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Buffalo General Medical Center
100 High Street
Buffalo, NY 14203

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Aortic Center

The Aortic Center at Buffalo General Medical Center/Gates Vascular Institute is comprised of highly skilled physicians who utilize the most advanced technologies, surgical and procedural approaches to treat aortic conditions and diseases. The Center offers state-of-the-art diagnostics, medical management, surgical and endovascular procedures that have proven to be lifesaving in even the most challenging of cases.

What is the Aorta?

The aorta is the largest artery and carries blood throughout the body. It rises up from the heart at the aortic valve and arches around the heart (descending aorta), with branches coming off to supply blood to the neck, head and arms. The aorta proceeds down through the chest (thoracic aorta), with branches supplying blood throughout the chest, and continues down to the abdomen. The abdominal aorta supplies blood to the major organs before splitting and supplying blood to the lower extremities.

Sometimes, due to genetics, disease or injury, the aorta can become weakened or damaged. An aneurysm for example, makes a portion of the artery balloon out, causing dangerous strain on the artery creating a risk for rupturing. The aorta can also be torn (dissection) or the aortic valve can be narrowed (stenosis) which restricts blood flow through the body.

The Aortic Center's physicians have dedicated their lives and careers to the study, diagnosis, and treatment of aortic diseases and conditions. Our multidisciplinary team in the areas of vascular, cardiothoracic, and interventional cardiology, work side-by-side in one building to provide comprehensive, coordinated care. They also have access to the world-renowned Jacobs Institute where surgeons and interventionalists can create a 3-D rendering of a patient's heart or arteries so the surgeon and interventionalist can better see the details of that patient's aortic anatomy and more appropriately plan their surgery or procedure.

Why Choose Us?

Our physicians have pioneered many aortic procedures in our region and gained national recognition for quality and outcomes, including:

  • The first transcatheter aortic valve replacement (TAVR) in Western New York (2011).
    • Today our TAVR program treats five times more patients than any other hospital in Western New York. Our program's mortality rate is lower than any other hospital in Western New York and more than half the mortality rate of Rochester hospitals.
  • First Center in Western New York to perform endovascular full arch repair
  • Only Center in Western New York with access to the arch branch graft
  • Perform most surgical repairs/replacements of aortic valves in the region (Niagara Falls to Albany) with lowest mortality in the region
  • Ranked by U.S. News & World Report as High Performing for endovascular repair of abdominal aortic aneurysms (EVARs)
  • Ranked by U.S. News & World Report as High Performing for abdominal aortic aneurysm (AAA) repair in consecutive years.

Aortic Diseases and Conditions we Treat

  • Aortic aneurysm
    • Thoracic aortic aneurysm
    • Abdominal aortic aneurysm (AAA)
  • Aortic dissection (tear)  
  • Aortic ulcers
  • Aortic valve stenosis (narrowing)

Diagnostics

  • Angiogram
  • Computed Tomographic Angiography (CTA)
  • Doppler and ultrasound
    • Accredited facility for vascular testing from the Intersocietal Accreditation Commission (IAC)
  • Magnetic resonance angiography
  • Soon to have 4-D CT scanner
  • Variety of cardiac testing

Endovascular and Open Procedures

  • Aortic valve repair/replacement
  • Aortic dissection repair
  • Ascending Aortic repair
  • Thoracic and Abdominal repair
    • Open
    • Endovascular

Medical Treatments (non-surgical)

  • Exercise
  • Healthy diet
  • Medication
  • Smoking Cessation

Clinical Trials

Gore 13-03 Assessment of the GORE® EXCLUDER® Conformable AAA Endoprosthesis in the Treatment of Abdominal Aortic Aneurysms

This study is being done for patients who have an abdominal aortic aneurysm. The purpose of this research study is to assess the safety and effectiveness of the GORE® EXCLUDER® Conformable AAA Endoprosthesis when used for the treatment of Abdominal Aortic Aneurysm. In this research study, the Study Device will be placed inside your abdominal aorta (in the approximate area of the belly button) and the Study Device will extend into both leg arteries. The Study Device will block the aneurysm (the weakened and bulging part of the artery) in the abdominal aorta from blood flow while maintaining blood flow to the arteries in the legs. Information will be collected on the performance of the Study Device for up to five (5) years.

Gore 11-02 Evaluation of the GORE® TAG® Thoracic Branch Endoprosthesis in the treatment of lesions of the aortic arch and descending thoracic aorta (ONLY SITE IN New York State)

This research study will look at treating certain aortic diseases and injuries with a new medical device called the GORE® TAG® Thoracic Branch Endoprosthesis. The conditions being treated are:

  • A bulge in your aortic wall (aneurysm)
  • A tear in your aortic wall (dissection).
  • Bleeding and blood clot within your aortic wall (intramural hematoma).
  • A lesion (wound) or ulcer in your aortic wall.

The reason we are doing this research study is to look at how safe the Study Device is and how well it works to treat your condition. The Study Device that will be used to treat your aortic condition is called a “stent-graft�. This device combines a surgical graft material with an outer metal mesh-like form (stent). The graft part of the Study Device is made of soft plastic material. This material is routinely and safely used for surgical procedures throughout the world today. The graft material has a long history of safe use as a graft in arteries. The graft is surrounded on the outside with a stent made from an elastic metal (nitinol wire) bent into a wave pattern and shaped to fit the graft

Bolton Relay Pro D

A Prospective, Multicenter, Non-Blinded, Non-Randomized Study of the RelayPro Thoracic Stent-Graft in Subjects with an Acute, Complicated Type B Aortic.

