- A Comparative Study of Histopathological Changes in the Ascending Aorta and the Risk Factors Related to Histopathological Conditions and Aortic Dilatation in Patients With Tetralogy of Fallot and a Functionally Univentricular Heart. [Journal Article]
- HLHeart Lung Circ 2018; 27(8):1004-1010
- CONCLUSIONS: Our findings indicate the existence of significant elastic fragmentation, muscle disarray, medionecrosis and fibrosis involving the ascending aortic media in patients with a functionally univentricular heart and dilated aorta. These histopathological changes are similar to those encountered in patients with TOF and dilated aorta.
- Brain Strokes Related to Aortic Aneurysma - the Analysis of three Cases. [Journal Article]
- OMOpen Med (Wars) 2017; 12:58-61
- Brain stroke connected with aortic blood flow disturbances is a rare disease and its incidence is difficult to assume. Nevertheless, 10-50% of patients with aortic dissection may not experience any p…
Brain stroke connected with aortic blood flow disturbances is a rare disease and its incidence is difficult to assume. Nevertheless, 10-50% of patients with aortic dissection may not experience any pain. In case of 18-30% patients with aortic dissection neurological signs are first disease presentation and among them ischemic stroke is the most common. The most popular aortic dissection classification is with use of Stanford system. Type A involves the ascending aorta and type B is occurring distal to the subclavian artery. Aortic dissection risk factors include hypertension, cystic medionecrosis, bicuspid aortic valve and Marfan's or Ehlers-Danlos syndrome.
- Morphometric changes in the aortic arch with advancing age in fetal to mature thoroughbred horses. [Journal Article]
- JVJ Vet Med Sci 2017 Mar 28; 79(3):661-669
- Aortic rupture is a well recognized cause of sudden death in thoroughbred horses. Some microscopic lesions, such as those caused by cystic medial necrosis and medionecrosis, can lead to aortic ruptur…
Aortic rupture is a well recognized cause of sudden death in thoroughbred horses. Some microscopic lesions, such as those caused by cystic medial necrosis and medionecrosis, can lead to aortic rupture. However, these microscopic lesions are also observed in normal horses. On the other hand, a previous study of aortic rupture suggested that underlying elastin and collagen deposition disorders might be associated with aortic rupture. Therefore, the purpose of this study was to compare the structural components of the tunica media of the aortic arch, which is composed of elastin, collagen, smooth muscle cells and mucopolysaccharides (MPS), in fetal to mature thoroughbred horses. The percentage area of elastin was greatest in the young horses and subsequently decreased with aging. The percentage area of collagen increased with aging, and the elderly horses (aged ≥20) exhibited significantly higher percentage areas of collagen than the young horses. The percentage area of smooth muscle cells did not change with age. The percentage area of MPS was inversely proportional to the percentage area of elastin. The fetuses exhibited a markedly larger percentage area of MPS than the mature horses. We concluded that the medial changes seen in the aortic arch, which included a reduction in the amount of elastin and increases in the amounts of collagen and MPS, were age-related variations.
- Pulmonary Artery Dissection: A Case Treated by Homograft Replacement. [Case Reports]
- ATAnn Thorac Surg 2017; 103(1):e47-e49
- Pulmonary artery dissection was diagnosed in a 32-year-old man who was admitted to the emergency department with intense chest pain. He had a history of pulmonary balloon valvuloplasty for congenital…
Pulmonary artery dissection was diagnosed in a 32-year-old man who was admitted to the emergency department with intense chest pain. He had a history of pulmonary balloon valvuloplasty for congenital pulmonary stenosis at the age of 7 and no pulmonary hypertension. The operation was performed with cardiopulmonary bypass. The dissected pulmonary arterial trunk was removed with the distorted valve, and replaced with a pulmonary artery homograft. The postoperative course was uneventful. Histologic examination revealed medionecrosis. Pulmonary artery dissection is a rare but highly lethal pathology. In the absence of pulmonary hypertension, surgical treatment with homograft replacement can lead to excellent results.
- Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. Noninflammatory degenerative diseases - nomenclature and diagnostic criteria. [Practice Guideline]
- CPCardiovasc Pathol 2016 May-Jun; 25(3):247-257
- Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syn…
Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syndrome, etc.), and vasculopathic aging processes involved in vascular injury can cause both distinct and nonspecific histopathologic changes with degeneration of the media as a common denominator. Terminology for these changes has varied over time leading to confusion and inconsistencies. This consensus document has established a revised, unified nomenclature for the variety of noninflammatory degenerative aortic histopathologies seen in such specimens. Older terms such as cystic medial necrosis and medionecrosis are replaced by more technically accurate terms such as mucoid extracellular matrix accumulation (MEMA), elastic fiber fragmentation and/or loss, and smooth muscle cell nuclei loss. A straightforward system of grading is presented to gauge the extent of medial degeneration and synoptic reporting tables are provided. Herein we present a standardized nomenclature that is accessible to general pathologists and useful for future publications describing these entities.
