Julius H. Jacobson Complex Aortic Disease Center

Aortic disease is one of the more dangerous medical conditions you can have, if left untreated. Fortunately, treatment advances for these conditions are growing rapidly. The Julius H. Jacobson Complex Aortic Disease Center, under the leadership of James F. McKinsey, MD, and Michael Marin, MD, is leading the way.

We are advancing research and treatment of this disorder by bringing together experts in various disciplines. Our vascular surgeons, cardiothoracic surgeons, cardiologists, primary care doctors, hypertension specialists, and pathologists work as a team to develop the best possible treatment plan for you.  

The Center was established in 2016, thanks to the generous support from Julius H. Jacobson, MD. Dr. Jacobson has devoted over 35 years to the treatment and management of vascular disease by bringing together the most accomplished physicians in field to provide superior patient care and educate the public and medical community about these serious conditions.

What is Aortic Disease?

Often, people with aortic disease do not experience any symptoms. We often find the condition during a routine physical exam or an imaging test for some other purpose. If you do experience symptoms, the first signs of trouble may be severe back or abdominal pain. The good news is that when we diagnose aortic disease before it reaches the “crisis stage,” we can usually treat it successfully. Aortic disease is one of the few issues in vascular surgery that we can address before you feel symptoms.

The aorta is the main blood vessel that carries blood from your heart to the rest of your body. Shaped like a candy cane, it starts in the heart, goes up towards the neck then goes down through the chest into the abdomen, where it splits into two smaller arteries going to the legs. Along the way, it connects with smaller blood vessels that bring blood to your kidneys, liver, bowels, and all your muscles.

The types of complex aortic conditions we treat are:

  • Aneurysm occurs when part of the artery wall becomes weak, bulges out, and threatens to rupture or break.
  • Dissection happens when there is a tear in the inner layer of the aorta, allowing blood to flow into the middle and/or outer layers, threatening to rupture or block off the vessels going to your vital organs or legs.
  • Occlusion is when the blood flow is blocked in the aorta, which keeps the areas of the body below the blockage from getting enough blood and oxygen to survive.

How We Treat Aortic Disease

Mount Sinai’s Center uses the latest in stent grafting or, if more appropriate, open surgical repair, to treat aortic disease. Stent grafts are tubes made of fabric and metal mesh designed to fit inside the artery and reline the diseased aortic segment. This allows the blood to travel through that segment while dramatically decreasing the risk of catastrophic aortic rupture. We use a minimally invasive approach to inserting stent grafts. This means, we use a small incision at the groin area to insert the stent and thread it through the artery until it reaches the spot we’re worried about.

In addition, our vascular surgeons have two investigational device exemptions (IDEs), granted by the U.S. Food and Drug Administration, for managing complex aortic aneurysms. An IDE allows us to use the very latest types of stent grafts for patients who would benefit from the technology, as part of a larger study of safety and effectiveness.

These innovative technologies help us repair the injured aorta even where critical branches to vital organs come off the aorta. In the past, these types of aortic weaknesses have required major surgery involving incisions in the chest and abdomen. We use highly sophisticated stent grafts that are designed to fit into a precise spot in the artery. Our innovations include small holes (called fenestrations) and branches to allow blood flow to continue to critical organs.

We are using the most novel approaches to treating aneurysms, dissections, and occlusion. By using 3-D imaging and time-of-flight sensors and stent grafts, we use minimally invasive approaches to maintain blood flow to vital vessels.

Why We Choose Minimally Invasive Procedures

In the past, we have had to treat aortic disease using open surgery, often with an incision that ran the length of the chest into the abdomen and down to the groin. Stent grafts allow us to treat you with minimally invasive techniques. We make only one or two small incisions in the groin area and possibly a third small incision below the collar bone. This approach makes it easier for you in several ways, offering:

  • Shorter hospital time
  • Quicker recovery
  • Lower complication rate
  • Less pain
  • Less scarring
  • One procedure rather than several

The disadvantages are that we might need to “tune-up” the stent graft after the initial procedure with a balloon or a small tent graft over time. Most people, however, do well after the first procedure.

Goals of the Center

The goals of the physicians of the Jacobson Complex Aortic Disease Center are to:

  • Effectively diagnose and treat aortic disease in the least traumatic method possible
  • Research the genetic components of aortic disease to try to find and treat problems before they become emergencies
  • Conduct clinical trials to develop breakthrough advances in treatment technology
  • Educate vascular surgeons on these new techniques
  • Educate our patients and their families about what aortic disease is and the treatment options.