About the Aorta
The aorta is the primary artery of the body that carries blood from the heart to the circulatory system. The anatomy of the aorta is divided into the following seven sections.
The aortic root is the transition point where blood first exits the left-sided pump of the heart. It is identified as the first portion of the aorta and essentially functions as the water main of the body. There are several important structures that reside in the aortic root, including the aortic valve, the origins of both coronary arteries, and an elastic segment know as the sinuses of valsalva. A variety of disease states, both genetic and acquired in life may contribute to problems of the aortic root. At the present time, disease of the aortic root that require surgery are still considered open-heart surgery, as not stent graft treatments for this area of the body currently exist.
The transition between the aortic root and ascending aorta is somewhat nebulous but it has implications on how operations are performed. Most would agree that the ascending aorta begins where aortic root leaves off. This transition is known as the sinotubular junction, but more importantly than the name it is where the consistency of the aorta changes between an elastic structure to a more rigid tube. The ascending extends to the aortic arch. Diseases of the ascending aorta are more likely due to acquired problems.
The aortic arch is where the tube transitions from the center of the chest to the back. Several important branches leave the aortic arch to supply blood to the arms and the brain. Operations on the aortic arch tend to be complex hybrid interventions that employ both open surgery and endovascular stent graft procedures.
Once the tube transitions from the center of the chest down to the back, it is referred to as the thoracoabdominal aorta. Diseases here may involve genetic origins but are far more likely to be due to a history of smoking, high blood pressure, and atherosclerosis. The treatment of these problems is often accomplished by hybrid interventions that may include open surgery but as technology advances, far more reliance on endovascular intervention.
Allan Stewart, MD
Director, Aortic Surgery Program
Department of Cardiovascular Surgery
The Mount Sinai Health System
1190 Fifth Ave: Box 1028
Assistant: Debra Segreti