Treating Aortic Disease

Treatment of aortic disease is a progressively evolving field while the natural course of common pathologies (e.g., bicuspid valve associated proximal aneurysm formation and increased risk for acute type A dissection) is still poorly understood, constantly causing controversy amongst experts reflected by contemporary guidelines for proximal aortic pathologies. In the past two decades, surgical strategies have mainly focused on improving neurological outcome in the transverse arch and thoracoabdominal aortic surgery (e.g., favoring antegrade over retrograde selective cerebral perfusion (SCP) or staged cross-clamping to maintain blood flow to the spinal cord in thoracoabdominal aortic aneurysm [TAAA] repair). Endovascular technologies are rapidly evolving and progressively targeting more proximal segments of the aorta. Steadily higher life expectancy and refined imaging technologies led to an increasing awareness of the asymptomatic chronic aortic disease in elderly, often frail patients constituting a need for more conservative treatment strategies.

Aortic surgery always was one of Friedrich Mohr's favorite specialties, and he consequently developed the aortic program at the Leipzig Heart Centre, Germany into a world-renowned reference center for aortic disease, contributing and refining various surgical strategies (e.g., the elephant trunk or the “arch first” technique), creating new solutions (e.g., hybrid arch/descending repair). As a leader in the field, he excelled in strengthening his team with international experts, themed: “Team up experts to provide optimal patient care,” who brought new impulses and ideas contributing to a progressive growth of the program.

Moreover, under his leadership generations of young Leipzig cardiac surgeons have been trained to safely perform aortic operations even during their residency under the guidance of internationally renowned experts in the field.

Since 1994 over 5,500 aortic surgeries have been performed, constituting Leipzig's leading role as one of Germany's largest high-volume aortic centers ([Fig. 1]). Today more than 5% (and rising) of all open aortic repairs in Germany are performed at the Leipzig Heart Center.

Fig. 1 Aortic program at the Leipzig Heart Center and in relation to national numbers.

• References

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