Emory Heart & Vascular

In December 2021, Thaddeus’ case started with a trip to the emergency department at Emory University Hospital with severe back pain. Initial imaging revealed a dissection in the inner wall of the aorta, necessitating immediate intervention due to uncontrolled hypertension. Brad Leshnower, MD, director of thoracic aortic surgery and co-director of the Emory aortic program, is one of only about 10 heart surgeons in the U.S. with specialized training in both open and endovascular aortic surgery. This dual expertise allows him to tailor the best treatment approach for each patient. In Thaddeus’ case, he opted for an endovascular approach, placing a stent graft to reinforce the weakened aortic segment, allowing Thaddeus to be discharged after a brief recovery period.

A Second Surgical Intervention

Ten days post-discharge, Thaddeus returned with recurrent symptoms. Imaging indicated further deterioration of the aorta, suggesting an underlying genetic disorder. Marfan syndrome was suspected due to the connective tissue involvement. The stent was intact, but the aorta's structural integrity was compromised.

Given the progressive nature of the aortic disintegration, Dr. Leshnower performed an open surgery to remove the stent graft and replace the diseased aortic segment with a synthetic graft. Thaddeus's recovery was complicated by his renal condition, requiring careful management of his blood pressure and dialysis needs.

Fixing the Problem Once and For All

While recovering, Thaddeus experienced acute internal bleeding. Rapid intervention was necessary, and within 15 minutes, he was prepared for surgery. Dr. Leshnower opened Thaddeus's chest cavity and removed two liters of blood and assessed the graft and native aorta. The decision was made to replace the ascending aorta and aortic arch, a complex procedure due to the critical blood supply these structures provide to the brain.

The surgery was successful, and Thaddeus spent several months in recovery. Genetic testing confirmed Marfan syndrome, and ongoing management includes regular monitoring by Dr. Leshnower and his team at Emory Heart & Vascular. Thaddeus continues to manage his end-stage renal disease with thrice-weekly dialysis and has adapted his lifestyle to accommodate his medical needs.

The Emory aortic team is a multidisciplinary team of cardiac and vascular surgeons, adult and pediatric cardiologists, radiologists, geneticists, and nurse practitioners. Patients with aortic disease are treated at multiple hospitals within Emory Healthcare. We lead the way in innovation when it comes to improving the quality of life of patients with life-threatening conditions.

Emory is uniquely qualified to provide these services thanks to extensive expertise in complex aortic surgery, including minimally-invasive interventions, open traditional and hybrid interventions. Our aortic team performs more than 750 aortic procedures annually.

What makes Emory aortic care unique:

• Unique collaboration between vascular surgery and cardiac surgery to provide patients with the best outcome.
• Early access to new devices through industry-sponsored clinical trials. We are approached by the industry about these trials early due to our extensive experience and academic reputation. Other community centers and low-volume academic medical centers do not get access to these devices.
• Excellent surgical outcomes historically due to our careful selection of patients for different treatment strategies. We provide long term care for these patients for their lifelong conditions.