Abnormal histology of the aortic arch in coarctation of the aorta

1993 ◽  
Vol 3 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Derk W. Wolterbeek ◽  
Arie P. Kappetein ◽  
Adriana C. Gittenberger–de Groot
Keyword(s):  
Neural Crest ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Lower Number ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Cardiac Neural Crest ◽  
The Media

SummaryWe examined the number of elastic lamellae in the wall of the proximal aortic arch, aortic isthmus and descending aorta in patients with coarctation of the aorta. In the proximal aortic arch, the number of elastic lamellae was significantly lower in patients with coarctation compared to those with normal hearts without aortic anomalies and those with intracardiac defects but without aortic anomalies. The isthmus also showed a significantly lower number of elastic lamellae in the presence of preductal coarctation. In the descending aorta, the number of elastic lamellae was not significantly different between the different groups. There is doubt about the etiology of coarctation. Recent investigations showed that cells from the cardiac neural crest contribute to the formation of the arch arteries and the media of the arch. A developmental error of the neural crest might be responsible for the abnormal mural structures found in patients with aortic coarctation.

scholarly journals Structural Features in Tunica Media of the Aorta in Lamb

2017 ◽  
Vol 74 (1) ◽  
pp. 111
Author(s):  
Dalma CSIBI ◽  
Adrian Florin GAL ◽  
Cristian RATIU ◽  
Viorel MICLAUS
Keyword(s):  
Aortic Arch ◽  
Outer Part ◽  
Structural Features ◽  
Ascending Aorta ◽  
Tissue Samples ◽  
Descending Aorta ◽  
Tunica Media ◽  
Classic Pattern ◽  
The Media ◽  
Thoracic And Abdominal

In blood vessels situated just after the heart, an irregular blood flow occurs due to some specific structural elements of the tunica media. The current paper describes the histological aspects of some post-cardiac arterial sections in lamb. The tissue samples were collected from five 30 days old male lambs (Țurcană breed). Histological specimens from different regions of the aorta were harvested (i.e., the ascending aorta, aortic arch, thoracic and abdominal regions of the descending aorta). From the specified regions, small pieces (cca. 0.5 cm) were fixed in neutral 10% buffered formalin. The tissues were subsequently embedded in paraffin wax, sectioned at 5 μm, and stained with Goldner’s trichrome and Verhoeff methods. Tissue analysis was performed using an Olympus system for image acquisition and analysis. Histological appearance of the assessed segments of the aorta in lamb is unusual. Major changes occur in tunica media of the aorta. In the ascending aorta, aortic arch and thoracic regions of the aorta, the histological outline is somewhat the same. The internal region of the media possesses the typical lamellar arrangement. Concerning the outer part of tunica media, the smooth muscle has a tendency to form bundles of various sizes. The muscle islands are not present in the media of abdominal region of the aorta, which exhibits the classic pattern of elastic arteries.

Coarctation-like Physiology with Cerebral Arteriovenous Fistula

PEDIATRICS ◽  
1969 ◽  
Vol 44 (6) ◽  
pp. 1024-1028
Author(s):  
P. B. Deverall ◽  
J. F. N. Taylor ◽  
G. S. Sturrock ◽  
Eoin Aberdeen
Keyword(s):  
Arteriovenous Fistula ◽  
Aortic Arch ◽  
Cardiac Failure ◽  
Ductus Arteriosus ◽  
Coarctation Of The Aorta ◽  
Aortic Isthmus ◽  
Obstructive Lesion ◽  
Cerebral Arteriovenous Fistula ◽  
Flow Through ◽  
Reduced Flow

Hemodynamic signs of coarctation of the aorta were present in a neonate dying in cardiac failure. A cerebral arteriovenous fistula was found at autopsy. No obstructive lesion of the aortic arch was present. Development of the aortic isthmus may be impaired if diminished flow through this segment is present. Reduced flow may be present if most of the systemic output is diverted to a fistula proximal to the isthmus, distal systemic flow being maintained by flow from right-to-left through the ductus arteriosus. Spontaneous duct closure after birth may then be followed by a reduction in distal systemic flow, resulting in signs suggestive of coarctation.

