[fernly]

I have some personal experience with the related problem. At age 60 a gradually increasing "murmur" led to a diagnosis of Aortic Ectasia[0], a stretching of the ring of muscle that is the base for the aortic valve. As the valve widens, the three leaflets overlap less and the valve doesn't seal properly, making the heart less efficient. In addition my ascending aorta, the big arched tube that is the subject of the above article, was stretching in the manner described. These effects can be the result of Marfan Syndrome[1] but I don't have any of the other signs of it, such as long, spidery fingers and toes (fold your thumb across your palm: if the tip of the thumb projects beyond the outside of your palm, you should read up on Marfan).

The "garden-hose wrap" method described in this article was not mentioned to me, probably because it would have no use on the more important failure, the stretched valve.

However, I was given a clear choice of replacement valve: metal or tissue. Tal Golesworthy presumably would have had the same choice, but the article doesn't mention that there is a choice.

The metal (actually metal frame with a carbon-fiber flap) replacement valve lasts pretty much forever. On the minus side, it sometimes has a harmless, but audible "tick" noise, but its main drawback is that it can be a source of blood clots, hence the need for the lifelong course of blood thinner. Miss a few days and you could have a stroke from a clot.

I opted for the tissue valve, which is taken from a pig (or a cow, if you object to pork products). All its cells removed, leaving only the collagen form, so there's no host-graft immune reaction. It's silent, it doesn't encourage clot formation -- but it doesn't last forever. At some point in the next decade I'll need another one.

The new valve and about 7 inches of new Dacron aortic arch were sewed in. The surgeon commented afterward that my removed aorta "felt very soft" and was "poor quality tissue" and that I was "fortunate" that it hadn't failed.

This leads me to wonder: a common failure mode of the aorta is Aortic Dissection[2] in which the tube delaminates. Rather than bursting, the lining separates from the supporting wall, and high-pressure blood gets between the layers and spreads them, reducing the cross-section of the pipe. (It's reputed to be one of the most painful experiences possible.) My wonder is: while the "hose-wrap" fix described in this article might prevent ruptures, would it be an effective preventative for aortic dissection?

[0]http://en.wikipedia.org/wiki/Annuloaortic_ectasia [1]http://en.wikipedia.org/wiki/Marfan_syndrome [2]http://en.wikipedia.org/wiki/Aortic_dissection

[gonzo]

In a word, No. It wouldnt fix the false lumen.

This is me:

http://aorticdissection.com/2011/12/06/jim-thompson-47/

[z3niMAGiNE]

If it has already dissected it's obviously too late. The parent comment asked if it would prevent dissection in those aneurysms that haven't yet dissected which is probably a more complicated question. It would probably depend on the elasticity of the vessel since we don't see dissection exclusively on absurdly dilated aortas. At the very least we can guess that it would help to extend the life of the native artery. Of course only long term monitoring of these patients will give us a somewhat conclusive answer.

[gonzo]

It's not always the aneurysm that causes the dissection. Sometimes the dissection causes the aneurysm. The theory is that a plaque tears a he in the surface of the aorta.

[vinceguidry]

> would it be an effective preventative for aortic dissection?

Even if it could measurably reduce the chances for known risk groups, would it really be prudent to perform open-heart surgery on a patient without a current condition?

[colanderman]

(It's reputed to be one of the most painful experiences possible.)

Tangent: why have humans (animals in general I guess) evolved pain receptors inside their bodies?

[coldtea]

Because the skin is not the only point that can give information of something going wrong?

[colanderman]

Yes, but when you're a caveman or peasant, there's not much you can do about physical trauma to your internal organs. External pain is useful because you can usually take action to stop it.

(Obviously with the advent of modern medicine, internal pain is useful.)

[coldtea]

>Yes, but when you're a caveman or peasant, there's not much you can do about physical trauma to your internal organs.

For one, you can sit still until they heal, and avoid straining them further.

Second, internal pain after eating something bad (e.g rotten or poisonous) for example, helps you avoid eating it again.

Just off the top of my head -- I'm pretty sure there are tons of other cases.

[colanderman]

Hm, OK. I'll buy this. I forgot that "doing nothing" is actually something you can do.