- Heart Conditions
- Heart Treatments
- Obstructive Hypertrophic Cardiomyopathy Management
- Personalised External Aortic Root Support
- Electrophysiology Testing for Arrhythmias
- Cardiac Ablation
- Cardiac Catheterisation (Coronary Angiogram)
- Coronary Angioplasty (Coronary Stenting)
- Coronary Artery Bypass Grafting (CABG)
- Renal Denervation for Hypertension
- Advanced Therapies to Treat Heart Failure
- Permanent Pacemakers and Implantable Defibrillators (ICDs)
- Valve Repair or Replacement (Mitral Valve Surgery & TAVI)
- Ventricular Assist Device (VAD)
- Heart Scans and Tests
- Imaging Services
- Lung Conditions
- Lung Treatments
- Diagnostic Services
At RB&HH Specialist Care we offer the expertise of a multidisciplinary Aortic Team that manage patients with diseases of the thoracic aorta.
Two aortic diseases treated by our specialist team include Aortic Dissection and Aortic Stenosis.
Aortic dissection 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. Immediate treatment is required for aortic dissection as it can quickly lead to death, even with optimal treatment, as a result of decreased blood supply to other organs, heart failure, and sometimes rupture of the aorta.
It is more commonly found in patients with the following risk factors:
- history of high blood pressure
- a known thoracic aortic aneurysm
- those with connective tissue diseases that affect blood vessel wall integrity such as Marfan syndrome and Ehlers–Danlos syndrome
In the majority of cases patients will experience a sudden severe pain, that may be described as tearing, stabbing, or sharp in character. The location of the pain is associated with where the dissection has occurred – it may be felt in the chest, back or it may cause sharp pain when breathing.
The treatment for Aortic Dissection will depend on the type of dissection, the severity and the patient condition.
Proximal Aortic Dissection (Type A), which starts in the ascending aorta, is the more life-threatening variant and will normally require surgical intervention. However it can affect middle age and very old patients at a high surgical risk. Catheter based endovascular repair may be an option the Aortic Team would consider in these cases.
Type B Aortic Dissection, which starts in the descending aorta, can be managed medically in a number of cases. Endovascular treatments, both in the acute setting and in the elective setting, are also proving to be a successful alternative resulting in improved survival and delayed disease progression. The idea is to remodel the aorta and thereby avoid future problems. For example the Aortic Team offer thoracic endovascular aortic/aneurysm repair TEVAR. This involves the placement of an expandable stent graft within the aorta without operating directly.
Aortic Stenosis is the narrowing of the exit of the left ventricle of the heart such that problems result. Stenosis due to calcification is the commonest pathology of the aortic valve. When severe it results in hypertrophy (enlargement) of the heart muscle and symptoms such as shortness of breath and chest pain.
Aortic valve stenosis may be present at birth, develop due to rheumatic fever, or from calcification of the valves. Men have a higher risk than women, with the condition most likely to occur between the ages of 60 to 80.
Aortic Stenosis may not present any symptoms in its earlier stages, and is normally picked up with diagnosis of other diseases. When the disease progresses the following symptoms may present:
- chest pain
- feeling tired or short of breath after exertion that you would normally be fine with
- heart palpitations (abnormal heartbeats)
- developing a heart murmur (can be described as a “swooshing” sound, heard in the heart as it beats)
Medications can be used to help manage the disease, for example blood pressure medication, to reduce the burden on the valves. A number of surgical approaches are available to repair or replace the damaged valve and have a high success rate, dramatically improving quality of life. Aortic Valve Replacement (AVR) is the highest standard for treatment of aortic valve stenosis while Sutureless AVR is an alternative to both conventional AVR and Transcatherter Aortic Valve Implantation (TAVI).
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- Aortic Dissection: A Case Study The specialist Aortic Team at RB&HH work together to treat patients with diseases of the thoracic aorta. Professor Christoph Nienaber,...
- Sutureless Aortic Valve Replacement A new aortic valve replacement, that doesn’t require sewing into place, is reducing surgery times and proving to be an...