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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.
A stent graft placed in the thoracic aorta to treat a thoracic aortic aneurysm. The size cut off for aortic aneurysm is crucial to its treatment. A thoracic aorta greater than 4.5 cm is generally defined as aneurysmal, while a size greater than 5.5 cm is the distinction for treatment, which can be either endovascular or surgical, with the ...
The treatment of arterial tortuosity syndrome entails possible surgery for aortic aneurysms, as well as regular clinical surveillance including regular follow-up echocardiograms. [7] The prognosis and lifespan of this condition are unclear. Early reports of mortality were high, [10] but more recent data suggests about 12% mortality. [5] [11]
Behind the descending thoracic aorta is the vertebral column and the hemiazygos vein. To the right is the azygos veins and thoracic duct, and to the left is the left pleura and lung. In front of the thoracic aorta lies the root of the left lung, the pericardium, the esophagus, and the diaphragm.
The most common mechanism leading to thoracic aortic injury is a motor vehicle collision. Other mechanisms include airplane crashes, falling from a large height and landing on a hard surface, or any injury that causes substantial pressure to the sternum. [10] The incidence of thoracic aortic injuries is approximately 1 in 100,000. [6]
The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections.
It makes aortic surgery difficult, especially aortic cross-clamping, and incisions may result in excessive aortic injury and/or arterial embolism. [6] The ascending aorta segment is of significant due to its susceptibility to aortic dissection, two times more than in the descending aorta. Early detection of dissection is critical because it ...
The tethering of the aorta by the ligamentum arteriosum makes the site prone to shearing forces during sudden deceleration. [8] A study of people who died after traumatic aortic rupture found that in 55–65% of cases the damage was at the aortic isthmus and in 10–14% it was in the ascending aorta or aortic arch. [4]