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Cardiovascular

Vascular Disease Program

The physicians at the Florida Hospital Cardiovascular Institute are expertly trained in the diagnosis and treatment of all kinds of arterial and venous conditions. They can offer patients the reassurance that comes with knowing that their doctors are among the best of the best. In fact, Florida Hospital Orlando has the top-rated cardiac program in the state of Florida, and the 23rd best in the country, according to U.S News & World Report. We’re also the only hospital in Central Florida with a dedicated floor for vascular surgery patients.

Our experts treat more than 1,600 vascular patients a year, more than any other hospital in the nation. These treatments include open and endovascular operations for aortic aneurysms, occlusive disease of the extremities, cerebrovascular disease, mesenteric ischemia, renal artery lesions and venous disorders.

The physicians at the Florida Hospital Cardiovascular Institute also specialize in less-invasive endovascular procedures and incorporate new, state-of-the-art technologies that allow our patients to get back on their feet sooner. These include balloon angioplasty, stents and catheter atherectomy. We’re also on the cutting edge of research into aneurysms, carotid disease and refractory hypertension, and the vascular experts at Florida Hospital Orlando are conducting clinical trials into new treatments and devices to ameliorate these and other conditions.

It’s not just the doctors who are top notch, either. The nurses at the Florida Hospital Cardiovascular Institute are specially trained in vascular conditions. This dedication to our vascular surgery patients produces results: Our survival rates for abdominal aortic aneurysm are significantly better than the national average, and our patients tend to have shorter stays in the hospital.

Ascending Aneurysm/Dissection

An aneurysm occurs when sack-like dilations form in the wall of a damaged or weakened artery. Ascending aneurysms involve the aortic valve and the major arteries leading to the head and arms. A ruptured aneurysm—called a dissection—can be fatal unless treated immediately with emergency surgery.

To repair the damage caused by an aneurysm, the expert surgeons at the Florida Hospital Cardiovascular Institute will perform a surgical procedure in which an enlarged section of the aorta is removed and replaced with a synthetic material so that blood can continue to flow normally. In some cases, doctors may have to replace or re-implant the aortic valve as well.

In addition, doctors may use medications to treat aneurysms. These include medications to control blood pressure, as well as alpha or beta-blockers or calcium channel blockers. While patients who receive these medicines will still need to undergo surgery, the medications can act as a stopgap measure to block the aneurysm from expanding.

Descending Aneurysm/Dissection

Descending aneurysms, or aneurysms of the descending thoracic aorta, are less common than abdominal aortic aneurysms, but they’re no less dangerous. As with other types of aneurysms, survival is relatively likely unless the aneurysm ruptures, in which case emergency surgery is required.

Descending aneurysms are sometimes caused by a weakened aortic wall. In other cases, the culprit is a tear in the inner wall of the aorta, which allows blood to burrow up and down the aortic wall, weakening it. This condition is called an aortic dissection. If blood leaks through the aortic wall into surrounding tissues, a rupture has occurred. 

Most aneurysms do not produce symptoms. In fact, aneurysms are often discovered incidentally, during a physical exam or a CT scan ordered to look for something else. Non-ruptured aneurysms sometimes cause back or abdominal pain. Patients with a dissecting descending aneurysm often experience severe pain between the shoulder blades, as well as back pain.

At the Florida Hospital Cardiovascular Institute, aortic aneurysms are commonly treated with a technique called EVAR, or the endovascular abdominal aortic aneurysm reconstruction technique. It’s a complicated name, but the procedure itself is fairly straightforward. The surgeon will thread a large stent covered in a cloth-like material through an artery in the groin. The stent graft is then opened on the inside of the aneurysm, relining the aorta and relieving pressure on the weakened aortic wall. Usually patients who undergo EVAR are ready to come home in a day or two.

This procedure isn’t for everyone. Some patients will require a more conventional surgery, which involves incisions in the chest and abdominal cavities.

Aneurysms that are less than five centimeters in diameter are unlikely to rupture. These smaller aneurysms are usually managed through medicine. In addition, quitting smoking and taking steps to reduce blood pressure can help decrease an aneurysm’s growth rate.

Carotid Artery Disease

The carotid arteries are major arteries in the neck that supply blood to the brain. When they become blocked by plaque and blood cannot flow efficiently, the patient has carotid artery disease. This is a serious condition that can lead to stroke if untreated. (Individuals experiencing any of the symptoms of stroke—including a feeling of weakness and/or numbness or a tingling sensation on one side of the body, as well as the loss of vision in one eye and/or an inability to speak clearly—should call 911 immediately.)

At the Florida Hospital Cardiovascular Institute, our expert physicians offer carotid artery patients a few different treatment options. The most common is surgery. The surgeon will remove the plaque clogging the artery in a procedure called a carotid endarterectomy. For patients who are not physically able to undergo surgery, we offer cardio angioplasty and stenting, a relatively new procedure in which a catheter is inserted into the groin artery and then threaded through the arteries to the area that has narrowed, after which a small balloon is inflated to widen the affected artery. A small metal stent is left in the left in that area to restore blood flow. Some patients will also receive medical management, in which the carotid artery disease is treated with medical or non-surgical therapy.

The expert physicians at the Florida Hospital Cardiovascular Institute have the tools and experience to go over all their patients’ options and develop a treatment plan that best serves their needs.

Legs/Peripheral Vascular Disease

Peripheral arterial disease (PAD) is a serious vascular disease that affects more than 8 million people in the United States. It occurs when there is a buildup of plaque in the arteries that supply blood to limbs, most commonly the legs. People with PAD are likely to have foot problems. Minor foot injuries can turn into serious infections necessitating the removal of a toe, foot or leg. In fact, PAD is one of the leading causes of foot and leg amputations in the United States.

At the Florida Hospital Cardiovascular Institute, our experts seek to improve patients’ mobility and quality of life, as well as to prevent heart attack, stroke and amputation. The four main approaches to treating PAD are:

  • Lifestyle changes: quitting smoking; lowering high blood pressure, cholesterol and blood glucose levels; eating well; increasing activity; and managing weight.
  • Medical therapy: medications to lower high blood pressure, treat diabetes, prevent the formation of blood clots and reduce leg pain.
  • Stenting: an angioplasty is used to dilate the obstructed blood vessel, then a stent is inserted it to maintain the newly dilated channel.
  • Surgery: usually a bypass to restore blood circulation to the affected extremity.

Renal Vascular Disease

The renal arteries supply blood to the kidneys. When they become narrow or blocked, a patient is said to have renal vascular disease. When blood flow to the kidney is restricted, the kidney may release excess amounts of a powerful hormone called renin, which can cause a severe form of hypertension that sometimes leads to heart failure or stroke. This condition may also cause kidney failure.

In many cases, there are no early symptoms of renal vascular disease. When symptoms appear, they usually include headache or blood in the urine. In addition, the abrupt onset of hypertension or hypertension that is difficult to control may suggest renal vascular disease, as does the loss of kidney function or the sudden onset of heart failure.

Treatment options used by the vascular specialists at the Florida Hospital Cardiovascular Institute include:

  • Stenting, in which a small balloon called an angioplasty is inserted through the groin artery and threaded into the affected renal artery to widen the narrow portion. After that, a wire-mesh coil, or stent, is inserted to keep the artery open.
  • While stenting is usually the preferred option, sometimes surgery, such as a bypass of the obstructed artery segment, may be used.
  • Many cases of renal vascular disease are managed with medical therapy, including antihypertensive medication to control blood pressure or medications to lower cholesterol levels.