New Devices, New Leadership, New Era

When Edward Woo, MD, took over the leadership of MedStar Heart & Vascular Institute’s (MHVI) vascular surgery department in 2013, he and Cardiac Surgeon Christian Shults, MD, created the Complex Aortic Center—a unique multidisciplinary approach to the diagnosis and treatment of a host of aortic pathologies. From the outset, the program brought together the talents of both cardiac and vascular surgeons.

The program has since grown to encompass a team of surgeons trained to perform the growing number of endo-vascular approaches that feature unique technology and techniques, including hybrid procedures that combine open and minimally invasive procedures.

Dr. Woo has recently recruited a national star to serve alongside Dr. Shults. “While I will still be actively involved, Dr. Javairiah Fatima will now co-direct the Complex Aortic Center,” says Dr. Woo.

Javairiah Fatima, MD, who joined the team in fall 2019, comes to MHVI from the University of Florida College of Medicine, where she was an assistant professor of vascular surgery and endovascular therapy.

“Dr. Fatima has a stellar reputation and a unique set of skills,” Dr. Woo notes. “She enhances an already strong program with capabilities not available elsewhere in the region.”

“The aortic disease program at MHVI is excellent, and I’m delighted to join the team,” Dr. Fatima says. “The complexities of the aortic anatomy require the skills of both vascular and cardiac surgeons. We bring different approaches, knowledge, and skills to the table that are critical to the treatment of aortic disease.”

Distinguished Clinical Research

In addition to her clinical excellence, Dr. Fatima brings exceptional clinical research expertise.

“Endovascular surgery is still evolving, and continued research is critical to develop devices and cutting-edge technology that can treat the aorta in its entirety with this minimally invasive approach,” Dr. Fatima says. “I have served as principal investigator for a number of aortic clinical trials geared towards this goal.”

Dr. Fatima is one of just a handful of vascular surgeons, and the only female vascular surgeon in the country, who has an approved Investigational Device Exemption (IDE) to study the use of fenestrated endovascular repair of aortic aneurysms in the thoracoabdominal aorta, as well as aneurysms secondary to aortic dissections.

This research joins a number of ongoing investigations at MHVI using innovative technology for endovascular treatment of aortic pathology.

Dr. Shults serves as principal investigator for the Relay Pro® FDA Phase II clinical trial assessing the safety and efficacy of a new aortic stent system for repair of acute complicated Type B thoracic aortic dissections. The study is underway at 22 sites across the country.

“We are also studying the efficacy of the GORE® TAG® Thoracic Branch Endoprosthesis in treating lesions of the aortic arch and descending thoracic aorta,” Dr. Shults adds. There are many other devices in the pipeline, and the aortic program is uniquely positioned to implement and evaluate these new technologies, broadening the scope of patients treated with endovascular procedures.

Lifetime of Individualized Care

“At MHVI, we are pushing boundaries of technology and using it to treat very complex disorders,” Dr. Shults notes. “Because we are a regional referral center, we tend to see the more critically ill patients with complex dissections or transections.”

In these kinds of emergency, practiced hands are crucial— as is speed of diagnosis and treatment. To expedite these cases, members of the aortic program team are on call 24/7, supported by online image sharing. Patients can be transferred by air or ground by MedSTAR Transport from hospitals across the region.

No matter the patient’s clinical issue, treatment decision-making frequently means a discussion between cardiac and vascular surgeon.

“It’s all about looking at individual patients and determining their best option. We consider age, anatomy, disease location, and extent of disease, and take the least invasive approach possible,” says Dr. Shults.

When surgery is the best treatment option, vascular and cardiac surgeons will often work together in the OR, or will operate in sequence, as sometimes a patient’s treatment requires both endovascular and open surgical procedures.

“Aortic disease is not a single event. Patients who have had one aneurysm are at risk for another at any point along the aorta,” Dr. Shults explains. “They will require life-long surveillance and medical management by an expert team with not just cardiac and vascular surgeons, but nurse practitioners, radiologists, and interventional cardiologists, as well. We are in a lifetime partnership with our patients and their referring cardiologists.”

“In order to provide patients the best care possible, I believe a collaborative, multidisciplinary team approach is essential and crucial to success,” says Dr. Fatima. (l to r) Complex Aortic Center Co-Directors Christian Shults, MD, and Javairiah Fatima, MD

MHVI is a 24/7 referral center for emergent, urgent, and elective evaluation and treatment of complex aortic disease. Our helicopter and ground transport systems provide expedited access to care, regardless of patient location. We accept all transfers.

We offer expertise for complex repairs, specializing in minimally invasive and hybrid techniques. To refer a patient and arrange for 24/7 transfer, call: 800-824-6814. Cases may include:

  • Aortic dissections
  • Aneurysms
  • Occlusions
  • Penetrating ulcers
  • Intramural hematoma
  • Other aortic pathology