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Better Treatment For Torn Aortas
Cardiologists Develop Method To Analyze Risk Of Death After An Aortic Aneurysm

March 1, 2008 — Cardiologists found that an aortic tear poses the highest risk to patients if the false channel it creates clots partially. Their study showed that CT and MRI images show how much clotting has occurred in the aorta, and that clotting raises the risk of death for patients.


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Each year, 10,000 Americans suffer a sudden tear of the aorta -- the largest blood vessel in the body.

Unfortunately, even patients who survive this traumatic experience aren’t in the clear. Now, doctors are working on a way to save more lives after an aortic tear. Not long ago, Walter Loesche was walking down the street when he almost lost his life.

“So I was bouncing along relatively happy when, wham, all of the sudden my left leg gave way, and I fell to the sidewalk,” says Loesche.

Loesche suffered a torn aorta, the largest blood vessel in the body that pumps blood to other organs. It can tear suddenly, without warning.

Walter is lucky to be alive, but patient's still face a one-in-four chance of dying within a few years. Now, cardiologists have a new way to predict who’s at risk of death later on, and help those patients sooner.

When the wall of the aorta tears, it creates a second channel. Often, small openings at the bottom of this new “false” channel will allow blood to flow back out. If not, clots form, causing increased pressure and possible rupture.

“Patients who have clot formation within that false channel have a 2.5 times greater risk of death, than patients who don’t have clotting within the false channel,” says Thomas Tsai, M.D., a cardiologist at the University of Michigan.

Identifying patients with this risk factor, doctors hope to help patients live longer.

“Our CAT scans and MRIs are able to find this risk condition and if we find it then we may be able to follow these patients more closely and even ultimately intervene earlier,” says Dr. Tsai.

Walter's health is being tracked -- so far he has a clean bill of health.

“I’m just so pleased that here I am!" says Loesche. Doctors also consider closing off or blocking the flow of blood into the second channel, leading it to clot completely, and decreasing any blood pressure, which may lead to a gradual healing.

WHAT IS THE AORTA? The aorta is the largest artery in the human body. It carries blood away from the heart to other parts of the body. Part of it runs through the chest; this is called the thoracic aorta. Once it reaches the abdomen, it is known as the abdominal aorta.

An aneurysm is a bulge in a blood vessel, like an over-inflated inner tube. They can develop if the wall of the aorta is weakened by the build-up of fatty deposits called plaque (atherosclerosis). The larger an aneurysm becomes, the greater the likelihood that it will burst.

WHAT IS ARTERY PLAQUE: Plaque doesn't just grow on your teeth. It can also form inside your arteries -- the blood vessels that carry oxygen and blood to the heart, brain and other parts of the body. Arteries have an inner layer of muscle. When it is damaged, plaque can form, sometimes leading to a bulge in the wall of the artery. The bulges can grow big enough to cause the inner lining to rupture. The body responds by sending clotting fibers to the damaged site. Minerals, especially calcium, can become trapped in the net of fibers, and so can fats like cholesterol. The minerals and fats build up over time, causing the arteries to narrow. Blood can't flow so easily through the restricted arteries. The arteries can also become clogged, stopping blood flow completely.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.


Note: This story and accompanying video were originally produced for the American Institute of Physics series Discoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law. All rights reserved.
 

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