"The Aorta, The Body's River of Life" - article

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Susan BAV

The Aorta, The Body's River of Life

By: BRADLEY J. FIKES - Staff Writer - North County Times

"From head to toes, fingers to nose, brain to bowel, the blood that keeps you alive leaves the heart through the aorta. The aorta is the largest artery in the body. It's the root of the Mississippi River of life, which spins off numerous branches, creeks and microscopic trickles.

Oxygenated blood from the lungs leaves the heart through the left ventricle, a large hollow chamber in the heart. When the heart muscle contracts, the left ventricle compresses the blood within. Blood squirts out an opening into the left ventricle into the aorta. The massive artery curves up around the middle of the heart and makes a left-hand turn before descending, getting smaller as branch arteries carry away parts of its flow. As it travels through the abdomen, the aorta becomes known as the abdominal aorta.

The aorta's critical role and physical characteristics are explained to a great degree by mechanics and hydraulics, not biology. When blood is expelled from the heart, it circulates under blood pressure to distant parts of the body. The aorta is elastic: It expands slightly under pressure and contracts when the pressure is lower, in the interval between heartbeats.

Hardening of the arteries, or atherosclerosis, robs the arteries of their elasticity. The arteries become brittle and weaker, somewhat like a rubber object left out in the elements. The walls of the arteries become roughened, making it easier for blood clots to form. And they can bulge out dangerously under pressure, like a weak spot in an inner tube. This is called an aneurysm.

An aortic aneurysm is by definition life-threatening, and the aorta is the most common place in the arteries for an aneurysm to form. That makes sense, because blood is under the greatest arterial pressure in the aorta. According to the Mayo Clinic, 15,000 people die of aortic aneurysms annually in the United States. However, the majority of aneurysms are small, grow slowly, and don't rupture.

Aneurysms sometimes make themselves known by causing back or abdominal pain. However, most of the time they do not cause symptoms. But they can be detected by tests such as ultrasound or MRI exams. When detected, they can be repaired, if sufficiently serious, by surgery. If they are minor, doctors may advise watching and waiting to avoid the risk of surgery.

Routine screening for aortic abdominal aneurysms (AAAs) would save lives, according to a September 2003 article in the Annals of Internal Medicine. Ruptures of these aneurysms are the 15th leading cause of death in the United States, the article pointed out. Only 20 percent of those who have such ruptures survive.

"On the other hand, screening would identify small AAAs unlikely to rupture in the patient's lifetime, but would cause worry and risk from unnecessary procedures. In the United States, physicians frequently repair AAAs smaller than 5.5 cm, and elective repair results in 1 in 6 AAA-related deaths," the article stated.

Keeping blood pressure within normal levels limits your risk from aneurysms, whether in the aorta or other critical parts of the body such as the brain, where they are called cerebral aneurysms. Lowered blood pressure may be achieved through reducing weight and exercise. In some cases, medication to lower blood pressure is needed."
 
Great article! With an AAA at 5 cm, and a bicuspid aortic vavle at 1cm, it seems to me like the AAA is the more critical issue.

I don't the mortality rate from "elective" AAA surgery (<5cm) is very high.

Ross's blew at 4.8, so there are probably a lot of individual variations going on. A sedentary person can probably get up to 5.5 or even above. People putting a lot of stress on the heart probably can't.


Thanks for posting it.
 
Information in the Article is For Abdominal Aorta

Information in the Article is For Abdominal Aorta

I am always glad to see information about the aorta in the press. However, sometimes this article speaks about the entire aorta, at other times only about the abdominal, perhaps without clear enough distinction. This is a common problem that I have seen with various reporting about the aorta. AAA most commonly stands for Abdominal Aortic Aneurysm. Sometimes this is confused with Ascending Aortic Aneurysm - which is in the chest.


The medical paper quoted and the size and statistics there are in reference to the abdominal aorta. Generally, there is more public awareness and more statistics available regarding abdominal aortic aneurysms. Abdominal aneurysms are easier to detect and deal with when compared to the chest, but certainly remain a serious situation also.

The aorta in the chest has its own set of information and statistics, which is specific to each section of the thoracic aorta - the ascending, arch, descending, and thoracoabdominal. These should not be confused with the abdominal aorta (or with each other). TAA can be used for Thoracic Aortic Aneurysm, but it is not specific to which part of the aorta in the chest is affected so is a general term.

Abdominal aneurysms generally have different underlying causes and the profile of the majority of people who are affected is different. (I do know someone with BAV who had an ascending aortic aneuyrsm but also has an abdominal aneurysm that is being watched.) The surgeons that treat abdominal aortic aneurysms (AAA) are vascular surgeons, and the technique and approaches are different.

Above the waist, a cardiothoracic surgeon (who should have specialization in the aorta) does the procedure.

The incidence of thoracic aortic aneurysm deaths is actually unknown because it is easily confused with a massive heart attack. The only conclusive determination is an autopsy, which is rarely done today except when crime is suspected.

I hope this provides some clarification. In all cases, discuss the mortality and morbidity statistics of the surgeon who will do your surgery and be sure that it applies to the specific situation and procedure involved in your case.

Best wishes,
Arlyss
 
Only the Creator could've thought of this!


Oxygenated blood from the lungs leaves the heart through the left ventricle, a large hollow chamber in the heart. When the heart muscle contracts, the left ventricle compresses the blood within. Blood squirts out an opening into the left ventricle into the aorta. The massive artery curves up around the middle of the heart and makes a left-hand turn before descending, getting smaller as branch arteries carry away parts of its flow. As it travels through the abdomen, the aorta becomes known as the abdominal aorta.

The aorta's critical role and physical characteristics are explained to a great degree by mechanics and hydraulics, not biology. When blood is expelled from the heart, it circulates under blood pressure to distant parts of the body. The aorta is elastic: It expands slightly under pressure and contracts when the pressure is lower, in the interval between
heartbeats.
 

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