Good morning family! Thank you for coming back to another beautiful day of #AorticDiseaseAwarenessMonth!
Today’s topic is a little unique. We are going to be discussing some of the amazing specialists that help treat aortic disease: Cardiothoracic Surgeons, Vascular surgeons, and cardiologists. While all of them work together to diagnose and repair aneurysms and dissections in the aorta, their expertise, training, and common surgeries are unique.
https://gvm-international.com/en-us/specialties/cardiothoracic-vascular-surgery
Let’s start with Cardiothoracic (CT) surgeons. These ladies and gentlemen are our beloved The Heart Surgeons, who specialize in surgical repair of diseases affecting the heart and lungs.
https://en.wikipedia.org/wiki/Cardiothoracic_surgery
CT surgeons complete medical school before starting residency. During residency, these surgeons train to learn general surgery procedures followed by cardiothoracic surgeries, which focuses specifically on surgeries of the heart and lungs.
A good rule of thumb is that their main area of operation involves the chest organs and surrounding blood vessels. Common surgeries done by CT surgeons includes coronary bypass surgery, valve repairs, heart and lung transplants, and of course aortic aneurysms and dissections.
https://www.ctsnet.org/article/aortic-root-remodelling-debranching-arch-ascending-aorta-replacement-lupiae-and-cabgx3-prior
Now on to our amazing Vascular surgeons. These ladies and gentlemen are our vessel specialists, which means their focus is treating diseases our entire vascular system, includes both arteries and veins throughout the body. This includes vessels near or stomach, in our limbs, and of course vessels of the heart, such as the aorta.
https://preferredvasculargroup.com/reasons-to-see-a-vascular-doctor/
Similar to CT surgeons, vascular surgeons complete medical school and spent some time learning general surgery. However, they go on to train in vascular surgery, which emphasizes the surgical treatment of vessels throughout the entire body.
A difference here between vascular surgeons and CT surgeons, is that vascular surgeons may find themselves operating far away from the chest, such as in arteries in the neck and in blood vessels from peripheral trauma, such as limb injuries carotid artery disease (in the neck).
https://navicenthealth.org/service-center/atrium-health-navicent-heart-vascular-care/open-peripheral-vascular
Last but certainly not least, cardiologists! These are the doctors who you will find yourself spending the most amount of time and scheduling the most appointments with throughout your journey with Aortic Disease!
Cardiologists are medical specialists. This means they specialize in non-surgical ways of treating heart disease. They complete four years of medical school followed by three years of internal medicine residency where they learn about how to manage diseases of the entire body (not just the heart and the aorta). After that cardiologists will further sub-specialize by completing a three-year cardiology fellowship where they will become experts in the diagnosis and medical treatment of diseases of the heart and vessels.
Several conditions may be managed with a cardiologist including hypertension, coronary artery disease, peripheral vascular disease, and valve disease. Often times a patient will be seeing a cardiologist and then during a routine test, incidentally find an aortic aneurysm for which their cardiologist will refer them to a CT or vascular surgeon.
After surgery, a patient will often follow lifelong with their cardiologist who will order routine CAT scans or MRIs to follow the size of their aorta and ensure it is not growing too large again. They truly are lifelong coaches of aortic health!
Together, CT, Vascular and Cardiology Superheroes will team up to diagnose and treat of aortic dissections and aneurysms.
This means that after your CT, echo, and MRI results come in, they may review your images together and plan the best way to repair the damage. Based on what part of your aorta has disease, one may find themselves being operated on by a CT surgeon, a vascular surgeon or both.
For example, open chest surgery is usually needed if an aneurysm or dissection involves the ascending aorta. CT surgeons here will be able to open the chest safely and repair the areas of damage, taking great care to ensure the great branches that come off of the aorta to feed blood to the brain remain in-tact.
Conversely, for type B dissections involving the descending aorta (further away from the heart) or those traveling down to the arteries of the leg (iliac), a vascular surgeon will be able to smoothly perform endovascular repair and deploy durable grafts to fix any leakages or aneurysms.
https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.110.958975
And that’s all for this session. Thanks for coming family and I hope you learned something new today. That’s all from me this week, but be sure to tune back in tomorrow for a genetics overview blog post!
See you soon family and remember always to #ThinkAorta!
Warmly,
Adham
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