Aortic Disease Treatments and Procedures

The University of Michigan Health Frankel Cardiovascular Center is nationally ranked for cardiology and heart surgery by U.S. News & World Report. This ranking reflects our exceptional cardiovascular surgeons and surgical teams.

Our Comprehensive Aortic Program at the Frankel Cardiovascular Center offers a wide range of treatment options for aortic disease. Many patients come to us for procedures that are not available elsewhere. Others choose us because they want to receive care at one of the top institutions in the country.

Why Choose Us to Treat Aortic Conditions?

Highlights of our Comprehensive Aortic Program include:

  • High performance ratings: Our program received a “high performing” rating (the highest possible) from U.S. News & World Report for abdominal aortic aneurysm repair and aortic valve surgery.
  • High volumes: Our surgeons perform the most aortic surgeries done annually anywhere in Michigan.
  • Innovative procedures: Our team is known for developing new aortic disease procedures that offer patients better results than standard procedures. For example, we have received global recognition for a procedure we developed called Y-incision/rectangular patch aortic root enlargement. (Learn more about this under "Open Aortic Valve Surgery" below.)
  • Specialized surgeons: We have Michigan’s largest team of skilled surgeons who specialize in aortic disease. Their specialization leads to better survival rates and lower hospital readmissions for our patients.
  • Clinical trials: We participate in numerous clinical trials involving aortic conditions.
  • Experience with repeat aortic procedures: Our surgeons have extensive experience with patients who had previous heart or aortic procedures and need additional treatment.

Nonsurgical Treatments for Aortic Diseases

We determine the most appropriate treatment approach for each patient based on:

  • Age and overall health
  • Current and expected disease progression
  • History and success of previous treatments and therapies
  • Symptoms
  • Your preference

In some cases, surgery is not always the best treatment for patients with aortic conditions. Your doctor may recommend medication and lifestyle changes. Our team coordinates with your cardiologist to monitor you closely.

Learn more about the aortic conditions we treat.

Aortic Valve Treatments and Procedures

Aortic valves can be replaced or repaired. In patients who have aortic valve stenosis, replacement is usually the only option. If the valve is leaking, it can be repaired or replaced.

The types of valves used in aortic valve replacement include:

  • Mechanical aortic valves: These are long-lasting, but they require you to take blood thinners for the rest of your life to prevent blood clots.
  • Tissue aortic valves: Made of animal or human tissue, these valves don’t require you to take blood thinners. The tradeoff is that they don’t last as long as mechanical valves and may need to be replaced.

In general, surgeons prefer aortic valve repair over replacement, especially in younger patients. Your surgeon will discuss your options and recommend the optimal procedure and valve type for you.

At the Frankel Cardiovascular Center, our surgeons perform all types of aortic valve repair and replacement, including:

Transcatheter Aortic Valve Replacement (TAVR)

TAVR is a minimally invasive procedure for patients with aortic stenosis. Our surgeons insert a tissue valve inside the diseased valve. The replacement valve expands in place, where it immediately takes over valve function.

Patients recover quicker with TAVR than with an open, invasive procedure. The risk of postoperative infection is also lower. Find out more about TAVR.

Open Aortic Valve Surgery

Open aortic valve procedures require direct access to the heart. Procedures available to patients at the Frankel Cardiovascular Center include:

Aortic valve repair or replacement: If you have a leaking valve, repair allows you to keep your valve, which may improve long-term outcomes. If repair is not possible, the valve can be replaced with a mechanical or tissue valve.

Ross procedure: This is a complex procedure in which your diseased aortic valve is replaced with your pulmonary valve (one of the other four heart valves). A valve from a human donor or animal tissue is attached in place of the removed pulmonary valve. The Ross procedure is most often performed on younger patients. Read more about the Ross procedure.

Y-incision/rectangular patch aortic root enlargement: This procedure developed at the Frankel Cardiovascular Center offers excellent outcomes for people who need a new aortic valve. The cardiac surgeon enlarges the aortic root and inserts a prosthetic valve that is three to four valve sizes larger. The large valve results in improved blood flow, quality of life and long-term survival.

