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Aortic Program

Baylor Scott & White Medical Center – Temple

What is the aorta?

The aorta is the blood vessel that exits the heart and takes blood to the rest of the body. There is a valve between the aorta and the heart called the aortic valve.

Immediately above the valve are three outpouchings called the aortic sinuses from which the blood vessels to the heart arise. The remainder of the aorta is divided into three parts, the ascending aorta in the front, the aortic arch that gives off the blood vessels to the head and the descending aorta that travels on the left side of the spine.

The descending aorta travels through the diaphragm into the belly to become the abdominal aorta.

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Aortic diseases
Aortic Aneurysm
An aortic aneurysm is a progressive enlargement of a part of the aorta. It is caused most often by atherosclerosis and high blood pressure. Aneurysms can occur in any part of the aorta. As the size of the aneurysm increases, clots begin to line the aneurysm, and the wall weakens until it becomes susceptible to rupture and dissection. For this reason, aneurysms need to be monitored once they are discovered.
Bicuspid Aortic Valve
Normally the aortic valve is made up of three cusps, or flaps. However, some people are born with only two cusps—bicuspid aortic valve. Bicuspid valves may degenerate over time and present with either a leaky valve or a stenotic—or tight—valve. In addition, patients with bicuspid valves have an associated abnormality of the aorta (aortopathy) that makes them more susceptible to aortic aneurysms. This disease may run in families, but it can skip generations.
Aortic Dissections
The wall of the aorta is made of multiple layers. If there is a tear in the inner layer, the blood can spread into the middle layer and separate or dissect the layers of the aorta. If the outer wall is breached, this can be fatal. Also, the dissection can cause occlusion of the branches of the aorta, leading to a loss of blood supply to the organ supplied by the branch. A dissection is therefore an emergency and needs immediate hospitalization—and in many cases surgery.
Genetic and Connective Tissue Diseases
There are a number of genetic syndromes such as Loeys-Dietz and Marfan syndrome and connective tissue diseases such as Ehlers-Danlos syndrome that are associated with weakness of the connective tissue in the aorta and the early development of aneurysms and dissection. Patients with these syndromes should be actively screened for aortic disease and may be candidates for early aortic surgery.
Inflammatory Diseases
Aortic inflammation may be form infections or from autoimmune diseases, such as Takayasu’s and Giant cell arteritis. Once a diagnosis is made, surgical revascularization or replacement may be required.
Trauma
Aortic rupture is a common cause of mortality after motor vehicle accidents. Patients who survive to get medical attention usually have a partial tear of the layers but will need emergency surgery. Some patients present late with pseudoaneurysms.

Diagnostic tests for aortic diseases include​:

 
 
  • EKG
  • Echocardiogram to look at heart and valve function
  • Coronary angiogram
  • CT scan with contrast (CT angiogram)
  • MRI
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