Histological regional analysis of the aortic root and thoracic ascending aorta: a complete analysis of aneurysms from root to arch

Journal of Cardiothoracic Surgery

Jim Manavis¹  John Matthew Abrahams¹  Karen Jane Reynolds¹  Timothy Luke Surman¹  Dermot O’Rourke¹  James Edwards¹  John Beltrame¹  Michael George Worthington¹  John Finnie¹ 

[1] D’Arcy Sutherland Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, SA, Australia;Cardiology Department, Queen Elizabeth Hospital, Adelaide, SA, Australia;Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, SA, Australia;Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia;Orthopedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia;

关键词: Aortic root;    Ascending aorta;    Aneurysms;    Histology;    Immunohistochemistry;   

DOI  :  10.1186/s13019-021-01641-5

来源: Springer

【 摘 要 】

BackgroundAlthough aortic root and ascending aortic aneurysms are treated the same, they differ in embryological development and pathological processes. This study examines the microscopic structural differences between aortic root and ascending aortic aneurysms, correlating these features to the macroscopic pathophysiological processes.MethodsWe obtained surgical samples from ascending aortic aneurysms (n = 11), aortic root aneurysms (n = 3), and non-aneurysmal patients (n = 7), Aortic collagen and elastin content were examined via histological analysis, and immunohistochemistry techniques used to determine collagen I, III, and IV subtypes. Analysis was via observational features, and colour deconvolution quantification techniques.ResultsElastin fiber disruption and fragmentation was the most extensive in the proximal aneurysmal regions. Medial fibrosis and collagen density increased in proximal aneurysmal regions and aortic root aneurysms (p < 0.005). Collagen I was seen in highest quantity in aortic root aneurysms. Collagen I content was greatest in the sinus tissue regions compared to the valvular and ostial regions (p < 0.005) Collagen III and IV quantification did not vary greatly. The most susceptible regions to ultrastructural changes in disease are the proximal ascending aorta and aortic root.ConclusionsThe aortic root differs histologically from the ascending aorta confirming its unique composition in aneurysm pathology. These findings should prompt further evaluation on the influence of this altered structure on function which could potentially guide clinical management.

【 授权许可】

CC BY