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An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. [1] Typically, there are no symptoms except when the aneurysm dissects or ruptures, which causes sudden, severe pain in the abdomen and lower back. [2] [3] The etiology remains an area of active research.
The ascending aorta (AAo) [1] is a portion of the aorta commencing at the upper part of the base of the left ventricle, on a level with the lower border of the third costal cartilage behind the left half of the sternum.
The aorta normally has three small pouches that sit directly above the aortic valve (the sinuses of Valsalva), and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [ 1 ]
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.
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.
Inferior vena cava size as estimate of central venous pressure; Aortic root size for thoracic ascending aortic aneurysm; Pericardial effusion size; All function dysfunction is graded on a scale (normal, trace, mild, moderate, or severe) based on various criteria.
An aortic sinus, also known as a sinus of Valsalva, [1] is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve.These widenings are between the wall of the aorta and each of the three cusps of the aortic valve.
As the blood moves into the aortic arch, the area with the highest velocity tends to be on the inner wall. Helical flow within the ascending aorta and aortic arch help to reduce flow stagnation and increase oxygen transport. [4] As the blood moves into the descending aorta, rotations in the flow are less present.