- The aorta is the...really the major highway of blood flow.
- The aorta is the biggest blood vessel in the body.
It courses within our body, in our trunk and in our abdomen.
It arises right out of the heart
and takes a course where it starts towards the front of the chest.
- The course is upwards and then sort of to the side and then downwards towards the feet,
all the essential branches of the body emerge from the aorta.
So you can think of it as really the major blood vessel
supplying the organs of the body.
- We often think about different organs in our body that are diseased.
Someone has kidney disease, someone has liver disease,
something wrong with the brain.
But it's important to understand that all those organs
need a rich and robust blood supply at all times to function.
There are discrete diseases associated with the aorta
that are important to carefully manage and treat.
- Even a tiny bit of error in management can have devastating consequences.
- Some conditions occur with age.
The other type of disease are genetic and could be inherited
and they tend to show up clinically at a younger age.
A third type of conditions is any other condition in the body,
such as inflammation or infection can affect the aorta,
and the last type is trauma.
So any injury to the aorta, such as in a car accident.
- The aorta can harbor disease for a long time
before it can cause any problems for the patient.
- One of the most common diseases of the aorta that we treat is aortic aneurysm disease
and often it's called a silent killer
because by the time patients manifest symptoms from this,
which most often happens to be either a tear in this wall of the aorta,
what we call an aortic dissection, or rupture
and if the aorta ruptures, most patients don’t even make it to the hospital.
- And these aneurysmal changes can happen at a variety of different locations in the aorta.
- When we treat pathologies of the aorta,
we cannot treat the entire aorta at the same time.
So we treat it in segments.
- Endovascular surgery changed the scenery for aortic disease.
- As the technology evolves, we can deliver these minimally invasive techniques
and there are branched and fenestrated technologies
that can be deployed in the ascending aorta and the aortic arch
that will make an area of the aorta that was previously deemed
solely appropriate for open surgery,
now accessible for minimally invasive stent graft technology.
And there can also be hybrid approaches where we combine traditional open surgery
with some of the newer techniques that are available.
From a genetic standpoint, we are also building a database of patients
and we're going to be doing correlative studies to see
what all these mutations in these family members mean in terms of their outcomes,
because I think that will be important.
My lab is studying from a biomarker profile because we know
that we don't have any blood test to screen for aortic aneurysm patients.
- When someone in the family has suffered from aortic condition
or some unknown lethal thoracic condition,
many times we find that they have the relatives
that actually do have a silent aortic disease or an aortic valve disease
and it's very rewarding that you are able to help patients in this capacity
because otherwise these patients would have never found out that they had a disease
and the same time offer awareness and screening and surveillance
for them and for the rest of the family members.