DR. MARK J. RUSSO, MD, MS

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Aortic Aneurysm Surveillance

What is an aortic aneurysm?

An aortic aneurysm, also known as an enlarged aorta, is an abnormal dilation of the wall of the aorta, that is 50% greater than its normal size.

An aneurysm is a bulging, weakened area in the wall of a blood vessel resulting in an abnormal widening or ballooning greater than 50 percent of the normal diameter (width).

What is the Aortic Aneurysm Surveillance Program?

Aortic Aneurysm Surveillance Program guides patient and their primary physicians regarding the management of known aortic aneurysms including the timing and type of imaging needed.

Why do I need repeat imaging?

Aortic aneurysms grow over time. As the size of the aneurysm grows, the risk of aortic catastrophe–including dissection, rupture, and death related to the aneurysm–increases. Therefore to assess growth and the need for treatment before an aortic catastrophe occurs, repeat imaging is recommended for all patients with aortic aneurysms.

Surgery is generally recommended when the proximal aorta is larger than 5 centimeters. However, depending on other factors, including other vascular conditions or the need for additional surgery (particularly heart surgery), this threshold varies with individual patients.

How do I prepare for my appointment?

Prior to your appointment, it is important that you provide us with your most recent medical information. We will review all of the materials in advance to ensure that your visit will occur without unnecessary delays. If you have had an echocardiogram, CT scan, MRI, and/or a cardiac catheterization, please provide us with a copy of the report as well as the actual images–which is usually provided a CD.

What are the risks of an aortic aneurysm?

 

The most feared complications related to aortic aneurysms include aorta dissection and/or rupture of the aorta. These are life-threatening conditions and may even lead to sudden death. In general, the larger the aneurysm, the greater the risk of dissection and rupture.

 

Most people with aortic aneurysms experience no symptoms.  Most often, their aortic condition is discovered incidentally while being tested for other reasons.

How frequently do I need aortic imaging ?

The type and frequency of imaging depends a number of factors including:

  • size of the aneurysm
  • type and location of the aneurysm
  • the presence or absence of recent changes
  • family history of aortic and heart disease
  • history of connective tissue disease

 

Dr. Russo and his team will provide recommendations based on objective evidence regarding expected future growth and risks.

Who can benefit from this program?

While some people with aortic aneurysms need treatment immediately when an aortic aneurysm is detected, more frequently patients may not require treatment for months or even years. Those who do not require immediate treatment will need regular surveillance, including imaging of the aorta and follow-up with an aortic specialist.

To schedule an in-person or telemedicine consultation with Dr. Russo,
please call 732-235-7231 or send an email.

Commonly Performed Procedures

Minimally invasive valve surgery is a specialized approach to treating heart valve disease that avoids the need to “crack the chest.” This method uses sophisticated instruments to perform the surgery through a smaller incision at the side of the chest and offers the patients less pain and faster recovery. We perform nearly all of our isolated valve surgeries minimally invasively.

An aortic aneurysm is a bulging, weakened area in the wall of main blood vessel in the body. The risk of aortic catastrophe, including dissection and rupture, increases dramatically with an aneurysm. Surgery may be recommended when the aorta is larger than 4.5-6 cms. Factors including family history, lifestyle, and need for other heart surgery guide decisions about surgery.​​

An aortic aneurysm is a bulging, weakened area in the wall of main blood vessel in the body. The risk of aortic catastrophe, including dissection and rupture, increases dramatically with an aneurysm. Surgery may be recommended when the aorta is larger than 4.5-6 cms. Factors including family history, lifestyle, and need for other heart surgery guide decisions about surgery.​​


A “bypass” or “cabg” surgery is the most commonly performed heart surgery. It is necessary when the coronary arteries, which provide blood to the heart become narrow preventing sufficient blood from passing through, and thus depriving the heart of oxygen and nutrients. RWJUH has CABG outcomes that exceed national benchmarks.

When other treatments are insufficient, a heart transplant is a surgical procedure offered to patients with the most severe damage to the heart. RWJUH is one of a limited number of centers in the US that offer advance heart failure surgery, including heart transplant. Dr. Russo has participated in 500+ successful transplant surgeries.

When other treatments are insufficient, a heart transplant is a surgical procedure offered to patients with the most severe damage to the heart. RWJUH is one of a limited number of centers in the US that offer advance heart failure surgery, including heart transplant. Dr. Russo has participated in 500+ successful transplant surgeries.

Clinical Trials at RWJUH

Transcatheter aortic valve replacement vs OMM (randomized) for asymptomatic severe AS The EARLY TAVR trial (Edwards) looks at transcatheter aortic valve replacement (TAVR) as an effective treatment for patients with asymptomatic aortic stenosis. Patients are randomized to either treatment with TAVR or clinical surveillance until the develop symptoms, at which point they are eligible to be treated with TAVR.  Read More

This study objective is to establish the safety and effectiveness of the Edwards SAPIEN 3/ SAPIEN 3 Ultra Transcatheter Heart Valve in subjects with moderate, calcific aortic stenosis. Patients are randomized to S3 TAVR device or medical management.  Read More

ALIGN-AR evaluates the safety and probable benefit of the transfemoral JenaValve Pericardial TAVR System in patients with symptomatic severe aortic regurgitation. Patients who are high risk for open surgical aortic valve replacement/repair are eligible. RWJUH is one of only 15 centers in the U.S. that can offer this therapy that has been granted a “Breakthrough Device Designation” by the US Food and Drug Administration. This designation is reserved for investigative therapies designed to treat a serious or life-threatening disease or condition and where preliminary clinical evidence indicates that the therapy may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development.

Transcatheter aortic valve replacement for severe AS with a novel deviceEvaluates the safety and efficacy of Acurate (Boston Scientific) valve for transcatheter aortic valve replacement. For patients with severe aortic stenosis who are at intermediate or greater risk for SAVR. Patients are randomized to Acurate or commerical TAVR device. Read More

The study is a prospective, multi-center, randomized controlled pivotal clinical trial to evaluate the safety and effectiveness of the EVOQUE System with optimal medical therapy (OMT) compared to OMT alone in the treatment of patients with at least severe tricuspid regurgitation. Subjects will be followed at discharge, 30 days, 3 months, 6 months and annually through 5 years.

This study will establish the safety and effectiveness of the SAPIEN M3 System in subjects with symptomatic, at least 3+ mitral regurgitation (MR) for whom commercially available surgical or transcatheter treatment options are deemed unsuitable.

The SUMMIT-Tendyne trial (Abbott) evaluates the safety and effectiveness of using the Tendyne Mitral Valve System for the treatment of symptomatic mitral regurgitation or mitral annular calcification in patients who are not appropriate for conventional mitral valve surgery. In the randomized arm, patients are treated with either the Tendyne device or MitraClip, while patients in the non-randomized and MAC arms receive the Tendyne device.
https://clinicaltrials.gov/ct2/show/NCT03433274

CLASP IID/F is a prospective, multicenter, randomized, controlled pivotal trial to evaluate the safety and effectiveness of transcatheter mitral valve repair in patients with degenerative/functional mitral regurgitation with the Edwards PASCAL Transcatheter Valve Repair System compared with the commercially available device (Abbott MitraClip).

RESTORE is a prospective, multicenter, non-randomized trial designed to evaluate the safety and effectiveness of the HARPOON™ Beating Heart Mitral Valve Repair System in patients with severe degenerative mitral regurgitation (DMR).

PBS: Heart Disease OnCall

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Newest heart valve options

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Miracle transplant at RWJUH

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