Aneurysm and Aortic Disease Care
If you or a loved one has an aortic aneurysm or another condition affecting your aorta, it’s important to get timely treatment to prevent life-threatening complications – and it’s critical to get care from an expert team with deep experience.
At Sanger Heart & Vascular Institute’s Aortic Center, we lead the nation in treating patients with complex aortic disease. We’re recognized by U.S. News & World Report as a high-performing hospital for aortic valve surgery and abdominal aortic aneurysm repair, placing us in the top 10% of hospitals in the country for these procedures.
With our team of renowned cardiovascular specialists by your side, you have the best chance of a good outcome.
To schedule an appointment, call 704-512-5734.
For educational information about aortic disease, visit our FAQ section.
Why choose Sanger for aortic disease care?
- Nationally recognized care
According to U.S. News & World Report, Sanger is the region’s top-rated heart and cardiovascular program, receiving high-performing recognition for aortic valve surgery and abdominal aortic aneurysm repair. - Minimally invasive therapies
Our skilled surgeons perform catheter-based procedures using stent grafts to repair aortic aneurysms and dissections, providing an opportunity for successful treatment to those who are considered too high risk for traditional open surgery. - Advanced genetic testing
We work with Sanger’s Marfan Syndrome and Genetic Aortopathy Clinic, nationally recognized by the Marfan Foundation, to offer advanced genetic testing. This can help guide treatment decisions and identify at-risk family members for early screening. - Robust emergency protocols
Our Aortic Center is only 1 of only 2 centers in NC with special treatment protocols for aortic dissections and ruptures. In emergency situations, we deliver fast, lifesaving treatment that can make all the difference when every second counts. - Innovative clinical trials
We’re breaking new ground in aortic disease treatment through our clinical trials, including leading-edge open procedures and minimally invasive endovascular repair techniques for thoracic and abdominal aortic aneurysms. - Seamless care through our new cardiology aortic clinic
Our cardiothoracic surgeons, vascular surgeons, cardiologists, geneticists, and imagers take a team approach to care. The cardiology clinic within our Aortic Center offers patients monitoring and long-term follow-up care.
Team approach
By working closely together, our team of experts provides comprehensive care and timely treatment to prevent life-threatening complications caused by aortic disease.
Our team includes:
- Advanced practice providers
- Cardiac imagers
- Cardiologists
- Cardiothoracic surgeons
- Geneticists
- Nurse navigators
- Vascular surgeons
What to expect from your appointment
It’s critical to treat aortic disease early to prevent serious emergencies like aortic tears and ruptures. The unique nature of your condition will determine the best treatment plan for you. Our specialized surgeons carefully evaluate your aneurysm or condition to determine when it’s best to move forward with treatment, and when it’s best to wait.
From diagnosis and monitoring to treatment and follow-up, we oversee every aspect of your care. Here's what you can expect before, during and after your first appointment.
Before your appointment: Please ask your provider to send us your medical records, including your medical history, test results and images (such as an echocardiogram, chest X-ray or CT scan). Please send records by fax to 704-372-1249.
During your appointment: You’ll meet with one of our experts, such as a specialized cardiologist, cardiothoracic surgeon or vascular surgeon, who will review your records and medical history, do a physical exam, discuss your test results, and provide you with a comprehensive assessment, including a personalized care plan.
After your appointment: Depending on your specific condition, you may be scheduled for a procedure or a follow-up appointment with additional testing. Your nurse will reach out to you with specific instructions.
Conditions treated
Our center treats diseases affecting any part of your aorta. We specialize in treating:
- Aortic aneurysms, including thoracic aortic aneurysms that occur in the part of the aorta that runs through your chest, and abdominal aortic aneurysms that affect the section of the aorta that runs through your midsection. Aortic aneurysms happen when a section of the aorta – your body’s largest blood vessel – weakens and bulges out. This weakened section is at risk of tearing (aortic dissection) or bursting (aortic rupture), which can lead to life-threatening complications, such as internal bleeding or blocking the blood flow to important parts of your body. Finding and treating an aortic aneurysm early lowers your chances of an aortic tear or rupture.
- Aortic dissection, a tear in the inner layer of your aorta. When blood gets behind the tear, it further separates the aorta’s inner and middle layers, increasing the chances of blocked blood flow, aortic rupture or other complications.
