Aorten

The aorta, referred to as Aorten in German, is the main artery of the systemic circulation. It transports oxygen-rich blood from the left ventricle of the heart to the entire body. It begins at the aortic valve, ascends as the ascending aorta, arches, and then descends as the thoracic (descending) aorta before becoming the abdominal aorta and finally dividing into the common iliac arteries.

Anatomy and major branches: The ascending aorta gives rise to the coronary arteries. The aortic arch gives three major branches: the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. The thoracic aorta gives rise to intercostal, bronchial, esophageal, and mediastinal arteries, while the abdominal aorta gives the celiac trunk, superior mesenteric, inferior mesenteric, renal, gonadal, and suprarenal arteries, among others, and ends by bifurcating into the common iliac arteries.

Structure and function: The aorta is a muscular, elastic artery with walls comprising intima, media, and adventitia. Its high elasticity, particularly in the proximal segments, supports the Windkessel effect, smoothing the pulsatile output of the heart to maintain steady blood flow and pressure. The aortic arch houses baroreceptors that contribute to short-term blood pressure regulation.

Clinical significance: Common conditions include aortic aneurysm (dilation), aortic dissection (tear in the wall layers), coarctation (narrowing, often near the arch), and atherosclerosis. Risk factors include hypertension, smoking, and age. Diagnosis relies on imaging such as ultrasound, computed tomography angiography, and magnetic resonance angiography. Treatments range from medical management of blood pressure to endovascular repair (EVAR/TEVAR) or open surgical repair, depending on location, size, and risk.