Family history: About 20 percent of all thoracic aneurysms develop in people with a family history of thoracic aneurysms. These cases tend to develop in younger people. Genetics: Certain inherited conditions are linked to a higher risk of ascending aortic aneurysms, including:.
These are called connective tissue disorders, and they can lead to many complications in addition to aortic aneurysms. Infection: Sometimes, certain infections can also weaken artery walls, including those in the aortic arch.
These infections include syphilis and salmonella. An ascending aortic aneurysm is often found during a routine checkup or an examination ordered for another condition.
For example, a chest X-ray can show a bulging aorta. Other imaging tests that can detect an aortic aneurysm include:. Once an aneurysm is discovered, the decision to treat it usually depends on its size or rate of growth. Usually, surgical repair is necessary once an aneurysm reaches 5 centimeters cm in diameter. An aneurysm that is less than 5 cm may be monitored without surgery. If you and your doctor agree that a watch-and-wait approach is best, you may be placed on medications to help lower your blood pressure and cholesterol.
Medications to bring down your blood pressure include beta blockers, which also slow your heart rate, and angiotensin receptor blockers ARBs. In this procedure, a surgeon opens up your chest and replaces the damaged portion of your aorta with a synthetic tube called a graft.
In some cases, they also replace the aortic valve with a synthetic valve. In this procedure, the weakened portion of the aorta remains in place. Your doctor inserts a tiny, flexible catheter into an artery in your leg and guides the tube up to your aorta. The catheter then deploys a graft that surrounds the vulnerable part of the aorta to strengthen it. Emergency surgery can sometimes be done to repair an aneurysm that ruptures, though it must be done fast.
The risk of a fatal bleeding event is high if bleeding is not treated promptly. Open surgery to repair an aneurysm can require a recovery time of about a month. Your age and overall health are also factors that affect your recovery speed.
The recovery time for a less-invasive endovascular procedure is shorter than for an open surgery. The entire ascending aorta is located in the chest cavity, known as the mediastinum. The ascending aorta is divided into two segments: the aortic root and the tubular segment of the ascending aorta. The aortic root is where the aorta meets the aortic valve. It is comprised of a combination of muscle from the left ventricle and typical arterial structure.
It's hard to discern where one ends and the other begins. Technically, the valve is not part of the aorta, but the three leaflets of the valve extend all the way into the aortic root, and they work in tandem to control blood flow and to backfill the coronary arteries. There are three sinuses in the aortic root sinuses are like depressions in the artery wall known as the sinuses of Valsalva.
Two of the sinuses lead to the origins of the left and right coronary arteries, which provide the cardiac muscle with blood. The third sinus in the aortic root is not connected with an artery. The three sinuses correspond with the three leaflets of a normal aortic valve. The sinuses are thought to provide back pressure to help close the valve and fill the coronary arteries. Superior to above the aortic root is the tubular segment of the ascending aorta. This portion is about 2 to 3 cm and rises away from the root until it reaches the brachiocephalic artery, which marks the beginning of the aortic arch.
The point where the aortic root and the tubular ascending aorta meet is called the sinotubular junction. The structure of the aortic walls is identical to other arteries. Common to all arterial walls are three main layers:.
The ascending aorta most commonly varies in its overall circumference and in the presence of a bicuspid aortic valve instead of a tricuspid aortic valve. While the valve leaflets are not technically part of the aorta, the development of the aortic root is related to the structure of the valve. The circumference of the ascending aorta is significant clinically and might be a precursor to an aneurysm. However, the size of the ascending aorta varies based on the size, age, and sex of the person.
Doctors consider the size and age of a patient when deciding whether an ascending aorta is dilated or of a normal circumference. The aorta supplies oxygenated blood to nearly all of the body's tissues. Its ability to dilate and constrict, like all arteries, plays a major role in regulating blood pressure throughout the cardiovascular system.
The ascending aorta provides a low-resistance pathway for blood flow being ejected out of the left ventricle when it contracts and squeezes blood through the aortic valve. The surge of blood flow creates a pressure wave that resonates through the entire cardiovascular system and is what causes a pulse to be felt in certain areas of the body. The constriction of the left ventricle is known as systole.
After contracting, the ventricle relaxes, which is known as diastole. The relaxation and subsequent dilation of the ventricle pull blood into it. The backflow of blood forces the three leaflets of the aortic valve to snap closed and prevent blood from flowing back into the ventricle.
While doctors aren't completely sure, it is thought that the sinuses in the aortic root create a swirling motion of blood to begin pushing the leaflets of the aortic valve closed even before diastole creates backward pressure. The sinuses might also simply keep the leaflets of the aortic valve from getting plastered flat along the walls of the aortic root, sticking them in the open position. Either way, when surgeons leave the sinuses in place during repairs of the aortic root, the valve functions better.
For such a small portion of the largest blood vessel, the ascending aorta has more than its share of issues. The aortic root and the ascending aorta are ground zero for many clinical procedures, including cannulization of the coronary arteries, repairs of the aortic valve, and surgical repair of thoracic aortic aneurysms.
Aortic stenosis and aortic aneurysm are the two most common conditions that can affect the ascending aorta. The most concerning condition that can affect the ascending aorta is an aortic aneurysm.
This is a localized dilation of the aorta—basically, a bulge. Aortic aneurysms are significant no matter where they are located. Our specialists can diagnose you with a series of tests, including:. You and your healthcare provider will choose a treatment method that suits your needs. Options include:. Edits to original content made by Rector and Visitors of the University of Virginia.
This information is not a substitute for professional medical advice. In This Section.
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