 Hi, my name is Dr. Brad Taylor. I'm the Chief of Cardiac Surgery at the University of Maryland School of Medicine. And I want to welcome you to Drawing Outside the Lines. Today, we're going to talk about acute aortic emergencies, specifically acute aortic dissections. The aorta is the blood vessel or the major pipe that exits out of the heart. Once blood is ejected from the heart, it's pushed through the aortic valve into the ascending aorta. Blood then transverses across the aortic arch. It goes to your right arm and to the right side of your brain. It then goes up to the left side of your brain and to your left arm and then descends to your lower body, to your guts, to your abdomen, and to your lower legs. There's a small risk that it can develop a tear and if a tear develops in it, blood will then go in between the layers of the aorta and share off and create a tear that then can limit blood flow to your upper body and to your lower body. If that tear occurs in your ascending aorta, we call that a type A aortic dissection. Type A aortic dissections are surgical emergencies. 90% of patients don't even make it to the hospital if that occurs. Once they do arrive at the hospital, we take them emergently to the operating room to an attempt to save their life. Traditionally, we'll resect this portion of this torn aorta, take out the tear and replace the ascending aorta with a piece of manufactured tubing that replaces that blood vessel. In patients who are prohibitive risk or extremely high risk for open surgery, we'll take a stented graft, bring it up, and then deploy a stent graft that will cover over that tear and basically reline the ascending aorta. Something we've been very excited about here over the last couple of years. If that tear occurs just after the blood vessel goes to your left arm, we call that a type B aortic dissection. Traditionally, type B aortic dissection can be managed with medical management and controlling blood pressure. But if that tear occurs and it causes a limitation of blood flow because of compression of blood by the false lumen into the true lumen, we then are in a position where we can then reline that ascending aorta with the stent graft, cover that tear, and then reestablish flow to the lower body. One of the things we're most excited about here at Maryland is taking that endovascular technology. We have access to three trial grafts through the FDA, and we've been manufacturing our own grafts with using commercial products where we then reline the arch with the stent graft through a small puncture in the groin and then access to the blood vessels from above and then can reline the inside of the aortic arch and then reestablish flow to the arms and to the brain via stents that are then placed into these respective blood vessels. We've been able to expand the pool of patients that we can care for due to the fact that we've become experts in using endovascular techniques to solve problems related to the aorta.