- Aortic rupture, a breaking or bursting of the aorta. This can cause extensive, life-threatening internal bleeding.
- Aortic coarctation, a narrowing of the aorta that causes your heart to work harder to pump blood through the narrowed section. Aortic coarctation is usually something you’re born with, and it can range from mild (slightly narrow) to severe (very narrow).
- Genetic conditions that increase the risk for aortic disease. These include:
- Bicuspid aortic valve disease
- Marfan syndrome
- Loeys-Dietz syndrome
- Ehlers-Danlos syndrome
- Turner syndrome
Aortic disease treatments
Our primary goal is to repair your aortic condition before it leads to emergency complications. Most of the time, we can do this with minimally invasive techniques that allow you to avoid open chest or abdominal surgery.
Aneurysm treatment options include:
- TEVAR, thoracic endovascular aortic repair, which uses a catheter to place a stent (tube) within the thoracic (chest) section of the aorta and seal the aneurysm off from the inside. As a top-5 center for national TEVAR volumes, we offer unmatched expertise.
- EVAR, endovascular aortic repair, which uses a catheter to place a stent (tube) within the abdominal section of the aorta and seal the aneurysm off from the inside. We do more EVAR procedures than any center in the country, meaning more experience and better outcomes for you.
- Open-heart surgery to repair aneurysms when minimally invasive approaches aren’t an option.
- Emergency repair of aortic dissection or rupture through Code Dissection and Code Rupture, which are award-winning care protocols that deliver fast, lifesaving treatment.
- Clinical trials that give you access to minimally invasive repair techniques that aren’t widely available elsewhere.
For other aortic diseases:
- Aortic root replacement, which removes the diseased portion of the aortic root and reconstructs it using a custom-designed synthetic conduit (tube). Your heart’s aortic valve may remain or it can be replaced with a prosthetic valve if needed.
- Ascending aortic replacement, which removes the diseased section of the ascending aorta and reconstructs it with a custom-designed synthetic conduit. If the aortic root or aortic arch also needs replacing or reconstructing, this can be done at the same time.
- Aortic arch reconstruction or replacement, which removes the diseased section of the aortic arch and reconstructs it with a custom-designed synthetic conduit. Our team has deep experience in the complicated circulation management the procedure requires.
- Aortic coarctation repair, which removes the narrowed portion of the aorta and replaces it with an open synthetic conduit. Treatment is delivered either through open surgery or through a catheter inserted through the groin artery and ballooned open to relieve the obstruction.
Research and publications
Clinical trials
We conduct a variety of clinical trials to bring you the latest treatment options – which often aren’t available anywhere else in NC. For instance, we’re 1 of only 2 locations in the country offering the Valiant Mona LSA clinical trial.
Our latest clinical trials include:
- Valiant Mona LSA: The device is being used to treat aneurysms in the descending thoracic aorta of patients who need to have their left subclavian artery (LSA) covered
- GORE-TAG: The GORE® TAG® thoracic branch endoprosthesis is being used to treat aortic arch and descending thoracic aorta lesions
- TAMBE AAA: The GORE EXCLUDER® thoracoabdominal branch endoprosthesis is being used to treat thoracoabdominal and pararenal aortic aneurysms
- TRIOMPHE: The NEXUS™ aortic arch stent graft system is being used to treat thoracic aortic lesions involving the aortic arch with a proximal landing zone
- Relay Pro D: The RelayPro® thoracic stent-graft is being used to treat acute, complicated type B aortic dissection
- Relay Pro T: The RelayPro thoracic stent-graft is being used to treat traumatic injuries of the descending thoracic aorta
Interested in a clinical trial?
Talk to your doctor or call us at 704-355-4794. You can also find information on our cardiology research page. Search for the trial you're interested in by name.
Publications on aortic disease
- Yammine, H., Briggs, C., & Arko, F. R., 3rd (2022). “Transcarotid Artery Revascularization (TCAR) in the Frail.” Annals of Vascular Surgery, 84, 135–136. https://doi.org/10.1016/j.avsg.2022.02.002
- Madjarov, J. M., Katz, M. G., Fazal, S., & Madzharov, S. (2021). “Proximal aortic arch re-dilatation after external aortic wrapping.” JTCVS Techniques, 9, 30–31. https://doi.org/10.1016/j.xjtc.2021.05.026
- "Yammine H, Briggs CS, Stanley GA, Ballast JK, Anderson WE, Nussbaum T, Madjarov J, Frederick JR, Arko FR. Retrograde Type A Dissection After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection. J Vasc Surg. 2019 Jan 1;69(1):24-33. doi: 10.1016/j.jvs.2018.04.047."
