Thoracoabdominal aortic aneurysm (TAAA) surgery has been a formidable challenge facing all cardiothoracic surgeons. Various surgical techniques have been used and scrutinized. Recently, catheter-based interventions, such as endoluminal aortic repair, represent a remarkable paradigm shift in treatment alternatives for vascular disorders. Some of these repairs, referred to as hybrid operations, combine endovascular exclusion of the aneurysmal aorta with open surgical procedures that secure blood flow to the visceral branches. Other repairs use state-of-the-art devices that enable one to take an entirely endovascular approach to aneurysm exclusion and branch artery perfusion.
However, not all descending thoracic aortic aneurysms can be dealt with by endovascular repair. In parallel with the increasing number of surgical options, the variety of clinical scenarios facing aortic surgeons is also expanding. Professor Yan underwent a comprehensive Aortic Surgery Fellowship at the Liverpool Heart and Chest Hospital, the largest Aortic Surgery Centre in the UK, where he was trained primarily on major aortic operations, including descending thoracic aortic and thoracoabdominal aortic surgery. He is appointed as a visiting Professor of Cardiac Surgery at St. Bartolommeo’s Heart Centre in London, where he performs complex aortic surgery abroad three times a year.
Royal Prince Alfred Hospital has the long-standing tradition of a subspecialised team approach for complex clinical conditions. There is a dedicated aortic team, formed by cardiac surgeons, cardiologists, radiologists, anaesthetists and physiotherapists who work closely together and manage patients with complex aortic conditions. Patients are discussed and looked after in this cohesive team environment. This multi-disciplinary team approach offers the best treatment option (open, endovascular vs. hybrid) for each individual patient.