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What 5 Facts Should You Know About The Aorta?

Written By: Adam Pick, Patient Advocate, Author & Website Founder
Medical Expert: Paul Fedak, MD
Page Last Updated: May 12, 2025

If you didn't know...

Your aorta is the largest artery in the body. It starts at the top of the heart's main pumping chamber, the left ventricle, and extends down to the abdomen. Blood is pumped from the left ventricle into the aorta through the aortic valve, which is a tri-leaflet heart valve for 98% of the population.

As many people in this patient community are aware, the aorta can weaken and expand. This bulge in the aorta is called an aneurysm. In worse case scenarios, an aortic aneurysm can rupture (or dissect). Together, we have learned that many patients with heart valve disease - especially bicuspid aortic valves - also have aortic aneurysms.

In a recent newsletter, I referenced an educational post by Dr. Thomas Gleason about timing the surgical intervention for an aortic aneurysm and bicuspid aortic valve. In the post, Dr. Gleason referenced the guidelines that doctors use to determine when to operate. Shortly after mentioning this article, Dr. Paul Fedak, a Calgary-based heart surgeon and long-time supporter of HeartValveSurgery.com, sent me an email. In his note, Dr. Fedak informed me that the guidelines had changed and that we should update our community.

I thought it was a great idea.

Dr. Paul Fedak - Heart Surgeon

Dr. Fedak's Top 5 Facts About Your Aorta

I asked Dr. Fedak, who is an incredibly nice guy, what should patients know about the aorta.

In response, he sent me these "Top 5 Fact About Your Aorta".

You are not a ticking time bomb. Research is showing that the risk of the aorta rupturing or dissecting is not as high as we once believed;
Surgery to remove an enlarged aorta is recommended for most people with Bicuspid Aortic Valve at 5.5 cm (based on a CT scan or MRI test);
Surgery to remove an enlarged aorta is recommended for some people with Bicuspid Aortic Valve at 5.0 cm (if they have other high risk features as determined by your physicians);
Surgery to remove an enlarged aorta is recommended for most people with Bicuspid Aortic Valve at 4.5 cm if they are already having valve or other heart surgery;
Surgery to remove an enlarged aorta is NOT recommended if the size of the aorta is under 5.0 cm if the valve is still working well and the patient is of average height/body size.

More Insights About Bicuspid Aortic Valves & Aortic Aneurysms

As you can see above, there is a direct connection between aortic aneurysms and Bicuspid Aortic Valves. Bicsupid aortic valves have two valve leaflets instead of three. And, Bicuspid Aortic Valves are the most common congenital cardiac disorder. If you would like to read more about this topic, you can review the American Association for Thoracic Surgery Consensus Guidelines on Bicuspid Aortic Valve-Related Aortopathy, by clicking here.

Many thanks to Dr. Fedak for keeping me and our patient community up-to-speed on the guidelines that help clinicians determine the best and most appropriate time for an operation!!!

Keep on tickin!
Adam

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Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

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