Heart - Cardiology & Cardiovascular Surgery

What is the Aorta?

At Mount Sinai Fuster Heart Hospital, we have extensive experience treating diseases of the aorta. The aorta is the largest artery of the body and carries blood from the heart to the circulatory system. It has several sections:

  • The Aortic Root, the transition point where blood first exits the heart, functions as the water main of the body. The aorta root contains the aortic valve, the origins of both coronary arteries, and an elastic segment called the sinuses of Valsalva. A variety of disease states, both genetic and acquired in life, can contribute to problems of the aortic root. Typically, we treat these disorders with open-heart surgery.
  • The Ascending Aorta is the portion of the aorta between the aortic root and the aortic arch. The point where the aortic root and the ascending aorta meet is called the sinotubular junction. At this junction, the aorta becomes less elastic and more rigid. Diseases in this area are rarely genetic.
  • The Aortic Arch is where the aorta transitions from the center of the chest to the back. Blood vessels from the aortic arch supply blood to the arms and legs. Operations on the aortic arch tend to be complex hybrid interventions that use both endovascular stent graft procedures and open-heart surgery.
  • The Thoracoabdominal Aorta is what we call the aorta once it transitions to the back of the body. Diseases here may involve genetic origins but are far more likely to be due to a history of smoking, high blood pressure, or atherosclerosis. We usually treat these conditions with hybrid interventions that have traditionally involved open-heart surgery. As technology advances, though, we rely much more on minimally invasive endovascular interventions.
  • The Descending Aorta runs through the chest and abdomen, starting after the aortic arch. Atherosclerosis, the weakening of the vessel wall, plays a large role in heart disease in the descending aorta.
  • The Abdominal Aorta is largest artery in the abdomen. It runs from the descending aorta down to just below the navel. High blood pressure is the most common cause of disease in the abdominal aorta.

Aortic Aneurysms and their Symptoms

An aneurysm is when the artery, or any other blood vessel, grows to twice its normal size. It happens when there is a weakening in the wall of the aorta.  Aortic walls weaken for a variety of reasons, including infection, smoking, atherosclerosis, trauma, high blood pressure, and genetic diseases/conditions such as Marfan syndrome and bicuspid aortic valve.

It is difficult to predict how quickly an aneurysm will grow. We do know, though, that the aneurysm’s size and location, as well as smoking habits and other medical problems, can affect growth. If you have a disorder such as Marfan disease or Elher-Danlos syndrome, and you have an aneurysm, it is likely to expand quickly.

Individuals with aortic aneurysms don’t always have symptoms. In fact, most don’t experience symptoms until the aneurysm is very large or bursts. When aneurysms enlarge, they can press on adjacent structures, causing pain. If you feel this type of severe pain, and you have an aortic aneurysm, you should seek immediate medical attention. Knowing what caused your aortic aneurysm helps us to determine the most appropriate treatment.

We typically find an aortic aneurysm when we are doing an imaging study for another medical condition. Sometimes it is best to treat an aortic aneurysm before it grows large enough that you experience symptoms. When we decide whether to do surgery, we take into account factors such as age and the presence of heart, lung, or kidney disease.