Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-10T16:51:57.614Z Has data issue: false hasContentIssue false
  • English
  • Français

Abnormal histology of the aortic arch in coarctation of the aorta

Published online by Cambridge University Press:  19 August 2008

Derk W. Wolterbeek ,
Arie P. Kappetein  and
Adriana C. Gittenberger–de Groot
Derk W. Wolterbeek
Affiliation:
From the Department of Thoracic Surgery, University Hospital, Rijksuniversiteit, Leiden
Arie P. Kappetein
Affiliation:
From the Department of Thoracic Surgery, University Hospital, Rijksuniversiteit, Leiden
Adriana C. Gittenberger–de Groot*
Affiliation:
Department of Anatomy and Embryology, Rijksuniversiteit, Leiden
*
Dr. Adriana C. Gittenberger Groot, Department of Anatomy and Embryology, Postbus 9602, 2300 RC Leiden, The Netherlands, Tel. (31) 71-276684.
Get access Rights & Permissions [Opens in a new window]

Summary

We 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.

Keywords

Isthmus hypoplasiaetiologyneural crestelastic lamellae
Type
Original Articles
Information
Cardiology in the Young , Volume 3 , Issue 4 , October 1993 , pp. 412 - 416
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

title

1.Moulaert, AJBruins, CLDCOppenheimer–Dekker, A. Anoma lies of the aortic arch and ventricular septal defects. Circula tion 1976; 53: 1011–1015.CrossRefGoogle Scholar
2.Ho, SYCoarctation, Anderson R., tubular hypoplasia, and the ductus arteriosus. Br Heart J 1979; 41: 268–274.CrossRefGoogle ScholarPubMed
3.Elzenga, NJGittenberger–de Groot, AC. Localised coarctation of the aorta. An age dependent spectrum. Br Heart J 1983; 49: 317–323.CrossRefGoogle ScholarPubMed
4.Elzenga, NJ, Gittenberger–deGroot, AC, Oppenheimer–Dekker, A. Coarctation and other obstructive aortic arch anomalies:their relationship to the ductus arteriosus. Int J Cardiol 1986; 13: 289–308.CrossRefGoogle Scholar
5.Hutchins, GM. Coarctation of the aorta explained as a branch-point of the ductus arteriosus. Am J Pathology 1971; 63: 203–209.Google ScholarPubMed
6.Elzenga, NJGitrenberger-de Groot, AC. Coarctation and related aortic arch anomalies in hypoplastic left heart syn drome. IntJ Cardiol 1985; 8: 379–389.CrossRefGoogle Scholar
7.Rudolph, AM. The changes in the circulation after birth. Their importance in congenital heart disease. Circulation 1970; 41:343–359.CrossRefGoogle ScholarPubMed
8.Van Meurs–van Woezik, H.Klein, HW.Krediet, P. Normal internal calibers of ostia of great arteries and of aortic isthmus in children. Br Heart J 1977; 39: 860–865.CrossRefGoogle Scholar
9.Rosenberg, HSKlima, THenderson, SRMcNamara, DG. Maturation of the aortic isthmus. Cardiovasc Res Center Bull Texas Heart Inst 1971; 10: 47–55.Google Scholar
10.Clarkson, PMBrandt, PWTBarratt–Boyes, BGRutherford, JD, Kerr, ARNeutze, JM. Prosthetic repair of coarctation of the aorta with particular reference to dacron onlay patch grafts and late aneurysm formation. Am J Cardiol 1985; 56: 342–346.CrossRefGoogle ScholarPubMed
11.Brom, AG. Narrowing of the aortic isthmus and enlargement of the mind. J Thorac Cardiovasc Surg 1965; 50: 166–180.CrossRefGoogle ScholarPubMed
12.Kappetein, AP, Gittenberger-de Groot, AC, Zwinderman, AH, Rohmer, J, Poelmann, RE.Huysmans, HA. The neural crest as a possible pathogenetic factor in coarctation of the aorta and bicuspid aortic valve. J Thorac Cardiovasc Surg 1991; 102:830–836.CrossRefGoogle ScholarPubMed
13.Kirby, ML. Cardiac morphogenesis–recent research advances. Pediatr Res 1987; 21: 219–224.CrossRefGoogle ScholarPubMed
14.Le Lievre, C.Le Douariri, N. Mesenchymal derivates of the neural crest: analysis of chimaeric quail and chick embryosm. J Embryol Exp Morphol 1975; 34: 125–154.Google Scholar
15.Congdon, ED. Transformation of the aortic arch system during the development of the human embryo. Contrib Embr Carnegie Institution Washington. 1922; 14: 47–110.Google Scholar
16.Rosenquist, THBeall, ACModis, LFishman, R. Impaired elastic matrix development in the great arteries after ablation of the cardiac neural crest. Anat Rec 1990; 226: 347–359.CrossRefGoogle ScholarPubMed
17.Beeson, WTKirby, MLvan Mierop, LHSTeabaut, JR. Effects of size of lesions of the cardiac neural crest at various embry onic ages on incidence and type of cardiac defects. Circulation 1986; 73: 360–364.CrossRefGoogle Scholar
18.Clark, JM, Glagov, S. Structural integration of the arterial wall. Lab Inv 1979; 40: 587–602.Google ScholarPubMed
19.Lindsay, J. Coarctation of the aorta, bicuspid aortic valve and abnormal ascending aortic wall. Am J Cardiol 1988; 61: 182–184.CrossRefGoogle ScholarPubMed
20.McKusick, VA. Association ofcongenital bicuspid aortic valve and Erdheim's cystic medial necrosis. Lancet 1972; 1: 1026.CrossRefGoogle Scholar
21.Cooper, RSRitter, SBRothe, WBChen, CKGriepp, RGolinko, RJ. Angioplasty for coarctation of the aorta: long-term results. Circulation 1987; 75: 600–604.CrossRefGoogle ScholarPubMed
22.Sehested, JBaandrup, UMikkelsen, E. Different reactivity and structure of the prestenotic and poststenotic aorta in human coarctation. Circulation 1982; 65: 1060–1065.CrossRefGoogle ScholarPubMed