ALERT CONTENT PLACEHOLDER

​What is the aorta?

Blood vessels are the channels or tubes that distribute blood to body tissues. The aorta is the largest blood vessel in your body. It carries blood from the heart to all other parts of the body.

Aorta  

The aorta is made up of these parts:

  • Aortic root
    • The part of the aorta closest to the heart where the aorta and heart connect.
    • Supplies the heart with blood. Has a valve (aortic valve) that allows blood to pass from the heart to the aorta.
  • Ascending aorta
    • Rises upward from the heart and carries blood towards the head.
  • Descending thoracic aorta
    • Goes downward from the heart and carries blood through the chest and towards the back.
    • Has many small branches connecting to the rib cage and spinal cord.
  • Aortic arch
    • Curved part of the aorta that carries blood to the head, neck, brain and arms.
    • Between the ascending and descending aorta.
  • Abdominal aorta
    • Begins at the diaphragm and splits off at the pelvis. Carries blood to your liver, bowels, kidneys and legs.
  • Thoracoabdominal aorta
    • Involves both the descending thoracic and abdominal aorta.

What is an aortic aneurysm?

An aortic aneurysm is a balloon-like bulge that can happen in weaker parts of the aorta. Aneurysms can happen anywhere in the aorta. For example, an aneurysm in the chest is called a thoracic aortic aneurysm.

Aortic Aneurysm  


Who is at risk?

Risk factors that can raise your chances of developing an aortic aneurysm over time include:

  • Age (over 60 years old)
  • Sex (most common in men)
  • Smoking
  • Health conditions, such as high blood pressure, high cholesterol and fatty deposit build up in the arteries (atherosclerosis)
  • Having a bicuspid aortic valve from birth
  • Having a genetic condition, such as Turner syndrome
  • Having a connective tissue disorder, such as Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome
  • Other members of your family have aortic problems
  • Having an inflammatory disorder, such as giant cell arteritis, Takayasu
  • Certain infections, such as syphilis
  • Sudden traumatic chest injury

Why is an aortic aneurysm dangerous?

Having an aortic aneurysm means the layers of the aorta may get so weak or thin that they can cause:

  • dissection, a tear in the inner layer of the aorta, causing the layers of the aorta to separate
  • rupture, a sudden break or burst of the aneurysm causing bleeding inside the body

A rupture or dissection can cause death if not treated urgently with surgery.

Treatment

Your doctor may recommend taking medicine and making lifestyle changes to help slow the growth of an aortic aneurysm. For example:

  • Taking blood pressure medicine (beta-blocker, ACE-inhibitor)
  • Stop smoking
  • Doing mild to moderate exercises (no strenuous activities)
  • Eating a healthy heart diet (including more fruits, vegetables, whole grains, food low in saturated fat and salt).

Your doctor may recommend surgery if the aneurysm reaches a certain size and depending on other factors (such as age, medical history, and health condition).

Open surgery

Open surgery replaces the section of the aorta affected by the aneurysm with a durable fabric tube (graft) connecting the healthy ends of the aorta.

Open Repair  

Endovascular stent graft

A device called a stent graft is put inside the aorta to divert the flow of blood away from the aneurysm.

  • Sometimes a combination of an open surgery and endovascular stent grafting is done.
  • Surgery may be done in stages to reduce the risk of complications. This depends on where the aneurysm is located and how weak the aortic wall is.
Endo Repair  

Dissection

What is aortic dissection?

An aortic dissection is a tear in the inner wall of the aorta, causing separation of the layers of the aortic wall. There are two types of dissections depending on which part of the aorta is affected:

  • Type A: a tear in the upper aorta
  • Type B: a tear in the lower aorta

Who is at risk?

Risk factors that can raise your chances of developing an aortic dissection over time include:

  • Health conditions, such as high blood pressure
  • Temporarily raised blood pressure from:
    • cocaine or other drug use
    • strenuous exercises like high-intensity weightlifting
  • Plaque buildup in the arteries (atherosclerosis)
  • Aortic aneurysms
  • Other members of your family have aortic problems
  • Age (over 60 years old)
  • Sex (most common in men)
  • Being born with certain health conditions, such as a bicuspid aortic valve or a narrow aorta
  • Having a genetic condition, such as Turner syndrome
  • Having a connective tissue disorder, such as Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome
  • Having an inflammatory disorder, such as giant cell arteritis, Takayasu)

What are the symptoms?

  • Sudden severe chest or back pain that feels like tearing or ripping
  • Sudden severe stomach pain
  • Shortness of breath
  • Loss of consciousness
  • Symptoms similar to those of a stroke:
    • Weakness or paralysis of one side of the body
    • Difficulty speaking
    • Loss of vision
  • Weak pulse in one arm or thigh
  • Sudden arm or leg pain

Treatment for Type A aortic dissection

Acute Type A aortic dissection is a dangerous, life-threatening condition. It’s important to get medical attention right away.

Your doctor may prescribe medications to lower your blood pressure before surgery to prevent the dissection from getting worse.

Type A aortic dissection is treated with open surgery:

  • A surgeon may remove part of the dissected aorta and use a graft to reconstruct the aorta.
  • The aortic valve may also need to be replaced if the damaged part of the aorta causes the valve to leak a lot.
  • You may need other surgery depending on your health needs.

Treatment for Type B aortic dissection

Your doctor can usually treat acute Type B aortic dissection with medication.

  • Your doctor may prescribe medications that slow your heart rate (such as Beta-blockers) and medication that lower your blood pressure.

Surgery may be needed for complicated cases:

  • Rarely, urgent open surgery is needed.
  • Endovascular stents are placed through the groin into the aorta to cover the tear and help heal the dissection.

What are the long-term health issues?

After receiving urgent treatment for aortic dissection, you may need to:

  • take medications that keep your blood pressure lower
  • follow an exercise or activity plan that limits straining

You will need life-long follow up with CT scans, MRIs and/or echocardiograms for monitoring.

You may need open surgery or endovascular stent graft if the aorta continues to grow over time.

Where can I get more information?


Visit UHN Patient Education and Engagement for reliable health information or to request a tailored consumer health search.

Email:tgpen@uhn.ca
Phone: 416 603 6277​


« Thoracic Aortic Surgery Clinic