Aortic Conditions Overview
About the Aorta
The aorta is the largest artery that supply’s oxygenated blood to the rest of the body. It is shaped like a candy cane and originates beyond the aortic valve (aortic root), supplying oxygenated blood to the heart through the coronary arteries. Traveling up, the aorta arches (the ascending aorta) and supplies oxygenated blood through the aortic arch branches (i.e, innominate artery, provides branches to the right carotid and right subclavian arteries, left carotid and left subclavian arteries) to the head. The aorta then descends (descending aorta) down the body providing oxygenated blood to the thoracic arteries and continues through the hiatus of the diaphragm. After the diaphragm, it becomes the abdominal aorta travels into the common iliac arteries. The thoracic aorta is above the diaphragm and the abdominal aorta is below the diaphragm.
Thoracic Aortic Aneurysm
An aneurysm is a weakening in the wall of an artery, which causes it to “balloon” or expand in size. The thoracic aorta is made of the aortic root, the ascending aorta, the aortic arch and the descending aorta. The aorta that is below the diaphragm and moves down through the abdomen is called the abdominal aorta. Although an aneurysm can develop anywhere along your aorta, most occur in the section running through your abdomen (abdominal aneurysms).
According to the US Centers for Disease Control and Prevention, aortic aneurysms were reported as the primary cause of 9,863 deaths in the US in 2014, but the actual number is likely much higher.
Aneurysms are often found incidentally during evaluation of other problems. Since they commonly cause no pain or discomfort, aneurysms can silently enlarge for long periods of time without being identified. When the aneurysm gets too large, it can cause pressure on a neighboring organ, or the wall of the blood vessel can split or tear (aortic dissection/dissecting aortic aneurysm) or even “burst” under pressure (aortic rupture/ruptured aortic aneurysm).
Thoracic Ectasia
Ectasia is defined as an enlargement or dilation of the aorta. It is not considered an aneurysm until the diameter is two times greater than your normal aortic size.
Aortic Dissection
The aorta is made up of three layers: the intima, the media, and the adventitia. An aortic dissection is a tear that begins in the inner (intimal) layer of the artery wall. Blood is forced through this opening, and bleeds into itself through the middle layer, extending this tear and leading to a separation of the layers of the aorta. An aneurysm may grow and eventually lead to dissection or rupture if not diagnosed or treated. Aortic dissections are known as the silent killer as most people don’t have symptoms until they experience an aortic emergency.
Stanford Type A Dissection
All dissections involving the ascending aorta regardless of the site of origin. Surgery is the treatment of choice for dissections of the ascending aorta. Type A dissections are a surgical emergency because of the risk of aortic regurgitation, cardiac tamponade, and
myocardial infarction.
Stanford Type B Dissection
All dissections involving the descending aorta. Medical therapy is usually the treatment of choice for an uncomplicated type B dissection. Type B dissections are considered chronic when they are 2 weeks from onset. Acute type B dissections can be complicated by the following retrograde extension in the ascending aorta, progression with compromise of the vital organs, rupture, or impending rupture. This can sometimes be treated with thoracic endovascular aortic repair (TEVAR).
Contact Us
The Elaine & Robert Matranga Aortic Center provides every therapeutic advantage, from a highly skilled team to advanced treatment approaches and state-of-the-art facilities. Call us for a consultation or a second opinion at 949-764-5314. For patients who live a long distance from Hoag, we are also available for virtual telehealth visits.