The Aorta - Yale Medicine Explains

Transcript

• 00:10- The aorta is the...really the major highway of blood flow.
• 00:15- The aorta is the biggest blood vessel in the body.
• 00:18It courses within our body, in our trunk and in our abdomen.
• 00:22It arises right out of the heart
• 00:25and takes a course where it starts towards the front of the chest.
• 00:29- The course is upwards and then sort of to the side and then downwards towards the feet,
• 00:35all the essential branches of the body emerge from the aorta.
• 00:39So you can think of it as really the major blood vessel
• 00:42supplying the organs of the body.
• 00:44- We often think about different organs in our body that are diseased.
• 00:47Someone has kidney disease, someone has liver disease,
• 00:50something wrong with the brain.
• 00:53But it's important to understand that all those organs
• 00:55need a rich and robust blood supply at all times to function.
• 00:59There are discrete diseases associated with the aorta
• 01:02that are important to carefully manage and treat.
• 01:06- Even a tiny bit of error in management can have devastating consequences.
• 01:12- Some conditions occur with age.
• 01:15The other type of disease are genetic and could be inherited
• 01:19and they tend to show up clinically at a younger age.
• 01:22A third type of conditions is any other condition in the body,
• 01:25such as inflammation or infection can affect the aorta,
• 01:28and the last type is trauma.
• 01:31So any injury to the aorta, such as in a car accident.
• 01:41- The aorta can harbor disease for a long time
• 01:44before it can cause any problems for the patient.
• 01:48- One of the most common diseases of the aorta that we treat is aortic aneurysm disease
• 01:53and often it's called a silent killer
• 01:55because by the time patients manifest symptoms from this,
• 01:59which most often happens to be either a tear in this wall of the aorta,
• 02:02what we call an aortic dissection, or rupture
• 02:06and if the aorta ruptures, most patients don’t even make it to the hospital.
• 02:15- And these aneurysmal changes can happen at a variety of different locations in the aorta.
• 02:21- When we treat pathologies of the aorta,
• 02:23we cannot treat the entire aorta at the same time.
• 02:26So we treat it in segments.
• 02:36- Endovascular surgery changed the scenery for aortic disease.
• 02:42- As the technology evolves, we can deliver these minimally invasive techniques
• 02:47and there are branched and fenestrated technologies
• 02:50that can be deployed in the ascending aorta and the aortic arch
• 02:54that will make an area of the aorta that was previously deemed
• 02:58solely appropriate for open surgery,
• 03:00now accessible for minimally invasive stent graft technology.
• 03:05And there can also be hybrid approaches where we combine traditional open surgery
• 03:10with some of the newer techniques that are available.
• 03:18From a genetic standpoint, we are also building a database of patients
• 03:22and we're going to be doing correlative studies to see
• 03:25what all these mutations in these family members mean in terms of their outcomes,
• 03:30because I think that will be important.
• 03:32My lab is studying from a biomarker profile because we know
• 03:36that we don't have any blood test to screen for aortic aneurysm patients.
• 03:42- When someone in the family has suffered from aortic condition
• 03:45or some unknown lethal thoracic condition,
• 03:48many times we find that they have the relatives
• 03:52that actually do have a silent aortic disease or an aortic valve disease
• 03:57and it's very rewarding that you are able to help patients in this capacity
• 04:01because otherwise these patients would have never found out that they had a disease
• 04:05and the same time offer awareness and screening and surveillance
• 04:09for them and for the rest of the family members.