Aorta

Course

Arises from the left ventricle behind the pulmonary trunk, ascends right of the sternum to the level of the sternal angle, arches posteriorly and to the left over the right pulmonary artery and left main bronchus, then descends through the posterior mediastinum and retroperitoneum on the vertebral bodies' left, bifurcating into the common iliac arteries at L4.

Branches

Ascending: left and right coronary arteries. Arch: brachiocephalic trunk, left common carotid, left subclavian. Descending thoracic: bronchial, oesophageal, intercostal. Abdominal: coeliac trunk (T12), superior mesenteric (L1), renal (L1), gonadal, inferior mesenteric (L3), lumbar, median sacral.

Clinical relevance

An aortic aneurysm's rupture kills in minutes; a Stanford A dissection's intimal tear peels the wall layers apart and needs surgery the same hour. The isthmus just beyond the left subclavian — where the mobile arch meets the fixed descending aorta — is deceleration injury's favourite tear point, and coarctation here explains young hypertension with radio-femoral delay.

Related conditions

• High blood pressure (hypertension)
• Abdominal aortic aneurysm
• Aortic dissection