Aorta: Aorta is the largest blood vessel carrying oxygenated blood from the heart to the whole body. It extends from the left ventricle through the chest to lower part of the abdomen (tummy). Its branches supply blood to all parts of the body. Aortic valve, a trileaflet valve prevents backflow of blood from aorta to left ventricle when the latter relaxes after contraction.
What are the important disease which can affect the aorta?
Aorta being a blood vessel, can be affected by all diseases which can affect large blood vessels. Most common disease affecting the aorta is deposition of fat within its wall causing ‘atherosclerosis‘. Fat deposits can cause narrowing of different regions, depending on where the deposit is maximum. Usually it is more at origin of various branches.
Weakening of the wall of the blood vessel wall due to degenerative process or other diseases can cause localized enlargements known as ‘aneurysms‘. Aneurysms can enlarge over time and become so large that they can rupture producing massive internal bleeding an death. An aneurysm of the aorta in the abdomen is known as abdominal aortic aneurysm (AAA). Occurrence of abdominal aneurysm increases with age so that in many countries, screening with ultrasound scan is recommended in older individuals.
When the wall of the blood vessel is weakened and the blood pressure rises due to some reason, breaks may develop within the layers of the aortic wall. This is known as ‘dissection of the aorta‘. Aortic dissection presents with severe pain in the chest or back and is a potentially life threatening condition unless prompt treatment is available. Initial treatment will be to bring down the blood pressure, to be followed in some cases by operative repair.
Inflammation of the wall of the vessel is known as ‘aortitis‘. An important form of aortitis, originally described from Japan, is known as Takayasu arteritis, of which involvement of aorta and its major branches is the hall mark.
What treatment options are available for aortic aneurysms?
Small aneurysms need only follow up and control of risk factors like high blood pressure and high cholesterol. Effective medications for these are easily available from your doctor. Large aneurysms with potential risk of rupture can be repaired by operation. Many of the aneurysms can also be repaired without surgery using metallic meshes covered with fabric known as ‘stent grafts‘. Stent grafts can be implanted by inserting small tubes through the groin blood vessels, loaded with the stents. The procedure is done under X-ray fluoroscopic guidance.