Prosthetic valves last about 8-10 years. Because the new valve is so large, you can have a minimally invasive TAVR procedure if you need to have the valve replaced again.

Aortic Aneurysm and Dissection Treatments and Procedures

Our aortic surgical teams perform a wide range of aortic procedures, including:

Minimally Invasive Aortic Procedures (TEVAR, EVAR, and FEVAR)

We offer minimally invasive procedures to fix areas of the aorta damaged by aortic aneurysm or dissection. Using a catheter (thin tube) inserted into an artery, surgeons fit a stent graft inside the affected area. Made of metal mesh covered by fabric, stent grafts provide reinforcement and long-lasting support.

Minimally invasive procedures target different parts of the aorta. Procedures include:

  • Thoracic endovascular aortic repair (TEVAR): This procedure repairs aortic aneurysms and dissections that occur in the chest. Learn more about TEVAR.
  • Endovascular aortic repair (EVAR) and fenestrated endovascular repair (FEVAR): Both procedures repair abdominal aorta aneurysms and dissections. EVAR uses standard stent grafts. FEVAR uses stent grafts with holes, or fenestrations, that are fitted so they line up with the arteries that branch off the aorta. The holes allow blood to continue to flow to these areas. FEVAR stent grafts can be customized based on a patient’s anatomy and the location of the aneurysm or dissection. See more about EVAR and FEVAR.

Open Aortic Surgery

Our surgeons frequently perform some of the most challenging aortic procedures. In some cases, we have developed new techniques and refined existing ones to give patients the best possible treatment options. Examples of these leading-edge procedures include:

Aortic arch replacement: Aneurysms and dissections involving the arch can be challenging to repair because of the arteries that branch off to the head. Our team uses a technique that temporarily cools the body to suspend blood flow while preserving brain function and preventing stroke. The technique is called hypothermic circulatory arrest

David procedure (valve-sparing aortic root replacement): Sometimes, when an aneurysm or dissection occurs near the root, our surgeon replaces the root and, possibly, the ascending aorta with a graft. But the healthy aortic valve is reimplanted. Our surgeons spare your valve when possible because it is more resilient and resistant to infection. Also, by keeping your own valve, you won’t have to take blood thinners for the rest of your life.

Laser-assisted treatment in dissection: When dissections occur, they may block blood flow to the branching arteries. This is called malperfusion syndrome. Our specialists use a laser inserted through a catheter to make holes (fenestrations) in the blockage and restore blood flow. Our team can then repair the dissection. This procedure was developed at University of Michigan Health and is known worldwide. It greatly improves survival in patients with life-threatening dissections.

Repair of the descending thoracic aorta: Open repair of a thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) is one the most complex operations surgeons do. The surgeon removes the damaged part of the aorta and replaces it with a graft. Repairs in the descending thoracic aorta can cause postoperative pain. Our surgeons use a special cryoablation procedure to freeze the nerves and reduce pain. This allows patients to go home without any narcotic pain medications.

Hybrid Aortic Procedures

Hybrid procedures combine open and minimally invasive procedures, allowing our surgeons to personalize treatments. They are especially useful when an aortic condition affects multiple areas. In this case, we can minimize the invasiveness of the overall surgery by treating one area with a catheter from a smaller opening elsewhere.

Aortic Disease Treatment: What to Expect From Our Team

When you visit the Frankel Cardiovascular Center, you can expect:

  • A nationally renowned surgeon with years of experience to lead your surgery and follow up with you afterward
  • Your nurse care coordinator to serve as your main point of contact and liaison to your surgical team
  • A personalized treatment plan, based on your input and in consultation with an extensive evaluation team
  • One-on-one education and guidance from our doctors, nurse practitioners and nurse care coordinators
  • Access to the aortic call center that connects you to our team 24/7
  • A referral for home care services to help us ensure you do well after you go home

Make an Appointment

To schedule an evaluation with a Frankel Cardiovascular Center physician, call 888-287-1082. Or visit the Make a Cardiovascular Appointment page to learn what to expect when you call us.

Physicians: To refer a patient, call M-Line at 800-962-3555.