Flow Chart
From your aorta to coronary arteries, here's what you need to know about your major blood vessels
By Kelly Casey
Most of us got a pretty good understanding of our bones in Kindergarten from the catchy song "the leg bone's connected to the knee bone." But what about the major branches of your blood vessels? Here are the ones you need to know about, how to keep them healthy, and the latest treatments to keep them flowing.
aorta
why it's important
The aorta is the body's largest artery. It carries blood from the heart to the vital organs and limbs.what can go wrong
Sometimes a bulge, or weak area known as an aneurysm, forms in either the upper (thoracic) or lower (abdominal) part of the aorta. More than 21,000 people in the U.S. are diagnosed as having a thoracic aortic aneurysm (TAA), which can lead to shock, bleeding and sudden death without quick treatment. The actor John Ritter died of a ruptured aorta in 2003 at age 54.
More commonly, a bulge forms lower down in the aorta. This is called an abdominal aortic aneurysm (AAA). Up to 2 million Americans have AAA but only about 200,000 cases are diagnosed each year because many people don't have symptoms. AAA results in about 15,000 deaths per year. Most insurance companies cover a simple ultrasound screening for those most at risk (See "Who Needs a AAA Screening?") Medicare also covers a AAA screening for at-risk seniors who are new to the Medicare system.
what doctors can do
Surgical repair of aortic aneurysms has been around for more than 50 years and is highly effective in permanently repairing the weakened area. When traditional open surgery is not a good option for a patient, doctors can now repair the weakened area using a less-invasive "endovascular" procedure in which a stent, or tubelike structure, is inserted into the aorta through a small incision in the thigh. University of Virginia Health System doctors helped pioneer endovascular repair of aortic aneurysms, and UVA's Vascular Program includes widely recognized experts in vascular surgery, vascular and interventional radiology, and interventional cardiology.
More good news for patients who need their aorta repaired; UVA's patient complication rates (compiled over 2005-2006) for TAA repairs were lower than the statewide average. And each year, UVA performs on average 100 AAA repairs. (National data show that hospitals which perform more than 50 AAA repairs each year have better patient outcomes.)
carotid arteries
why they're important
These two large blood vessels in your neck supply your brain with blood.
what can go wrong
When these arteries become narrow, usually from the buildup of cholesterol and other material, it can lead to carotid artery disease. If a blood clot sticks in the narrowed arteries, this can prevent blood from reaching the brain, raising the potential for a stroke.
what doctors can do
There are no clear symptoms of carotid artery disease, but tests can tell your doctor if you have it. If these arteries are very narrow, you may need an operation called a carotid endarterectomy (CEA) to remove the plaque. UVA performs more than 100 of these procedures each year. Another option for people who can't have surgery is carotid angioplasty (when doctors place balloons and/or stents into the artery to open it and hold it open).
coronary arteries
why they're important
These arteries supply blood to the heart muscle.
what can go wrong
When these arteries become hardened and narrowed from buildup of cholesterol and other material on their inner walls, coronary artery disease (CAD) forms. This is the leading cause of death in the United States in both women and men. As the disease progresses, the heart muscle is not able to receive all of the oxygen it needs. This can lead to angina (chest pain or discomfort) or a heart attack (when heart muscle cells die from a lack of oxygen.) Over time, CAD can lead to heart failure and changes in the normal beating rhythm of the heart.
what doctors can do
A minimally invasive angioplasty procedure can open blocked or narrowed coronary arteries to help prevent a heart attack. If your doctor recommends coronary artery bypass surgery, surgeons can bypass your narrowed coronary arteries using blood vessels taken from other areas in your body.
In 2007, UVA celebrated 50 years of performing cardiac surgery. Its pioneering history includes performing Virginia's first coronary artery angioplasty. And today UVA offers heart attack patients a heart-saving angioplasty on average within 48 minutes of arriving to the Emergency Department-well below the 90 minutes recommended by national guidelines.
why they're important
The pulmonary arteries carry oxygen-poor blood from the right ventricle in the heart to the small arteries in the lungs.what can go wrong
Pulmonary arterial hypertension (PAH) is continuous high blood pressure in the pulmonary artery. This can cause the artery to become narrower and, over time, become completely blocked. PAH is more common in women than men, and even women in their 20s can develop it for unknown reasons. This is why it's so important not to ignore symptoms such as shortness of breath, lightheadedness and fainting. PAH can also be caused by heart disease, lung disease and even sleep apnea.
what doctors can do
Doctors have learned a lot about PAH in recent years. There are now several FDA-approved medications to treat it, helping prolong lives as well as improve the quality of life for people living with PAH. At UVA's Pulmonary Hypertension Clinic, patients have access to the latest treatments, promising clinical trials, and even lung transplantation which can reverse the disease. Robyn Boedefeld, M.D., a PAH expert, runs the UVA clinic and works closely with lung and heart disease experts to help patients manage underlying conditions.
peripheral arteries
why they're important
These arteries supply blood to the limbs, especially the legs.
what can go wrong
The buildup of plaque on the walls of these arteries causes them to narrow or become blocked, causing peripheral arterial disease (PAD). This common, but seriously under-diagnosed, condition (also called peripheral vascular disease) can lead to heart attack, stroke or loss of limbs. Men are more likely to have symptoms, such as pain when walking, but both men and women can develop the disease.
what doctors can do
UVA interventional radiologists and vascular surgeons are leaders in offering patients minimally invasive techniques for opening blocked arteries. UVA surgeons are among the early adopters of a less-invasive technique for harvesting a vein (used to bypass the blocked portion of the artery) that requires only a small incision in the thigh.
How to keep all your arteries healthy
What's good for one artery is good for another. And what's good for your arteries is good for your heart. Quit smoking. Get moving. Eat lots of fruits, vegetables and fiber-rich foods. Avoid foods high in cholesterol and saturated fats. Control your high blood pressure (a good night's sleep-7 to 9 hours-can help.) See your doctor regularly to make sure your blood pressure and cholesterol levels stay in a healthy range.
If you need medication, it's important to see a cardiovascular doctor at least once a year to make sure you're getting the medication, and amount, best for you. UVA Health System offers the full range of cardiovascular care-from helping you make long-lasting lifestyle changes to offering the most advanced surgical procedures. What's more, many of UVA's cardiovascular doctors are consistently listed in the reference book, America's Top Doctors, including Kenneth Cherry Jr., M.D., head of UVA's Division of Vascular Surgery. He joined UVA in 2004 after a 22-year career at Mayo Clinic.
"It's exciting to work closely at UVA with national and international leaders in the field of vascular disease," Cherry says. "To each patient, we bring years of experience and innovative technology. This way, our patients recover as quickly as possible and can rest assured that their blood vessels will keep doing their vital work for a long, long time."
To put UVA on your heart-healthy team, call 888-882-9892.
This article appeared in the spring 2008 issue of Vim & Vigor, a family health magazine sponsored by UVA Health System. If you don't already receive it at home, sign up today. It's free.