The Aorta is an artery in the human body that carries oxygenated blood from the heart to different parts of the body. It is the largest artery in the body and is divided into 4 parts –
- Ascending Aorta
- Aortic arch
- Descending aorta
- Abdominal arch
Proper functioning of the Aorta is fundamental for survival, as it is a carrier of oxygen and essential nutrients to different parts of the body.
Aortic aneurysm or cardiac aneurysm is a condition wherein a bulge forms in a part of the aorta due to the weakening of the wall.
The Aortic wall is divided into 3 parts –
- Tunica intima – This is the innermost layer of the aortic wall which is in contact with blood. This layer is very thin and lined with endothelial cells. It is highly prone to injury.
- Tunica medica – This is thick, muscular, middle layer of the aorta which forms the largest part of the aortic wall.
- Tunica adventitia – This is the outermost layer of the aortic wall that is collagenous and contains vasa vesorum and nerves. It has the greatest tensile strength of all the three layers.
In case of an aortic aneurysm, a split occurs between the layers of the aorta leading to seepage and entrapment of blood. This creates a bulge in the affected part and can lead to further problems like-
- Rupture – The formation of a hole in the bulge that causes blood to burst or leak into the adjoining tissue.
- Dissection – The enlargement of a small split due to vigorous pumping of the blood through the aorta and leakage into space in between the walls, which in turn weakens other sections in the wall to develop splits.
Types of aortic aneurysms –
- Aortic root aneurysm
- Thoracic aortic aneurysm
- Abdominal aortic aneurysm
Types of aortic aneurysms –
The weakening of the walls of the aorta and subsequent development of cardiac aneurysms can occur if you have the following conditions –
- Atherosclerosis – Formation of plague on the interiors of the blood vessels can cause high blood pressure and considerable weakening of the walls of the blood vessels. This becomes more common with progressing age.
- Genetic conditions – People with Marfan syndrome are prone to cardiac aneurysms.
- Inflammatory conditions – Conditions like Giant Cell Arteritis, that affect the blood vessels can be a precursor to cardiac aneurysms.
- Dysfunction of the aortic valve – Complications in normal functioning of the aortic valve can be diagnosed by a doctor.
- Untreated infection – If untreated, infection like syphilis and salmonella can lead to aortic aneurysms. Tertiary syphilis can be a cause of aneurysm.
- Traumatic injury – Trauma to the aorta can also lead to aortic aneurysm due to weakening of the walls.
Aortic aneurysm treatment
Open chest surgery as well as Endovascular Aneurysm Repair (EVAR) are done to correct aortic aneurysm. Both these surgeries focus on placing a graft on the site of the aneurysm to reinstate proper flow of blood. In some cases, doctors can also skip surgery and advise medication for lowering blood pressure.
- Valve-sparing Aortic root repair – The damaged section of the aorta will be replaced with a prosthetic Dacron tube graft.
- Bentall Procedure – Cardiac surgery involving composite graft replacement of the Aortic valve, Aortic root, and Ascending aorta with the replacement of the coronary arteries into the graft.
However, surgical repair of cardiac aneurysms can lead to the risk of blood loss during and after the surgery, causing complications in the body. This can be prevented with the help of a haemostat that quickly initiates blood clotting.
Axiostat – for cardiac aneurysm repair
Axiostat is a natural biopolymer-based haemostat that helps to stop bleeding within minutes of application. It works on the principle of Protonated Bioadhesive Technology (PBT) and is even effective on people using blood thinners.
Where can Axiostat be used?
Axiostat can be applied to oozing from Suture line Anastomosis sites in VSARR & Bentall procedures.
It is easy to apply owing to its high flexibility. The product has considerable strength and does not disintegrate during removal. Size of Axiostat for cardiac aneurysm repair is 5 x 5 x 0.5 cm.
How does Axiostat work on aortic aneurysm?
Axiostat works on contact activation and skips the process of the coagulation cascade. The 100 % natural biopolymer Chitosan haemostat duplicates the fibrin mesh formation by charge-based adhesion. It attracts platelets, RBCs, and plasma, resulting in faster platelet activation and, in turn, quicker clot formation.
Axiostat detaches from the clot on irrigation post haemostasis, without dislodging the clot or rebleeding.
Advantage of using Axiostat over Fibrin sealants:
- It acts as a hemostat as well as a sealant due to its PBT properties.
- It can be easily removed from the site without any complication.
- it is cost-effective.
- Can be used on all kinds of bleeding (Mild to Severe)
It is always advisable to check previous medical records prior to using a product.