The focus of our research program, which derives directly from our clinical interest in the surgical treatment of patients with thoracic aortic aneurysms and dissections, encompasses outcomes after thoracic aortic repair, strategies for preventing perioperative complications, genetic factors related to aortic disease, and the pathobiology of aortic wall degeneration. Our clinical research team has had a long-standing interest in the analysis of outcomes following aortic surgery, and has conducted randomized clinical trials comparing the effectiveness of various techniques for preventing associated ischemic complications. Further, our research team has conducted several studies to evaluate the safety profile of surgical adhesives, which are an important adjunct for limiting bleeding complications during aortic repairs. In 2002, our research group initiated the Thoracic Aortic Disease Tissue Bank, which currently houses samples and corresponding phenotypic data from over 2,500 patients with thoracic aortic disease and has served as a core for the NHLBI supported Specialized Center of Clinical Oriented Research in Thoracic Aortic Aneurysms and Dissection, as well as a resource for numerous collaborative studies evaluating the genetic factors and molecular mechanisms involved in the development of thoracic aortic disease. Our basic science laboratory is currently focusing on the role of various aspects of extracellular matrix metabolism in the development of aortic aneurysms and dissections. In particular, our group is studying the roles of destructive factors, such as inflammatory cells and proteases, as well as reparative mechanisms, such as stem cell recruitment and transformation, during the development of aortic aneurysms and dissections.