A Multidisciplinary Aortopathy Clinic: The McGill Experience.

BACKGROUND

Guidelines recommend that patients with thoracic aortic disease (TAD) be seen in a multidisciplinary aortopathy clinic, because of their complex and high-risk profile. However, reports on such clinics are limited.

METHODS

From September 2016 to May 2024, we evaluated 567 patients with TAD. They were seen by our multidisciplinary team, which is comprised of 1 cardiac surgeon, 2 vascular surgeons, 1 cardiologist, 1 cardiothoracic radiologist, a team of 4 engineering researchers, a dedicated member from the genetics department, and an administrative assistant. For patients who had computed tomography or magnetic resonance imaging performed outside our institution, image reanalysis was conducted by our cardiothoracic radiologist. Genetic testing was performed for patients with suspected hereditary TADs.

RESULTS

Reanalysis of external computed tomography and/or magnetic resonance imaging by our radiologist altered clinical decision-making in 5 of 51 cases (9.8%). Genetic testing that examined 25 genes associated with Marfan syndrome and related aortopathies was conducted on 250 patients, revealing a positive TAD gene in 32 (12.8%), a variant of unknown significance in 99 (39.6%), and a negative result in 119 (47.6%). Forty patients (7%) had surgery within a median of 2.7 months (quartile 1-quartile 3: 1.1-4.9) from their initial clinic visit.

CONCLUSIONS

Our 8-year experience at the aortopathy clinic of McGill University demonstrates that a multidisciplinary approach to TAD can deliver complete, precise, and timely care to this complex patient population.