Comprehensive Aortic Program

The CAP delivers comprehensive care to patients with the full spectrum aortic disorders including aneurysm, dissection, connective tissue disorders and occlusive disease. Specific areas for continued advancement in the CAP include:

• New patient evaluation:
  • Comprehensive evaluation for patients with a new diagnosis of an aortic disorder and for patients with chronic aortic disorders or prior aortic procedure. This includes clinical evaluation, imaging, medical optimization, patient education, and discussion of treatment options.
  • Pre-procedure risk stratification via institutional risk algorithms guides discussion of treatment options, associated risks and pre-procedure medical optimization.
• Procedural optimization:
  • Enhanced recovery program for complex endovascular treatment and open aortic disease.
• Return patients:
  • Continued surveillance of aortic disorder with emphasis on patient convenience and clear communication of results.
  • Emphasis on longitudinal medical optimization and patient education.
  • Multidisciplinary engagement of nurse coordinator, social work and psychology with focus on adherence to medical therapy and surveillance program
• Urgent and emergent evaluation and treatment of acute aortic syndromes including ruptured aortic aneurysm and acute aortic dissection via our “Code Aorta” program.
• Genetics evaluation for at-risk patients. Risk assessment of heritable aortic disorders with education, screening and surveillance of family members.
• Remote imaging evaluation for referring physicians: referring physicians within NM are able to “upload” imaging to an NM server (via Ambra) for initial anatomic review and determination if in-person patient evaluation is warranted.

The CAP has a mandate to advance the optimal care and treatment of aortic disorders. This encompasses both understanding the pathophysiology and natural history of aortic disorders, advancing the “technology and techniques” for treatment and understanding the impact of aortic disease and disease treatment for patients and their family/caregivers. We will:

• Participate in multiple clinical trials advancing the minimally invasive treatment of complex aortic disease. This will be in collaboration with industry partners and the BCVI Clinical Trials Unit.
• Advance institutionally sponsored clinical trials advancing the minimally invasive treatment of complex aortic disease.
• Leverage developing translational research infrastructure (tissue biobank) to investigate pathophysiology of aortic disease and potential role for microbiome.
• Utilize EDW and retrospective clinical data review to improve our clinical care processes, optimize collaboration with other specialties and to disseminate our experience.
• Continue to engage with VQI and VISION to leverage large data to expand our understanding of aortic disease, device innovation and appropriate use.
• Expand our qualitative research structures to support of our efforts around patient education and appropriate use.

We apply a holistic approach to the educational endeavors of the CAP acknowledging that patients, physicians, physicians-in-train, nurses, clinical staff and administration can all contribute to the teaching and learning environment of the program.

• Patient-centered care and education is a hallmark of the CAP. This includes disease and procedure education, education related to heritability of aortic disorders, risk stratification education and decision support.
• Expansion of education opportunities will target Northwestern trainees in the Division of Vascular Surgery and the Department of Surgery. In collaboration with the broader NM and NU community, educational opportunities will additionally focus on trainees, staff and faculty in NM and NU departments involved in the treatment of patients with aortic disease.
• Outreach will engage regional clinical providers to advance care quality care delivery to patients with aortic disease. This will focus on perioperative and longitudinal care of patients with aortic disorders.
• Surgeon education within and beyond NM will focus on diagnosis and treatment of aortic disorders, particularly related to advanced endovascular therapy and clinical decision-making.