monitoring of aneurysm activity.

We also offer a wide variety of treatments and surgical procedures for aortic disease, including open surgical procedures and minimally invasive stent therapies. The Aortic Institute’s outcomes for safety and effectiveness for all types of aortic surgery are unsurpassed. 

Patient Consultation

In this hour-long session, the patient and family meet with the surgeon and the clinical nurse coordinator to discuss the patient’s case in detail. During this session, the doctor performs a physical evaluation of the patient, takes a health history and discusses results of any patient tests conducted.

Various tests and procedures may be needed to clarify the diagnosis and may be required before a surgery, if one is recommended. When surgery may not be an option, the patient and the doctor discuss other possible treatment alternatives.

Possible tests include:

• CT scan of chest and abdomen
• Computed tomography angiogram (CTA) of coronary arteries
• Cardiac catheterization
• Carotid ultrasound
• Transthoracic echocardiogram
• Electrocardiogram (EKG)

Post-surgical Evaluation and Continuing Care

The surgical team is available to answer any questions the patient may have following hospital discharge. Four weeks after surgery, a patient will meet with the surgeon and the clinical nurse coordinator for an evaluation to include a chest X-ray, an electrocardiogram, and a physical including a wound check; remaining sutures will be removed. Patients who have had aortic surgery will be scheduled for a CT scan of the chest about six months after post-surgical evaluation. Annual or bi-annual visits at the Aortic Surveillance Program are then scheduled to monitor the aorta.