- Analysis of the aortic root in patients with tetralogy of Fallot undergoing early repair: form follows function. [Journal Article]
- JTJ Thorac Cardiovasc Surg 2014; 148(4):1555-9
- CONCLUSIONS: Infants with ToF undergoing repair around 6 months old already had limited features of aortic wall degradation at surgery. Echocardiographic follow-up, however, demonstrated significant reductions in the indexed aortic diameters. We presume that early repair of ToF will prevent a disproportionate aortic diameter increase by halting progression of the limited histologic changes potentially predisposing to late aortic dilatation.
- Vascular histopathologic reaction to pulmonary artery banding in an in vivo growing porcine model. [Journal Article]
- PCPediatr Cardiol 2013; 34(7):1652-60
- Pulmonary artery banding (PAB) is used as a surgical palliation to reduce excessive pulmonary blood flow caused by congenital heart defects. Due to the lack of microscopic studies dealing with the ti…
Pulmonary artery banding (PAB) is used as a surgical palliation to reduce excessive pulmonary blood flow caused by congenital heart defects. Due to the lack of microscopic studies dealing with the tissue remodeling caused by contemporary PAB materials, this study aimed to assess histologic changes associated with PAB surgery by analyzing local tissue reaction to the presence of Gore-Tex strips fixed around the pulmonary artery. Gore-Tex strips were used for PAB in a growing porcine model. After 5 weeks, histologic samples with PAB (n = 5) were compared with healthy pulmonary arterial segments distal to the PAB or from a sham-treated animal (n = 1). Stereology was used to quantify the density of the vasa vasorum and the area fraction of elastin, smooth muscle actin, macrophages, and nervi vasorum within the pulmonary arterial wall. The null hypothesis stated that samples did not differ histopathologically from adjacent vascular segments or sham-treated samples. The PAB samples had a greater area fraction of macrophages, a lower amount of nervi vasorum, and a tendency toward decreased smooth muscle content compared with samples that had no PAB strips. There was no destruction of elastic membranes, no medionecrosis, no pronounced inflammatory infiltration or foreign body reaction, and no vasa vasorum deficiency after the PAB. All the histopathologic changes were limited to the banded vascular segment and did not affect distal parts of the pulmonary artery. The study results show the tissue reaction of palliative PAB and suggest that Gore-Tex strips used contemporarily for PAB do not cause severe local histologic damage to the banded segment of the pulmonary arterial wall after 5 weeks in a porcine PAB model.
- Cystic medionecrosis of the carotid bifurcation as an uncommon cause of stroke. [Case Reports]
- NNeurologist 2012; 18(6):395-7
- CONCLUSIONS: Patients with cystic medionecrosis may have a stroke due to short-track stenosis of the internal carotid artery.
- [The rupture of splenic artery aneurysm in Erdheim disease]. [Case Reports]
- AIAnn Ital Chir 2012 Jan-Feb; 83(1):59-62
- Splenic vessel aneurysm is often a casual pathology during strumental imaging or laparotomy. The first cause for the formation of the aneurysm is a vessel primitive degenerative pathology of the medi…
Splenic vessel aneurysm is often a casual pathology during strumental imaging or laparotomy. The first cause for the formation of the aneurysm is a vessel primitive degenerative pathology of the medium wall, or idiopathic cystic medionecrosis, that to develop in aneurysmatic dissection. In the early diagnosis, in the selective patients, resulted indicate an endovascular therapy, while in emergency the laparotomy is a gold strandard for reduction morbility and mortality. In this paper, the Authors described a rare case of rupture of the lienal vessel aneurysm in Erdheim disease, and reported clinical features, indications and procedures for better treatment.
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- Age is a risk factor for maladaptive changes of the pulmonary root in rats exposed to increased pressure loading. [Journal Article]
- CPCardiovasc Pathol 2012 May-Jun; 21(3):199-205
- CONCLUSIONS: The pulmonary artery wall seems to present maladaptive architectural changes in the media when exposed to systemic pressure. The PAB-related increase of the apoptotic index seems to reflect an accelerated involution of the pulmonary root's media. The physiologic higher degree of elastic fibers disarray in adult rats can possibly influence the worst adaptation of the pulmonary arterial wall to a systemic pressure load.