- "Yammine H, Krcelic D, Ballast JK, Nussbaum T, Stanley GA, Frederick JR, Arko III FR. Cocaine Abuse is Associated with Worse Outcomes after TEVAR in Patients with Type B Aortic Dissections. J Vasc Surg. 2019 Jul;70(1):60-66. doi: 10.1016/j.jvs.2018.10.061"
- "Ballast J, Frederick J, Arko F. Multidisciplinary Aortic Centers. In: Dieter et al, editors. Diseases of the Aorta. Willowick (OH): Springer Publishing. July 2019."
- "Yammine H, Briggs CS, Stanley GA, Ballast JK, Anderson WE, Nussbaum T, Madjarov J, Frederick JR, Arko FR 3rd. Retrograde type A dissection after thoracic endovascular aortic repair for type B aortic dissection.J Vasc Surg. 2019 Jan;69(1):24-33."
- "Erben Y, Oderich GS, Verhagen HJM, Witsenburg M, van den Hoven AT, Debus ES, Kölbel T, Arko FR 3rd, Torsello GB, Torsello GF, Lawrence PF, Harlander-Locke MP, Bacharach JM, Jordan WD Jr, Eskandari MK, Hagler DJ. Multicenter experience with endovascular treatment of aortic coarctation in adults. J Vasc Surg. 2019 Mar;69(3):671-679"
- "Kashyap VS, Schneider PA, Foteh M, Motaganahalli R, Shah R, Eckstein HH, Henao S, LaMuraglia G, Stoner MC, Melton J, Massop D, Hanover T, Titus J, Moore WS, RodríguezCarvajal R, Malas MB, Arko FR 3rd, Pierce D, Anain P, Oskin T; ROADSTER 2 Investigators*.
- Early Outcomes in the ROADSTER 2 Study of Transcarotid Artery Revascularization in Patients With Significant Carotid Artery Disease. Stroke. 2020 Sep;51(9):2620-2629. doi: 10.1161/STROKEAHA"
- "Halim Yammine, MD, Daniel Krcelic, MD, Jocelyn K. Ballast, BA, William E. Anderson, MS, Tzvi Nussbaum, MD, Charles S. Briggs, MD, Gregory A. Stanley, MD, John R. Frederick, MD, Frank R. Arko, III, MD. Cocaine Abuse is Associated with Worse Outcomes after TEVAR in Patients with Type B Aortic Dissection. J Vasc Surg. 2019 Jul;70(1):60-66. doi: 10.1016/j.jvs.2018.10.061. Epub 2019 Feb 18."
- "Halim Yammine, Jocelyn K. Ballast, Joel Harding ad , Jeko M. Madjarov, Tzvi Nussbaum, Frank R. Arko, III. Evaluation of Dynamic Intimal Flap Movement using IVUS in patients with Type B Aortic Dissections before and after TEVAR. Biomedical Journal of Scientific & Technical Research 2019 Feb 14(2)."
- "Nguyen-Lee JJ, Zubair MM, Chegireddy V, Yammine H, Bennett ME, Lumsden AB, Bechara CF, Bismuth J. Clinical Experience with the Gore Hybrid Vascular Graft in Complex Revascularizations Demonstrates Safety and Efficacy. Ann Vasc Surg. 2020 Jul;66:646-653. doi: 10.1016."
- "H Yammine, JK Ballast, N Poulsen, FR Arko III. EVAR in an asymptomatic COVID-19 positive patient with a symptomatic inflammatory abdominal aortic aneurysm. Journal of Vascular Surgery Cases and Innovative techniques, September 2020."
- "Halim Yammine, MD, Charles S. Briggs, MD, Quantel V. Rolle, MD, John R. Frederick, MD, Eric Skipper, MD, William Downey, MD, Michael J. Rinaldi, MD, Markus D. Scherer, MD, Frank R. Arko, III, MD. Simultaneous Trans-Catheter Aortic Valve Replacement and Endovascular Aortic Aneurysm Repair. J Am Coll Cardiol. 2021 Apr 27;77(16):2156-2157."
