The aorta is the largest artery in the body. The aorta begins at the top of the left ventricle, the heart's muscular pumping chamber. The heart pumps blood from the left ventricle into the aorta through the aortic valve. Three leaflets on the aortic valve open and close with each heartbeat to allow one-way flow of blood.
The aorta is a tube about a foot long and just over an inch in diameter. The aorta is divided into four sections:
• The ascending aorta rises up from the heart and is about 2 inches long. The coronary arteries branch off the ascending aorta to supply the heart with blood.
• The aortic arch curves over the heart, giving rise to branches that bring blood to the head, neck, and arms.
• The descending thoracic aorta travels down through the chest. Its small branches supply blood to the ribs and some chest structures.
• The abdominal aorta begins at the diaphragm, splitting to become the paired iliac arteries in the lower abdomen. Most of the major organs receive blood from branches of the abdominal aorta.
Like all arteries, the aorta's wall has several layers:
• The intima, the innermost layer, provides a smooth surface for blood to flow across.
• The media, the middle layer with muscle and elastic fibers, allows the aorta to expand and contract with each heartbeat.
• The adventitia, the outer layer, provides additional support and structure to the aorta.
- Aortic atherosclerosis: Cholesterol plaques build up in the wall of the aorta, posing a risk for stroke. High blood pressure and abnormal cholesterol levels are often responsible.
- Aortic aneurysm: A weakness in the aorta's wall allows a section to expand like a balloon. Aortic aneurysms are slow to grow, but they can be fatal if they rupture.
- Aortic dissection: High blood pressure and/or damage to the aorta's wall cause the wall's layers to separate. Aortic dissection can be life-threatening.
- Aortic insufficiency: The aortic valve does not close completely, allowing some blood to flow back into heart with each beat. Autoimmune diseases, Marfan's syndrome, or endocarditis can cause aortic insufficiency.
- Aortic regurgitation: Another name for aortic insufficiency. Blood regurgitates backward through the incompletely closed aortic valve and into the heart's left ventricle
- Aortic stenosis: Narrowing of the aortic valve, which causes the heart to strain to pump blood through. Rheumatic fever is the most common cause of aortic stenosis, which can cause chest pain or shortness of breath.
- Coarctation of the aorta: Narrowing of the aorta between its branches to the arms and those to the legs. This birth defect causes heart strain due to high blood pressure in the upper body.
- Bicuspid aortic valve: 1% to 2% of people have an aortic valve with two leaflets instead of three. A bicuspid aortic valve can eventually lead to aortic insufficiency or aortic stenosis.
- Aortitis: Inflammation of the aorta. Infections or autoimmune diseases are usually responsible.
- Aortogram (angiogram): A catheter is inserted into an artery in the groin and advanced into the aorta. Injected contrast material allows X-rays to make an image of the aorta on a screen.
- Abdominal ultrasound: A probe placed on the abdomen uses sound waves to make an image. Abdominal aortic aneurysms can be detected and measured to estimate the risk of rupture.
- Computed tomography (CT scan): A CT scanner uses X-rays and a computer to create images of the aorta and surrounding structures.
- Magnetic resonance imaging (MRI scan): An MRI scanner uses radio waves inside a magnetic field to generate images of the aorta.
- Transthoracic echocardiogram: A probe placed on the chest projects ultrasound waves off the aorta and heart. The breastbone (sternum) obstructs clear ultrasound views of the aorta during transthoracic echocardiograms.
- Transesophageal echocardiogram: An ultrasound probe on the end of a flexible tube is advanced through the mouth down the esophagus. Transesophageal echocardiograms allow better views of the first part of the aorta.
- Aortic aneurysm repair: When aortic aneurysms reach a certain size, surgery may be needed to prevent rupture. This is usually done through an incision in the abdomen.
- Aorta grafting (endograft): A damaged part of the aorta may be surgically replaced or reinforced with synthetic mesh.
- Aortic valve replacement: A damaged aortic valve may be surgically replaced, usually for aortic stenosis. The new aortic valve may be man-made or come from a pig
- Aorta surgery: In cases of aortic aneurysm, dissection, or coarctation, part of the aorta may need to be surgically removed. A surgeon reconnects the cut edges directly or with a graft.