This research study is for patients who have been diagnosed with an acute (very sudden onset or rapid change, within 2 weeks), complicated type B aortic dissection (a tear in the inner lining of the aorta or the main artery of the body). An aortic dissection is a potentially life-threatening medical condition resulting from a tear in the inner lining of the aorta, which is the body's main blood vessel that carries blood away from your heart to all parts of your body. The tear causes bleeding between the inner and outer layers of the aortic wall. This results in separation of the layers, creating a false channel for blood flow. This study involves an investigational device. The word “investigational� means it is still being tested and is not approved by the Food and Drug Administration (FDA) for sale in the United States. If you are invited to participate in the study, this is the type of treatment you will receive. A stent-graft is a polyester fabric tube (graft) sewn onto metal springs (stent). In endovascular repair, a patient is given anesthesia (a drug administered for loss of feeling in any part of the body) and an incision is made in the groin area. Through this incision, a stent-graft that is compressed inside a narrow plastic tube called a delivery system is inserted. The delivery system with the stent-graft inside is threaded into the vessels in this area (femoral/iliac artery) and then threaded through the artery until it arrives at the area of the dissection inside the aorta. The plastic sheath on the device is then removed, and the stentgraft opens inside the vessel and creates a new, healthy channel for blood flow. The stent-graft shields the dissection from the healthy aorta and helps guide the flow of blood. It may also help prevent possible rupture; however, because the diseased vessel is not actually replaced, there is a chance of a vessel rupture. Generally, patients who receive this type of repair spend approximately one week in the hospital.

EDWARDS Early TAVR 

For subjects with Aortic Stenosis who are asymptomatic.

The main reason for the study is to determine whether aortic valve replacement is helpful for patients who have severe, calcific, aortic stenosis (a narrowing of the aortic heart valve, where calcium has attached to the valve surface, resulting in obstructed blood flow) and do not have symptoms. This study will evaluate the Edwards transcatheter heart valve (THV) and associated delivery systems. The Edwards SAPIEN 3 THV and its delivery system are not approved for commercial use by the U.S. Food and Drug Administration (FDA) in patients that do not have symptoms of aortic stenosis.

BOSTON SCIENTIFIC-ACURATE-TAVR

Boston Scientific-A prospective, 1:1 randomized controlled trial (ACURATE versus Control [commercially available Sapien 3 or CoreValve] TAVR device).

This study is a research project to assess a way of replacing aortic valves without the need for open-heart surgery and without surgically opening your heart to remove your own narrowed valve. The device under study is called the ACURATE Transfemoral Aortic Valve System. The purpose of this study is to evaluate the safety and effectiveness of the ACURATE Transfemoral Valve System for TAVR in patients with severe native aortic stenosis who are indicated for TAVR. The study will compare the safety and effectiveness of the ACURATE Valve, along with other commercially available TAVR devices (Control Valves). The commercially available devices that would be used as Control Valves in the study are SAPIEN 3™ Transcatheter Heart Valve or future iteration (made by Edwards Lifesciences LLC, Irvine, CA, USA) or CoreValve® Transcatheter Aortic Valve Replacement System, CoreValve® Evolut™ R Recapturable TAVR System, EVOLUT™ PRO System, or future iteration (made by Medtronic, Inc., Dublin, Ireland).

BOSTON SCIENTIFIC

Protected TAVR:Stroke Protection with Sentinel during TAVR

The purpose of this study is to show whether the use of Sentinel significantly reduces the risk of stroke (within 72 hours) after TAVR. Severe aortic valve stenosis is the narrowing of one of the heart's major valve (through which your heart pumps blood to the rest of your body). Severe aortic valve stenosis is caused by stiffening and hardening of the heart valve leaflets (tissue that opens and closes in the heart valve) so that the valve cannot work properly. If left untreated, excessive strain put on the heart muscle will eventually cause it to fail or lead to other serious complications. Sentinel is designed to capture embolic debris (examples include tissue, calcium, blood clot or foreign body material) during TAVR and has the potential to reduce the risk of stroke associated with catheter-based replacement of aortic valves. A TAVR procedure to replace the aortic valve carries risks including the potential for stroke. Research has shown that a majority of stroke risk is attributed to catheters that have the potential to knock debris off vessel walls as they are delivered to the heart. A TAVR procedure to replace the aortic valve carries risks including the potential for stroke. Research has shown that a majority of stroke risk is attributed to catheters that have the potential to knock debris off vessel walls as they are delivered to the heart. 

CLEVELAND CLINIC (Funding BOSTON SCIENTIFIC) - WATCH-TAVR

Randomized to TAVR+medical therapy vs. TAVR+Watchman. Patients with non-valvular A-fib undergoing TAVR will be enrolled in this trial

The purpose of this study is to look at the safety and effectiveness of the WATCHMAN device procedure when it is done in combination (at the same time) with the TAVR procedure. This combined approach will be compared to the TAVR procedure along with medical treatment only for an extended period of time. Subjects will be asked to participate in this research study because they are diagnosed as having atrial fibrillation (AF or AFib) and aortic stenosis (AS) requiring a Transcatheter Aortic Valve Replacement (TAVR).

MEDTRONIC - OPTIMIZE PRO (Post market study)

The purpose of this study is to collect clinical evidence on valve performance and procedural outcomes associated with an “optimizedâ€� TAVR care pathway and using the EvolutTM PRO and EvolutTM PRO+ devices.

The purpose of this study is to learn more about how well this device works and to learn about the effects of following a particular set of steps when treating a patient with the Evolut PRO or EVOLUT PRO+ system. Subject diagnosed with aortic stenosis and will have the EvolutTM PRO device or the EvolutTM Pro+ device used to correct their aortic stenosis. The devices used for this study are FDA approved. This is a data collection study only.