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The thoracic aorta is a continuation of the descending aorta and becomes the abdominal aorta when it passes through the diaphragm. The initial part of the aorta , the ascending aorta , rises out of the left ventricle, from which it is separated by the aortic valve .
The descending aorta anatomically consists of two portions or segments, the thoracic and the abdominal aorta, in correspondence with the two great cavities of the trunk in which it is situated. Within the abdomen, the descending aorta branches into the two common iliac arteries which serve the pelvis and eventually legs.
Aortic unfolding is an abnormality visible on a chest X-ray, that shows widening of the mediastinum which may mimic the appearance of a thoracic aortic aneurysm. [ 1 ] With aging, the ascending portion of the thoracic aorta increases in length by approximately 12% per decade, whereas the diameter increases by just 3% per decade.
Following the aortic arch, the aorta then travels inferiorly as the descending aorta. The descending aorta has two parts. The aorta begins to descend in the thoracic cavity and is consequently known as the thoracic aorta. After the aorta passes through the diaphragm, it is known as the abdominal aorta.
Coming out of the heart, the thoracic aorta has a maximum diameter of 40 mm at the root. By the time it becomes the ascending aorta, the diameter should be < 35–38 mm, and 30 mm at the arch. The diameter of the descending aorta should not exceed 25 mm. [8] [9] The arch of the aorta lies within the mediastinum.
Between the mobile ascending aorta and the relatively fixed descending thoracic aorta is the aortic isthmus. When there is a sudden deceleration the mobile ascending aorta pushes forward creating a whiplash effect on the aortic isthmus. [9] However, a different mechanism is involved when the ascending aorta proximal to the isthmus is torn.
Familial aortic dissection or FAD refers to the splitting of the wall of the aorta in either the arch, ascending or descending portions. FAD is thought to be passed down as an autosomal dominant disease and once inherited will result in dissection of the aorta, and dissecting aneurysm of the aorta, or rarely aortic or arterial dilation at a young age.
The aortic sac is the embryological precursor of the proximal portion of the aortic arch. It is chronologically the first portion of the aorta to form, and appears as a dilation superior to the truncus arteriosus. Between the two horns of aortic sac, right horn gives rise to the brachiocephalic artery.
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