[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Chest](https://durgical.com/en/anatomy/region/chest/) › Ascending aorta [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Chest](https://durgical.com/en/anatomy/region/chest/) # Ascending aorta The ascending aorta is the first part of the body's main artery, rising from the [left ventricle](https://durgical.com/en/anatomy/left-ventricle/); the coronary arteries branch from its root. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=thorax&select=ascending_aorta&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The first part of the aorta, rising from the left ventricle behind the sternum. The coronary arteries start at its root. ## What it does Carries all the blood the left ventricle pumps out toward the body. ## Key points - Its root has three aortic sinuses (of Valsalva): the right and left coronary arteries leave the right and left sinuses; the non- [coronary sinus](https://durgical.com/en/anatomy/coronary-sinus/) gives no artery - Lies in the middle mediastinum inside the pericardium; the transverse pericardial sinus separates it and the pulmonary trunk from the superior vena cava and atria behind - Most common site of thoracic aortic aneurysm; a dissection that involves it is Stanford type A, a surgical emergency ## Key facts **Origin** Aortic valve of left ventricle, behind left sternum at 3rd intercostal space; inside pericardium, about 5 cm long **Branches** Right and left coronary arteries (from aortic sinuses) **Supplies** Heart (via coronaries); continues as aortic arch at level of sternal angle ## Relations **In front** Start of the [pulmonary trunk](https://durgical.com/en/anatomy/pulmonary-trunk/) and the right ventricular outflow tract, the right [auricle](https://durgical.com/en/anatomy/auricle/); further forward the [pericardium](https://durgical.com/en/anatomy/pericardium/), the thymic remnant and the [sternum](https://durgical.com/en/anatomy/sternum/) **Behind** Transverse pericardial sinus, then the [left atrium](https://durgical.com/en/anatomy/left-atrium/), the [right pulmonary artery](https://durgical.com/en/anatomy/right-pulmonary-artery/) and the [right main bronchus](https://durgical.com/en/anatomy/right-main-bronchus/) **Lateral** On the right, the [superior vena cava](https://durgical.com/en/anatomy/superior-vena-cava/) and [right atrium](https://durgical.com/en/anatomy/right-atrium/); on the left, the pulmonary trunk and the left auricle **Above** Becomes the [aortic arch](https://durgical.com/en/anatomy/aortic-arch/) at the sternal angle plane (T4–T5), behind the right 2nd sternocostal joint ## How to find it Not palpable. It projects behind the left half of the sternum at the 3rd intercostal space and rises toward the right 2nd [costal cartilage](https://durgical.com/en/anatomy/costal-cartilage/); aortic valve sounds and murmurs carry along it to the right 2nd intercostal space at the sternal edge. ## On imaging Contrast CT angiography measures it at the sinuses, the sinotubular junction and mid-ascending level, and shows a dissection flap between true and false lumens; transesophageal echo shows the root and valve. On a frontal [chest](https://durgical.com/en/anatomy/region/chest/) X-ray a dilated ascending aorta bulges the right upper mediastinal border. ## Common problems - Aneurysm: the wall weakens and widens, usually silently; it can tear (aortic dissection), an emergency with sudden tearing chest pain. ## How it is diagnosed Echocardiogram, CT or MRI. ## Treatment - Blood-pressure control and monitoring; surgical replacement with a graft when it gets too wide. ## Clinical notes - Aneurysm of the root and ascending aorta is linked to Marfan syndrome, bicuspid aortic valve and other connective tissue disorders; a widened root can make the aortic valve leak - A type A dissection can rupture into the pericardium (tamponade), shear off a coronary ostium (myocardial infarction) or detach the valve (acute aortic regurgitation) - Site of arterial cannulation and cross-clamping for cardiopulmonary bypass; the proximal ends of vein grafts are sewn onto it in coronary bypass surgery - Syphilitic aortitis classically affected the ascending aorta, giving a wrinkled tree-bark intima and aneurysm ## Development Forms from the truncus arteriosus, divided from the pulmonary trunk by the spiral aorticopulmonary septum (neural crest cells); failure of the septum leaves a persistent truncus arteriosus. ## Related conditions - [Hypertensive emergency and urgency](https://durgical.com/en/conditions/hypertensive-emergency-and-urgency/) - [Transposition of the great arteries](https://durgical.com/en/conditions/transposition-of-the-great-arteries/) - [Hypoplastic left heart syndrome](https://durgical.com/en/conditions/hypoplastic-left-heart-syndrome/) - [Truncus arteriosus, TAPVR and tricuspid atresia](https://durgical.com/en/conditions/truncus-arteriosus-tapvr-and-tricuspid-atresia/) - [Marfan syndrome](https://durgical.com/en/conditions/marfan-syndrome/) - [Williams syndrome](https://durgical.com/en/conditions/williams-syndrome/) - [Thoracic aortic aneurysm and aortitis](https://durgical.com/en/conditions/thoracic-aortic-aneurysm-and-aortitis/) - [Aortic regurgitation](https://durgical.com/en/conditions/aortic-regurgitation/) - [Tetralogy of Fallot](https://durgical.com/en/conditions/tetralogy-of-fallot/) ## Test yourself Think of the answer, then tap the question to see it. ## Which arteries arise from the aortic sinuses of the ascending aorta? The right and left coronary arteries, from the right and left aortic sinuses; the non-coronary sinus gives no artery. ## What Stanford type is an aortic dissection that involves the ascending aorta, and how is it managed? Stanford type A, a surgical emergency. ## Which three complications can a type A dissection of the ascending aorta cause near the heart? Rupture into the pericardium (tamponade), shearing off a coronary ostium (myocardial infarction) and detaching the aortic valve (acute aortic regurgitation). ## Which conditions are linked to aneurysm of the aortic root and ascending aorta? Marfan syndrome, bicuspid aortic valve and other connective tissue disorders; a widened root can make the aortic valve leak. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/ascending-aorta/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** aorta ascendens TA2 4176 **Official Spanish (DeCS)** Aorta ascendente DeCS D001011 **English (TA2)** Ascending aorta ## Related - [Aortic right coronary cusp](https://durgical.com/en/anatomy/right-coronary-leaflet/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=1016); [Anatomy, Thorax, Heart Great Vessels](https://www.ncbi.nlm.nih.gov/books/NBK547680/); [Anatomy, Thorax, Mediastinum Superior and Great Vessels](https://www.ncbi.nlm.nih.gov/books/NBK519576/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/ascending-aorta/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/ascending-aorta/