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Aortic Dissection





The aorta, the great artery, is the largest blood vessel in the body. It is about 3 centimeters or 1 ½ inches in diameter. It begins at the outflow tract of the left ventricle. Blood is pumped from the left ventricle through the aortic valve and is carried by the aorta to deliver oxygen to all parts of the body. The valve is present to prevent blood from flowing back into the left ventricle. The aorta is composed of structural fibers which are quite elastic in nature. This allows the aorta to stretch and contract allowing it to handle the large quantities of blood that it receives throughout the years.  















Images source: Cleveland Clinic Foundation


Image source for all above - Cleveland Clinic Foundation



 
An
aortic aneurysm (left)  is a dilation of the aorta to greater than 1.5 times normal it is due underlying weakness in the wall of the aorta. While

The stretched vessel may cause discomfort and there is a significant risk of rupture, which causes severe pain, massive internal bleeding and, unless treated immediately, death.

An aortic dissection (right)  occurs when a tear in the inner wall of the aorta causes blood to flow between the layers of the wall of the aorta, forcing the layers apart. 


Aortic dissection is relatively uncommon but is extremely dangerous. About 2000 cases occur yearly in the United States. If not treated, a quarter of people die in the first day. One half dies in the first week. Surgery is very complex and can involve replacing the aorta with a synthetic graft with or without replacement of the aortic valve. Sometimes bypass surgery also needs to be done. Mortality of the surgery can be as high as 20 to 30 percent.




Image Source:  Clotbuster Archives



This is a CT scan of a patient with an aortic dissection.