THE MAIMONIDES AORTIC CENTER COMBINES THE HOSPITAL’S THORACIC AND VASCULAR SPECIALTIES TO PROVIDE OPTIMAL PATIENT CARE

BY JESSICA JONES GORMAN • PHOTOS © AMESSÉ PHOTOGRAPHY

After practicing as a vascular specialist for more than two decades, Dr. Robert Rhee is currently using his expertise and experience to lead several international studies on the treatment of complex aortic disease. And it’s all taking place right here in Brooklyn.

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“We’re offering some very innovative therapies that are changing the way we manage complex abdominal, thoracic and aortic aneurysms and dissections,” noted Dr. Rhee, chief of vascular and endovascular surgery at Maimonides Medical Center, who also serves as the national principal investigator of a study of the next generation of devices that will help with complicated aortic disease. “Maimonides is the only center in New York City that has access to these therapies and devices. So it’s a very exciting time for this hospital and for this field in general.”

Dr. Rhee, who earned his medical degree from the University of Rochester, where he completed his internship and residency, did his fellowship at Mayo Clinic Medical School in Minnesota before taking a position as clinical director of vascular surgery at the University of Pittsburgh Medical Center. He also served as professor of surgery at the University of Pittsburgh School of Medicine, a position he held for over 16 years. In 2012, while visiting his parents in New York City, he learned of an opening at Maimonides and decided to take it.

“I knew Brooklyn was a relatively underserved area in terms of vascular surgery it wasn’t saturated with vascular centers, and at that time there really was no high level aortic disease care going on in the borough,” Dr. Rhee said. “Most patients were being treated at Manhattan hospitals or had to be transported there, so I knew there was a good opportunity to expand here.”

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Gardian Spread

Under the direction of Dr. Rhee, the Vascular program at Maimonides Medical Center did just that expand. The staff increased from two surgeons to four and many innovative minimally invasive technologies began being offered at the hospital. In 2012, the Maimonides Aortic Center was founded.

“The goal of the Aortic Center is to provide concierge care to patients who are afflicted with complicated aortic problems,” noted Dr. Rhee, who serves as co-director of the Center, along with Dr. Benjamin Youdelman. “There’s a level of specialty care here that other hospitals do not provide.”

Dr. Youdelman, who has served as Maimonides director of thoracic aortic surgery since 2017, cited the importance of the hospital’s efforts to blend these two specialties.

“Partnering with Dr. Rhee, blending our vascular and thoracic specialties, allows us to take optimal care of our patients,” Dr. Youdelman said, explaining the difference between cardiac surgery, which operates on the heart and aorta (including coronary bypass surgery, valve surgery and complex aortic surgery in the chest) and vascular surgery, which focuses on complex aortic surgery in the abdomen as well as diagnosis and treatment of conditions affecting the vascular system.

“In collaborating on these cases at the Aortic Center, we are able to offer patients expertise from two specialties,” Dr. Youdelman continued. “And that makes a major difference in the progress of their care.”

Offering the latest minimally invasive treatment options, including fenestrated and branched graft aortic endovascular repair, the Aortic Center is on the forefront of care.

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“There has been so much progress in the field of aortic surgery over the past two decades,” noted Dr. Rhee. “When I first started practicing, most problems were addressed with major surgery long operations that were very invasive and difficult in terms of recovery. The aorta, which is the largest blood vessel in the body, can become dangerously narrowed by disease, or weakened by the formation of an aneurism. In the past, we had to replace entire segments, but currently, most if not all conditions are being grafted with special devices within the artery. Instead of weeks in the hospital, patients are released in 24 to 48 hours,” adding that vascular surgery has experienced similar progression. “In vascular we treat a whole range of patients with minimally invasive technology. Dissection, blockages, cerebrovascular disease these are all conditions that are now seamlessly treated with minimally invasive technology.”

Maimonides is also on the cutting edge in terms of clinical trials, and is the first medical center in the nation to offer the most advanced device for the repair of Abdominal Aortic Aneurisms in patients with challenging anatomies.

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“It’s a revolutionary procedure that allows us to put this device in the aortic blood vessels surrounding the aneurysm,” explained Dr. Rhee. “The device itself is curved and twisted, and allows us access to difficult areas, granting the ability to treat high risk patients who otherwise would not have been candidates for surgery.”

Dr. Rhee also pointed out that these innovations will only continue to expand in the future.
“The future of vascular innovation is ongoing,” he said. “Right now the frontier involves the treatment of patients with big aneurysms next to the heart. Traditionally, that condition has only been treated with major surgery, but recently we have been doing branched grafts in the artery, which significantly decrease the risk of stroke and allow the patient to be released in a few days time. It’s a very exciting advance.”

Dr. Youdelman agreed.

“We are at the forefront of an endovascular branched graft revolution,” he observed. “Many of the extremely difficult and high risk surgeries are not going to be replaced with endovascular treatment, but those that are able to be replaced are slowly but surely being addressed. And as that technology is evolving, we are also putting in more advanced endovascular stent graphs, performing branching procedures, and are actively in conversations with a number of researchers to remain at the forefront of the field of aortic branched graft surgery. All these developments make this an extremely exciting time for this specialty and this hospital.”

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Maimonides Aortic Center
4802 10th Avenue / 888.MMC.DOCS / nycheart.org