- Halim Yammine, MD, Charles Briggs, MD, Frank R Arko III, MD Trans carotid arterial revascularization (TCAR) in the frail Invited commentary, Annals of Vascular Surgery 2022
- "Halim Yammine Treating Calcified PAD with the New Shockwave M5+ IVL Catheter Interview and Case Report Vascular Disease Management July 2022"
Make a referral
When you refer a patient to us, we keep you involved and informed throughout the treatment process.
If you’re a potential patient, a self-referral is only necessary if it’s required by your health insurance provider.
If you’re a physician, medical professional or you need to self-refer, please call 704-373-0212.
Find a provider
We look forward to meeting and caring for you.
Location
Get the region’s highest quality care for aortic disease at Sanger.
Sanger Heart & Vascular Institute
Cardiothoracic Surgery Kenilworth
1237 Harding Place, Suite 4300
Charlotte, NC 28204 (get directions)
Phone: 704-373-0212
Frequently asked questions
The aorta is an artery (type of blood vessel) that runs from the heart down through the chest and abdomen. It’s the largest artery in the body, carrying oxygen-rich blood. Aortic disease refers to a group of medical conditions that impact the aorta, such as an aortic aneurysm.
Aortic disease can be very serious and even life-threatening in some cases.
There are several types of aortic disease, including:
- Abdominal aortic aneurysm
- Aortic aneurysm
- Aortic dissection
- Aortic regurgitation
- Aortic stenosis
- Marfan syndrome
- Thoracic aortic aneurysm and dissection
The severity of the condition depends on the type and extent of the disease.
The causes of aortic disease vary depending on the type of the disease. In some cases, aortic disease may be caused by genetic factors, while in others lifestyle factors or underlying medical conditions may contribute to the development of the disease.
For example, aortic stenosis and regurgitation can be caused by aging, autoimmune disorders, infections or congenital defects (structural or functional abnormalities present at birth).
Pinpointing the underlying cause or causes of the aortic disease is crucial for developing the most effective treatment plan.
The symptoms of aortic disease can vary depending on the type and severity of the disease. Some people with aortic disease may not experience any symptoms at all, while others may experience symptoms that can range from mild to severe.
Some common symptoms of aortic disease include:
- Chest pain or discomfort
- Back pain
- Shortness of breath
- Trouble swallowing
- Hoarseness
- Coughing
- Dizziness or lightheadedness
- Rapid or irregular heartbeat
- Sweating
- Fatigue
Aortic disease can also cause more severe symptoms, like loss of consciousness or sudden severe chest or abdominal pain. Such symptoms may indicate a medical emergency and require immediate attention.
While some factors are beyond your control, here are some actions you can take to prevent aortic disease:
- Control stress. Stress that lasts for several weeks or months (chronic stress) can lead to high blood pressure and other risk factors linked to aortic disease. Finding ways to lower your stress levels, such as through exercise, meditation or talking to a mental health therapist, can help reduce your risk.
- Exercise regularly to help manage blood pressure, cholesterol levels and weight, which are all factors that can contribute to aortic disease.
- Don’t smoke or use tobacco products. Smoking damages blood vessels, including the aorta and increases the risk of plaque building up in the arteries.
- Eat a healthy diet that’s rich in fruits, vegetables, lean protein, healthy fats and whole grains can help prevent high blood pressure, plaque buildup in the arteries and obesity.
- Manage medical conditions. Conditions like high blood pressure, high cholesterol and diabetes can increase the risk of aortic disease. Managing such conditions with medication, lifestyle changes and regular medical checkups can help.
- Get regular medical checkups to help identify risk factors and detect aortic disease early when it’s more treatable.
Your aorta is your body’s largest blood vessel, carrying oxygen-rick blood from your heart to the rest of your body.
When the part of your aorta that runs through your abdomen gets week and bulges out, it’s called an abdominal aortic aneurysm.
If this weak section bursts, it can cause serious internal bleeding and even death.
For information on how to spot the warning signs of an abdominal aortic aneurysm, prevention tips and more, go here.
The time it takes for an aortic aneurysm to rupture (burst) varies depending on factors such as the location, size and underlying medical conditions. Some aneurysms may never rupture, while others can rupture unexpectedly.
Finding and treating an aortic aneurysm early lowers your chances of an aortic rupture or tear.