The assessment of aortic coarctation among the children's population in lviv region

2020 ◽  
Vol 26 (4) ◽  
pp. 4-12
Author(s):  
A.А. Malska ◽  
◽  
O.B. Kuryliak ◽  
Keyword(s):  
Aortic Valve ◽  
Arterial Hypertension ◽  
Aortic Arch ◽  
Bicuspid Aortic Valve ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Oval Window ◽  
Surgical Correction ◽  
Congenital Defects ◽  
Surgical Methods

Aim. To determine the rate of aortic coarctation, the correlation of its anatomical forms - critical and not critical, and the frequency of combination with the associated pathology; to define the features of the clinical course of its different anatomical forms; and to analyze the remote results of the surgical correction of this defect. Material and Methods. The article represents the statistical analysis of outpatient medical records and case histories of 86 children with aortic coarctation in Lviv region. In the course of the research, retrospective and epidemiological studies were carried out; clinical (data acquisition of medical history, physical examination), instrumental (Doppler echocardiography, ECG, X-ray imaging of organs of the thoracic cavity), and statistical methods were used. Results and Discussion. It was determined that over the period of 2008-2020 years, out of 74 neonates with CoA registered at Lviv Regional Children's Hospital (Health Care of Mother and Child) 40,54% had the critical CoA form, while 59 (46%) - uncritical CoA form. In children with the critical CoA form, the most frequent findings were hypoplasia of the aortic arch (56,67%), open aortic duct (53,33%), and open oval window (53,33%); in 36,6% cases CoA was combined with the bicuspid aortic valve, interatrial septal defect, and transposition of great vessels. However, the uncritical CoA form was more frequently combined with the bicuspid aortic valve (52,27%), and hypoplastic aortic arch (31,82%); aortic stenosis was revealed in 20,45% of children. After the surgical correction in 43,59% of the operated patients with uncritical CoA, excessive arterial hypertension was observed, while in critical form, the frequency of excessive arterial hypertension among the operated patients amounted to 10%. According to our research, after the plasty of the critical CoA, aortic recoarctation was observed in 3.33% of the operated patients, whereas, in case of the uncritical CoA form, it occurred in 30,77% of the operated ones. Conclusions. Coarctation of the aorta is a congenital heart disease with relatively high incidence, amounting to 5-8% out of all congenital defects of the heart. In newborns, it is manifested by acute cardiac failure, while in elder children it is presented with arterial hypertension. Echocardiographic examination after Doppler analysis is the basic procedure of diagnostics and allows for precise determination of the CoA anatomy. The majority of cardiologists recommend prompt surgical intervention after the diagnosis has been made, and, particularly, in patients with hypertension. At present, the available surgical methods include surgical excision of the aortic obstruction, and catheter intervention (the balloon angioplasty and stent implantation) . After the surgical correction has been performed, arterial hypertension persists. The duration of hypertension after the coarctation correction depends on its duration before the diagnosis is made and the timing of surgical correction of the defect. With the child's growth , recoarctation may occur. In such patients, normal arterial pressure can be determined in the state of rest, but it may increase in the upper extremities during physical exertion. Key words: aortic coarctation, associated pathology, excessive arterial hypertension, recoarctation

Transcatheter mechanical thrombectomy of neonatal occlusive aortic thrombus using an Amplatzer Piccolo PDA occluder

2021 ◽  
pp. 1-3
Author(s):  
Christopher Herron ◽  
Stuart Covi ◽  
Athina Pappas ◽  
Daisuke Kobayashi
Keyword(s):  
Aortic Arch ◽  
Critical Condition ◽  
Mechanical Thrombectomy ◽  
Coarctation Of The Aorta ◽  
Premature Neonate ◽  
Interrupted Aortic Arch ◽  
Thromboembolic Events ◽  
Descending Aorta ◽  
Aortic Thrombus

Abstract Neonatal aortic thrombus is a rare and critical condition that can present mimicking severe coarctation of the aorta or interrupted aortic arch. Transcatheter thrombectomy for this lesion has not been well described. We report a premature neonate with an occlusive proximal descending aorta thrombus, who underwent transcatheter mechanical thrombectomy using an Amplatzer Piccolo PDA occluder (Abbott, North Chicago, IL, USA). The procedure was successful with no subsequent distal thromboembolic events.

One-stage repair with separated cardiopulmonary bypass for coarctation of the aorta with left aortic arch and right thoracic descending aorta

2012 ◽  
Vol 60 (9) ◽  
pp. 575-577
Author(s):  
Masatoshi Shimada ◽  
Takaya Hoashi ◽  
Koji Kagisaki ◽  
Tatsuya Oda ◽  
Isao Shiraishi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Coarctation Of The Aorta ◽  
Descending Aorta ◽  
One Stage

scholarly journals Bioelastic properties of the aorta in children, adolescents and young adults after cardiac transplantation: a cardiovascular magnetic resonance study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Mueller ◽  
K Gummel ◽  
B Reich ◽  
H Latus ◽  
C Jux ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Cardiac Transplantation ◽  
Ascending Aorta ◽  
Control Group ◽  
Cross Sectional ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Myocardial T1 ◽  
Study Population

