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ChristianaCare Surgeons Are First in Delaware to Perform TAMBE Procedure

This minimally invasive procedure is an alternative to open surgery for aortic aneurysms

November 4, 2025
ChristianaCare Surgeons Are First in Delaware to Perform TAMBE Procedure

ChristianaCare’s multidisciplinary Center for Aortic Health is the first in Delaware, and among the first in the region, to offer thoracoabdominal branch endoprosthesis (TAMBE), a new minimally invasive treatment for complex aortic aneurysms.

Schedule an appointment with ChristianaCare's Center for Heart and Vascular Health.

TAMBE is designed to treat complex abdominal aortic aneurysms that are at high risk of rupture. During this minimally invasive procedure, surgeons implant an innovative device into the patient’s blood vessels at the site of the aneurysm. The TAMBE device seals off the aneurysm while allowing blood to flow through freely.

More than 1 million Americans between the ages of 50 and 84 have complex abdominal aortic aneurysms. It’s uncommon for people to notice symptoms early on, but some people experience pain in their lower back, abdomen or legs.

Vascular surgeon Kathryn Bowser, M.D., and cardiothoracic surgeon J. Daniel Robb, MBBS, who are co-directors of the Center for Aortic Health, led the initial TAMBE procedure in January with Mikael Fadoul, M.D.

A surgical team performs a TAMBE procedure in the operating room, guided by live imaging displayed on a large monitor. ChristianaCare surgeons perform the minimally invasive TAMBE procedure to treat complex abdominal aortic aneurysms that are at high risk of rupture.

“ChristianaCare stands out as a leader in our region for the innovative care that we provide for aortic aneurysm,” said Kirk Garratt, M.D., MSc, medical director of the Center for Heart and Vascular Health. “Patients who are seeking a minimally invasive alternative to open surgery for aortic aneurysm can find that care close to home.”

Portrait of Kirk Garratt Kirk Garratt, M.D., M.Sc.

Minimizing Pain, Maximizing Benefit

Before TAMBE received FDA approval in 2024, surgeons treated complex aortic aneurysms with open surgery, through an incision in the chest and/or abdomen. Recovery from that open surgery typically takes three to six months.

Because TAMBE is performed through tiny incisions in the groin and arm, the recovery time is significantly shorter, and patients experience less pain after the minimally invasive procedure.

TAMBE is available to patients with complex aortic aneurysms who meet certain anatomical requirements for treatment. Surgeons at the Center for Aortic Health can determine whether a patient is a good candidate for the procedure.

“Aortic pathology requires specialized management, and we provide the most optimal care,” Bowser said. “Our center incorporates all of the latest research into our decision-making to create a personalized treatment plan for each patient.”

Portrait of J. Daniel Robb J. Daniel Robb, MBBS

The vascular surgeons, cardiothoracic surgeons, cardiologists, interventional radiologists and other specialists at the Center for Aortic Health provide individualized care to patients with aortic disease, helping to improve patient outcomes. TAMBE is the latest treatment option available at the Center.

“We pride ourselves in having expertise and experience with multiple surgical and treatment approaches so that we can truly offer patients the best options for their specific needs,” Robb said. “We strongly believe that these various approaches are best used in a multidisciplinary team setting to provide patients with inclusive and optimal care.”

Portrait of Mikael Fadoul Mikael Fadoul, M.D.
“From the moment I met Dr. Bowser, I had 100% confidence in her,” said Pat Gardner. “She explained everything about TAMBE to me. After the procedure, I was tired, which I expected, but I felt better than I had anticipated. There was no pain involved at all.”

'I Had 100% Confidence'

Pat Gardner of Millsboro, Delaware, was the first patient to undergo TAMBE at ChristianaCare. She was diagnosed with aortic aneurysms eight years ago. Because her aneurysms were slow-growing, providers monitored them until it became necessary to treat them.

Last year, Gardner’s doctor referred her to Bowser. Quickly, Gardner was convinced that the TAMBE procedure was right for her. When she learned that she was an ideal candidate, she committed to the procedure, becoming ChristianaCare’s first TAMBE patient on January 31.

“From the moment I met Dr. Bowser, I had 100% confidence in her,” Gardner said. “She explained everything about TAMBE to me. After the procedure, I was tired, which I expected, but I felt better than I had anticipated. There was no pain involved at all.”

“If my doctor hadn’t referred me to Dr. Bowser, I probably would have gone to another surgeon and had open surgery, and I’ve witnessed from family members how hard those recoveries are. I’m so lucky that I was a candidate for TAMBE.”