aorta

And Dr. Eric Jeng.

He's the director of the UF Health Aortic Disease Center and an associate professor in the Division of Cardiovascular Surgery at the University of Florida College of Medicine.

Doctors, thank you so much for joining us today.

And Dr.

Well, that's certainly a comprehensive approach with the importance of that multidisciplinary aspect.

So, Dr. Jang, when we think of the key anatomic and clinical factors, and you mentioned shared decision making and what the patient really wants, and I'm sure that that is a little bit challenging for patients to think of that open repair and open heart surgery.

Tell us a little bit about your management strategies for patients Aortic anatomy, when maybe that presents the challenge to your standard endovascular access or repair techniques, whatever their clinical factors might be, how are you working with them? And then how do you help them to make those decisions based on your expertise?

Because we work so closely together with, I mean, even the interventional cardiologists, the radiologists, the vascular surgeons, we come up with what we think is the best and the simplest approach.

Cardiovascular, this is the most dangerous aspect.

Aortic root dilatation is the hallmark, leading to risk of aortic dissection the most serious complication and a common cause of death.

Mitral valve prolapse is also common, often causing mitral regurgitation.

Ocular, the classic finding is upward lens subluxation, ectopia lentis, which occurs in around 60% of patients.

Beta-blockers such as atenolol are first-line to reduce aortic wall stress by lowering heart rate and blood pressure, slowing the rate of aortic dilatation.

Losartan, an angiotensin II receptor blocker, is used as an alternative or additional agent, with evidence suggesting it may reduce the rate of aortic growth.

Aortic root surgery prophylactic aortic root replacement is recommended when the aortic root diameter exceeds 4.5 cm or when the rate of dilatation is rapid.

Emergency surgery is needed for aortic dissection.

He has an aneurysm.

Aortic, right? Yes.

Right.

And it's fatal.

... you have a lot of pressure there.

Aorta.

And, and also when the capillaries start really becoming extremely narrow, you will naturally have, you know, sort of a, a fl- a flow that sort of, uh, um, has, has to fit in.

Um, and that's exactly where, where it's hitting.

Oz is a doctor, medical doctor.

He has all the credentials in the world, all right? The man is a cardiothoracic surgeon, and I believe primarily today he uses catheters, right? If you want to unblock, say, the artery, the main artery, what is that artery called, the aorta? Aorta, the big one.

If you want to unblock that thing, if it's jam-packed with cheeseburger residue and been clogged, You go in with a catheter to break it up.

Well, in the olden days, as in like 20 years ago, you had to open the whole damn thing up.

And if people are found to be Rh negative, they should also be given rho(D) immune globulin to reduce the risk of possible alloimmunization.

REBOA, so Resuscitative Endovascular Balloon of the Aorta, there's very limited data really in pregnant patients, and so they really aren't able to make any recommendations as to whether this should or shouldn't, shouldn't be used.

So unfortunately, the jury is out on that one.

Airway and ventilation management, remember that the pregnant patient has a different airway than they previously had in the non-pregnant state.

Mitral regurgitation may be due to rheumatic disease, mitral valve prolapse, or congenital causes.

Aortic regurgitation may be rheumatic or associated with a bicuspid valve or aortic dilation.

Women with mild or moderate regurgitation and normal ventricular function usually do well with standard antenatal care and periodic echocardiography.

Problems arise in women with severe regurgitation and symptoms or with impaired left ventricular function who may develop heart failure, especially in the third trimester.

You don't see every day.

The aorta is the largest blood vessel in your body coming straight off the heart.

Aorta tissue is here on the like supports, like principle to support your cardiovascular system, your heart and your vessels.

And it belongs because circulation, blood flow, male performance, it matters, right? And as we age, we get less of it, just like the testosterone and just like the prostate risk.

So there's some really protective things here.