How should we approach intervention thresholds, repair strategies, and lifelong surveillance in patients with genetic aortopathies? Prof. Sherene Shalhub (Oregon Health & Science University) and Prof. Rana Afifi (McGovern Medical School at UTHealth Houston) discuss the practical challenges, controversies, and unanswered questions that shape decision-making in the management of these complex patients.
Shownotes:
Lian T, Pai CW, Woznicki E, et al. Nonsyndromic familial type B aortic dissection exhibits distinct clinical profiles and operative outcomes. J Vasc Surg. 2026. doi:10.1016/j.jvs.2026.04.022.
MacCarrick G, Afifi RO, Allen R, et al. Loeys-Dietz Syndrome: 2026 updated care management primer. Genet Med. 2026. doi:10.1016/j.gim.2026.102577.
Lian T, Bhandari A, Shalhub S. What Every Vascular Surgeon Should Know About Vascular Ehlers-Danlos Syndrome. Ann Vasc Surg. 2026. doi:10.1016/j.avsg.2026.03.032.
Calderon-Martinez E, Velasco WV, Guo D, et al. Differences in Arterial Events in Vascular Ehlers-Danlos, Loeys-Dietz, and Marfan Syndrome. J Am Coll Cardiol. 2025;85:2355-2367. doi:10.1016/j.jacc.2025.04.023.
Shalhub S. The aortic and arterial vulnerability spectrum: A conceptual biological framework for risk stratification and precision surgical decision-making in aortopathy and arteriopathy. J Vasc Surg. 2025;82:722-739.e4. doi:10.1016/j.jvs.2025.04.028.
Dittman JM, Prakash SK, Gupta PC, et al. Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons. Ann Vasc Surg. 2024;105:140-149. doi:10.1016/j.avsg.2024.01.032.
Shalhub S, Byers PH. Endovascular repair of a common iliac artery aneurysm with an iliac branch device in a patient with vascular Ehlers-Danlos syndrome due to a null COL3A1 variant. J Vasc Surg Cases Innov Tech. 2023;9:101192. doi:10.1016/j.jvscit.2023.101192.
Dittman JM, Saldana-Ruiz N, Newhall K, et al. Open repair of abdominal aortic aneurysms in patients with vascular Ehlers-Danlos syndrome. J Vasc Surg Cases Innov Tech. 2023;9:101194. doi:10.1016/j.jvscit.2023.101194.
Shalhub S, Nkansah R, El-Ghazali A, et al. Splenic artery pathology presentation, operative interventions, and outcomes in 88 patients with vascular Ehlers-Danlos syndrome. J Vasc Surg. 2023;78:394-404. doi:10.1016/j.jvs.2023.04.007.
Regalado ES, Morris SA, Braverman AC, et al. Comparative Risks of Initial Aortic Events Associated With Genetic Thoracic Aortic Disease. J Am Coll Cardiol. 2022;80:857-869. doi:10.1016/j.jacc.2022.05.054.
