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Acute aortic syndrome (AAS) describes a range of severe, painful, potentially life-threatening abnormalities of the aorta. [1] These include aortic dissection, intramural thrombus, and penetrating atherosclerotic aortic ulcer. [2] AAS can be caused by a lesion on the wall of the aorta that involves the tunica media, often in the descending ...
An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. [1] Typically, there are no symptoms except when the aneurysm dissects or ruptures, which causes sudden, severe pain in the abdomen and lower back.
One example in the treatment of thoracic aortic disease is revascularization of the left common carotid artery and/or the left subclavian artery from the innominate artery or the right common carotid artery to allow treatment of a thoracic aortic aneurysm that encroaches proximally into the aortic arch.
The size cut off for aortic aneurysm is crucial to its treatment. A thoracic aorta greater than 4.5 cm is generally defined as aneurysmal, while a size greater than 5.5 cm is the distinction for treatment, which can be either endovascular or surgical, with the former reserved for pathology at the descending aorta. [12] [13]
After the heart has been arrested, the enlarged aorta is removed close to the insertion line of the aortic valve cusps. The origins of the coronary arteries must be detached from the aorta. For the procedure, according to Magdi Yacoub [ 16 ] a graft is tailored to create 3 tongues that replace the aneurysmatic aortic wall in the root.
When the aortic valve is diseased in addition to the ascending aorta, the Bentall procedure is used to treat the entire aortic root. An axillary-bifemoral bypass is another type of vascular bypass used to treat aortic pathology, however it is not true open aortic surgery as it reconstructs the flow of blood to the legs from the arm, rather than ...
For many years, the gold standard treatment for patients with aortic valve disease and aortic root aneurysms was to replace both the aortic valve and the ascending aorta with a composite graft. This also applies to patients with different levels of AI and annuloaortic ectasia, where the aortic valve may be largely preserved without any ...
In the ascending aorta (the portion of the aorta which is almost vertical), one mechanism of injury is torsion (a two-way twisting). [5] There are clinical predictors of an aortic injury. [ 6 ] The predictors include if a patient is older than 50, was an unrestrained patient, has hypotension, has a thoracic injury requiring thoracotomy, has a ...