M Machii1, A E Becker. 1. Department of Cardiovascular Pathology, Academic Medical Center, University of Amsterdam, The Netherlands.
Abstract
BACKGROUND: Whether a hypoplastic transverse arch will grow after successful coarctectomy remains controversial. METHODS: We studied 15 coarctation specimens with hypoplastic transverse arch. Eight patients were less than 1 month old and 7 were between 1 and 3 months. The diameter and length of the various segments of the aortic arch were measured. The number of elastin lamellae was determined histologically. Collagen density was quantified with a microdensitophotometer. Using immunohistochemistry, we determined alpha-actin-positive smooth muscle cells in the media of the ascending aorta and the hypoplastic transverse arch. RESULTS: Despite a hypoplastic transverse arch, the ascending and descending aorta grew. The absolute number of elastin lamellae in the hypoplastic transverse arch was low, but when expressed as a ratio versus its diameter, this number was high (p < 0.05). Collagen density showed high absolute values in the descending aorta. In the older group, 4 of 7 showed no staining for alpha-actin in the hypoplastic transverse arch, whereas under 1 month of age, only 2 of 8 cases were negative. CONCLUSIONS: The hypoplastic transverse arch is characterized by a relatively high number of elastin lamellae. Fewer alpha-actin-positive cells in the hypoplastic transverse arch occur in older specimens, which could indicate a diminished potential growth.
BACKGROUND: Whether a hypoplastic transverse arch will grow after successful coarctectomy remains controversial. METHODS: We studied 15 coarctation specimens with hypoplastic transverse arch. Eight patients were less than 1 month old and 7 were between 1 and 3 months. The diameter and length of the various segments of the aortic arch were measured. The number of elastin lamellae was determined histologically. Collagen density was quantified with a microdensitophotometer. Using immunohistochemistry, we determined alpha-actin-positive smooth muscle cells in the media of the ascending aorta and the hypoplastic transverse arch. RESULTS: Despite a hypoplastic transverse arch, the ascending and descending aorta grew. The absolute number of elastin lamellae in the hypoplastic transverse arch was low, but when expressed as a ratio versus its diameter, this number was high (p < 0.05). Collagen density showed high absolute values in the descending aorta. In the older group, 4 of 7 showed no staining for alpha-actin in the hypoplastic transverse arch, whereas under 1 month of age, only 2 of 8 cases were negative. CONCLUSIONS: The hypoplastic transverse arch is characterized by a relatively high number of elastin lamellae. Fewer alpha-actin-positive cells in the hypoplastic transverse arch occur in older specimens, which could indicate a diminished potential growth.
Authors: D Y Li; G Faury; D G Taylor; E C Davis; W A Boyle; R P Mecham; P Stenzel; B Boak; M T Keating Journal: J Clin Invest Date: 1998-11-15 Impact factor: 14.808
Authors: I El Sayed Massoud; H El Farghly; A Abdul-Monem; N Botros; A Kassem; A El Magraby; A Dawood; M Abdul-Hakam Journal: Pediatr Cardiol Date: 2008-05 Impact factor: 1.655