MyCareQuestions Clinicians
Alessia Rossi, MD, MBSS
Essex Cardiothoracic Centre, London Bridge Hospital- HCA, The Wellington Hospital- HCA
Ishtiaq Ahmed, BSc (Hons) MBChB PhD FRCS (C-Th)
Royal Sussex County Hospital, London Bridge Hospital, Versorium Clinic Sussex
David Rose, MD, MBBS, PhD
Spire Manchester Hospital, Circle Health Group, Alexandra Hospital Manchester, Lancashire Cardiac Centre, Blackpool Victoria HospitalWhat is an Aortic Surgeon?
An aortic surgeon is a cardiac surgeon who specialises in disease of the aorta in the chest, especially the aortic root, ascending aorta and aortic arch. Patients often search for terms such as enlarged aorta surgeon, aortic aneurysm surgeon, aortic root surgeon, or aortic dissection specialist. In practice, these searches usually point to the same type of specialist.
Many people are referred after an echocardiogram, CT scan or MRI shows that the aorta is wider than it should be. Others are referred because they have a bicuspid aortic valve, a family history of aneurysm or dissection, Marfan syndrome, Loeys-Dietz syndrome, or another inherited aortic condition. Some patients need urgent treatment, but many need careful monitoring before surgery is advised.
The surgeon’s job is not simply to operate. Aortic care is often about timing, judging risk, and choosing the safest operation for the exact problem. Patients usually want to know how large the aorta is, how quickly it is changing, whether the aortic valve is involved, whether the valve can be preserved, and whether surgery is safer than continued surveillance.
Table of Contents
Ready for Your Specialist Consultation?
Generate a personalized, clinical summary PDF to guide your next doctor's visit.
Common conditions treated by an Aortic Surgeon
Ascending aortic aneurysm: this is an enlargement of the first part of the aorta above the heart. If it keeps growing, the wall can weaken and the risk of tearing or rupture rises.
Aortic root aneurysm: the aortic root is the part of the aorta attached to the heart and the aortic valve. When this area enlarges, it can affect both the artery and the valve at the same time.
Aortic arch aneurysm: some patients have disease in the curved part of the aorta higher up in the chest. These cases are more specialised and are usually best assessed in an experienced aortic centre.
Aortic dissection: an aortic dissection is a tear within the wall of the aorta. Acute dissections are life-threatening emergencies, while chronic dissections may later need planned surgery or specialist follow-up.
Bicuspid aortic valve with aortopathy: some people are born with an aortic valve that has two leaflets instead of three. This can be linked with enlargement of the ascending aorta or root, so the valve and aorta often need to be assessed together.
Inherited or family aortic disease: conditions such as Marfan syndrome, Loeys-Dietz syndrome, or a strong family history of aneurysm or dissection can increase lifetime risk. These patients often need earlier specialist follow-up and family screening.
Aortic regurgitation linked to root disease: if the root enlarges, the aortic valve may stop closing properly and begin to leak. In that situation, surgery may need to address both the aorta and the valve.
Common procedures and treatments
Ascending aorta replacement: the enlarged or damaged section of the ascending aorta is replaced with a surgical graft. The aim is to prevent rupture or dissection before it happens.
Valve-sparing aortic root replacement: if the patient’s own aortic valve is still healthy enough, the surgeon may keep the valve while replacing the enlarged root. Patients often search for this as David procedure or valve-sparing root surgery.
Bentall procedure: this operation replaces the aortic valve, the aortic root and the ascending aorta together using a combined graft and valve. It is often used when both the valve and the root are diseased.
Aortic arch surgery: some patients need surgery extending into the arch. This is more complex surgery and is usually best carried out in a centre with strong aortic experience.
Hybrid or endovascular treatment: selected patients may need a stent graft or a combined procedure planned with vascular or endovascular specialists, particularly when the disease extends beyond the root or ascending aorta.
CT, MRI and echocardiogram surveillance: not every patient needs immediate surgery. Regular imaging is a key part of treatment because timing depends on size, growth, valve function, symptoms and the wider clinical picture.
When should you see an Aortic Surgeon?
You should see an aortic surgeon if you have been told you have an enlarged aorta, ascending aortic aneurysm, aortic root enlargement, aortic arch aneurysm, bicuspid aortic valve with aortic dilatation, or an aortic dissection that needs specialist follow-up. A referral is also sensible if you have a strong family history of aortic aneurysm, dissection or unexplained sudden death.
Seek urgent medical help for sudden severe chest pain, upper back pain, tearing pain, collapse, fainting, shortness of breath, or stroke-like symptoms. These can be warning signs of an acute aortic dissection or another serious heart and aortic emergency and should not wait for a routine clinic appointment.
For planned care, the common reasons for referral are increasing aortic size, faster growth on repeat scans, new valve leakage, symptoms that suggest the heart is under strain, or uncertainty about whether watchful waiting is still the safest option.
A specialist opinion is often most useful before a dissection or long-standing valve leakage has caused further harm. Early referral can help you understand timing, risks and options while surgery is still planned rather than emergency.
What to expect at your first appointment
Your first consultation is usually about understanding exactly which part of the aorta is affected and how serious it is. The surgeon will review your echocardiogram, CT scans and MRI scans carefully, and will often compare the measurements over time rather than looking at one scan in isolation.
Bring any scan reports you have, a list of your medicines, details of previous heart operations or procedures, and any family history of aneurysm, dissection or sudden death. Blood pressure history is also very useful because controlling blood pressure is a key part of aortic care.
The discussion will usually cover four practical questions: what part of the aorta is involved, whether the aortic valve is involved too, whether surgery is needed now or later, and what type of operation would be most suitable if treatment is recommended.
If surgery is being considered, the surgeon should explain whether your own valve could be preserved, how major the operation is likely to be, what recovery may involve, and what warning symptoms mean you should seek urgent help while waiting.
Top 5 questions to ask your Aortic Surgeon
How large is my aorta now, and how quickly has it changed over time?
Why you should ask this:
Which part of the aorta is affected – the root, ascending aorta, arch, or more than one area?
Why you should ask this:
Is my aortic valve involved as well, and could it be preserved if I need surgery?
Why you should ask this:
What operation do you recommend for me, and why is that the best fit for my anatomy and risk?
Why you should ask this:
What symptoms mean I should seek urgent help while waiting for further scans or surgery?
Why you should ask this:
Frequently asked questions
What does an aortic surgeon do?
Does every enlarged aorta need surgery?
What is the difference between an aortic aneurysm and an aortic dissection?
Can a bicuspid aortic valve affect the aorta?
What is aortic root surgery?
What is recovery like after aortic surgery?
Ready for Your Specialist Consultation?
Generate a personalized, clinical summary PDF to guide your next doctor's visit.
