The aorta – Its location and its structure
The largest artery in our body is the aorta. It originates from the left ventricle of the heart which is the major blood pumping chamber. Blood that is rich in oxygen enters the aorta as the left ventricle contracts. This oxygenated blood is then distributed throughout the body via small arteries that branch out from the aorta.
There are 3 layers of tissues that make up the wall of the aorta. The innermost and the outer layer is thin compared to the middle layer, which is thicker and elastic in nature. Depending upon the formation of its 3 layers is the proper functioning mechanism. With every heart beat , the heart contracts, and blood is forced through the open aortic valve, and then blood gushes into the aorta. Thus the walls of the aorta have to be flexible to endure the force of blood as it surges into it.
The aorta, which is elastic like a blood vessel, has its walls constituted of connective fibers which help the blood vessel to stretch out as it handles a lot of pressure when blood is flowing through it. It then comes back to its original state as and when the force of blood decreases. In its normal state, the aorta which is made up of elastic fibers that run throughout its length, but it gets thicker in the walls of the rising aorta, as because it has to withstand the maximum force of blood flow with every contraction as the heart beats.
The aortic root
The aortic root is at the beginning of the aorta. And continues till the sinotubular junction. The aortic valve is the starting point and is known as an annulus, it becomes a bit wider in diameter. The root gives rise to 2 coronary arteries and ends where the ascending artery begins. These 2 coronary arteries carry oxygenated blood to the heart muscle. The distance from the aortic valve annulus to the sinotubular junction measures 1.5 to 3.5cm as it varies from person to person. Another point on the aortic root is the Sinuses of Valsalva. There is a natural dilation of the aortic root, which helps the blood to flow out of the aortic valve by systolic ejection, and then the blood forces into the coronary arteries.
Overtime, the sinuses grow weak and there is some expansion. There is heavy stress on the aortic tissues of this region which differs from other parts of the aorta, as it has to withstand a huge rush of blood flow from the left ventricle of the heart.
Causes of aortic root disease
The aortic tissue present in the aortic root can be genetically abnormal from birth. Aortic root disease and valve disease also affects patients suffering from ankylosing spondylitis. The aortic root disease that occurs as a collective vascular syndrome is a disorder of the aortic root. Its features are mainly root thickening, dilation, and stiffness. In some patients, there is also valve thickening. Besides the abovementioned problems, there are some other forms of aortic root diseases like cusp thickening, aortic mitral regurgitation, the sub aortic bump or the anomalous coronary artery and Marfan”s syndrome. These disorders are grouped together as the aortic root diseases.
The maximum number of cardio vascular disorders along with a high rate of mortality is due to aortic root diseases. Aortic root diseases are related to age As age advances, one is more likely to get these diseases. With medical science and technology making fast progress, diagnosis if these diseases have become easier, thus giving rise to early detection and better and improved medical intervention.
Features of the aortic root disease
When necrosis of the cell and tissues that line the aortic wall happens, the aortic root disease sets in. Degeneration of tissues takes place, making them weak, loses the quality of elasticity, thus the capability to stretch and the contract is also lost. The area that has become weak, widens, that is the diameter of the thoracic aorta becomes 4 to 5 cm, and is called dilation of the aorta, and when the diameter reaches more than 5 cm, it is termed as aneurysm. This widened and more opened up or dilated part of the aorta weakens and may reach a stage when it might burst, which happens rarely. Until it reaches this stage, the body does not give out any signal of any abnormality. When necrosis sets in, the aortic tissues may tear even if the aortic root does not get dilated. This is a condition where the inner layer of the aortic walls slit open, there is profuse leakage from the middle layer and this is the cause of separation of the inner and outer walls. This is termed as dissection.
Treatments of aortic root disease
Aortic root disease treatments require a surgical procedure that is quite complex, depending on the type of disorder, that is, whether it is dilation or an aortic aneurysm, and how much of the root is affected. Doctors perform this open heart surgery to treat the affected portion of the aorta. The main aim of this surgery is to prevent the aneurysm from rupturing, and tearing of the inner layer of the dilated aorta. A doctor should be consulted about the individual’s condition and the pros and cons of the surgery should be discussed.
Many of these aortic root surgeries or aneurysm procedures require minimal invasive techniques which incur less of pain, less of scars, and a shorter time for recovery. Aortic root surgery uses axillary cannulation, whereby surgeons try to keep the natural flow of blood in tact, during the operation, through the body and brain and letting it flow from the aorta, through an artery under the collarbone.
Therefore timely intervention, correct diagnosis by an efficient surgeon is what is required to treat and repair an aortic root disease.