Abstract Background Long-term complications after cardiac transplantation are common and typically include arterial hypertension and coronary allograft vasculopathy. Few studies also suggested that heart transplant recipients have an increased arterial stiffness. Purpose This prospective study aimed to assess the bioelastic properties of the aorta as well as LV function, morphology and structure in children and young adults after cardiac transplantation. Methods CMR studies from 34 patients (median age: 17.1 years, range: 8–24 years) who underwent cardiac transplantation in childhood were analysed. Aortic anatomy and distensibility were assessed at five locations of the thoracic aorta using steady-state free precession cine sequences. Pulse wave velocity (PWV) of the aortic arch and the descending thoracic aorta was measured from 2-dimensional phase contrast images. Size and function of the left atrium and the ventricles were assessed from a stack of short axis slices. Myocardial T1 times were determined using a standard MOLLI sequence. Results Cross-sectional areas of the ascending aorta and the aortic arch tended to be lower in patients compared to controls (ascending aorta 464.5±172.5 mm2 vs. 515.3±186.3 mm2, aortic arch 342.4±113.3 mm2 vs. 376.9±148.5 mm2) whereas cross-sectional areas of the descending aorta tended to be higher (aortic isthmus 283.7±102.1 mm2 vs. 257.9±89.5 mm2, aorta descendens diaphragmal 218.4±75.8 mm2 vs. 214.2±75.0 mm2) and showed a correlation with systolic blood pressure (r=0.33). PWV was higher in the aortic arch (4.8±2.4 m/s vs. 3.6±0.7 m/s). Aortic distensibility was slightly higher at all measuring points in the study population compared to the control group and showed an increase with rising distance from the heart (ascending aorta 10.5±5.8 10–3 mm Hg-1, aortic isthmus 13.1±7.5 10–3 mm Hg-1, descending aorta 16.6±6.8 10–3 mm Hg-1). Biventricular volumes were slightly reduced in the patient group compared to the control group but this was not statistically significant. Only left ventricular mass messured during the systolic phase was higher in the study population compared to the control group (males 55.1 g/m2 vs. 53.0 g/m2, females 46.2 g/m2 vs. 45.2 g/m2). T1 mapping demonstrated increased T1 times in the heart-transplanted group compared to published data in healthy adults. In particular, T1 times of the lateral and inferior myocardial segments were higher. Conclusion Patients who underwent cardiac transplantation in childhood seem to have a reduced bioelasticity of the thoracic aorta. Increased myocardial T1 times suggesting alterations in myocardial structure. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Delayed Therapy of Descending Aortic Coarctation Results in Anterior Cerebral Rupture: A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Kele Qin ◽  
Jinfu Yang ◽  
Mi Tang ◽  
Chukwuemeka Daniel Iroegbu ◽  
Shijun Hu ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Delayed Diagnosis ◽  
Coarctation Of The Aorta ◽  
Endovascular Stent ◽  
Case Presentation ◽  
Descending Aorta ◽  
Delay In Diagnosis ◽  
Upper And Lower Extremities ◽  
Blood Pressures ◽  
Percutaneous Transluminal

Background: Coarctation of the aorta (CoA) is the congenital constriction or narrowing of the aortic lumen. These constrictions are primarily located in the descending aorta causing significant discrepancies in systolic blood pressures of the upper and lower extremities. Thus, a delay in diagnosis and treatment may lead to severe and adverse consequences.Case presentation: Herein, we present a 13-year-old boy with anterior cerebral rupture following a delayed diagnosis for descending CoA. Percutaneous transluminal balloon dilatation and endovascular stent implantation were urgently and successfully performed alongside cerebral clipping of the vascular aneurysm.Conclusion: An early diagnosis is crucial for CoA's successful treatment and management to prevent complications, including anterior cerebral rupture.

Insertion of a bypass graft from carotid artery to descending aorta in the management of aortic coarctation with severe hypoplasia of the aortic arch—a report of two cases

1993 ◽  
Vol 3 (1) ◽  
pp. 76-78
Author(s):  
Ganga Prabhakar ◽  
Naresh Kumar ◽  
Zohair Al Halees ◽  
Neil Wilson
Keyword(s):  
Surgical Technique ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Bypass Graft ◽  
Descending Aorta ◽  
Residual Stenosis ◽  
Cardiac Abnormalities ◽  
Standard Procedures ◽  
The Individual

AbstractRepair of severe hypoplasia of the aortic arch with coarctation must be based on the individual anatomy of the lesion and, where necessary, one should take into consideration associated cardiac abnormalities. We report a surgical technique which was employed when standard procedures for reconstruction of the arch had failed to relieve the obstruction adequately. A conduit from the carotid artery to the descending aorta was used successfully in two patients to abolish residual stenosis.

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