Abstract:Purpose: Bicuspid aortic valve (BAV) is associated with increased prevalence of annulo-aortic ectasia, dissection and ascending aortic aneurysm. This study was undertaken to compare the amount of fibrillin-1 and elastin in the media of great vessels of patients with bicuspid and tricuspid aortic valve disease. Method: Tissue samples of ascending aorta and pulmonary artery were obtained from 22 patients with bicuspid aortic valve disease (BAV) and 17 patients with tricuspid aortic valve disease (TAV), including 6 normal valves from the transplant program. Indirect immunofluorescence and computerized image analyses were used to quantify fibrillin-1 and elastin of the media of the arteries. The results were expressed as the mean integrated optical density (IOD). Results: In the ascending aorta, the IOD for fibrillin-1 was 15 ± 8 in the BAV group and 24 ± 7 in the TAV group (p = 0.001). In the pulmonary artery, the IOD for fibrillin-1 was 18 ± 10 in the BAV group and 25 ± 9 in the TAV group (p = 0.07). In respect to the elastin measurements of the aorta, the specific IOD was 34 ± 13 in the BAV group and 29 ± 14 in the TAV group. In the pulmonary artery the IOD for elastin was 30 ± 12 in the BAV group and 29 ± 14 in the TAV group (p = 0.34). Conclusions: Patients with BAV were found to have less fibrillin-1 in the ascending aorta and pulmonary artery than patients with TAV. These findings may explain aortic root dilation and ascending aortic dissection in patients with BAV disease.Descriptors: Aortic valve, pathology. Aorta, aneurysm, dissection, surgery. Fibrillin. Elastin. Marfan syndrome. ResumoObjetivo: A valva aórtica bicúspide (VAB) está associada a maior prevalência de ectasia anulo-aórtica, aneurisma e dissecção da aorta ascendente. Este estudo investigou a quantidade de fibrilina-1 e elastina nos grandes vasos de portadores de VAB.Método: Amostras de tecidos foram colhidas da aorta ascendente e tronco da artéria pulmonar de 22 portadores de VAB e 16 portadores de valva aórtica tricúspide (VAT) submetidos a cirurgia cardíaca, incluindo seis portadores de valva aórtica normal, provenientes do programa de transplante. Imunofluorescência indireta e análise computadorizada de imagens foram utilizadas para Rev Bras Cir Cardiovasc 2003; 18(2): 148-156
Os autores apresentam uma série de 15 pacientes submetidos a cirurgia cardíaca cuja proteção miocárdica foi obtida por infusão de solução cardioplégica sangüínea isotérmica por via retrógrada atrial. As operações consistiram em 11 revascularizações do miocárdio e 4 cirurgias orovalvares. Após instalação da circulação extracorpórea, iniciou-se a infusão da solução cardioplégica de indução na porção inicial da aorta, exceto nos casos de insuficiência aórtica. A solução de indução foi infundida por cinco minutos, passando-se, então, à solução de manutenção. No início da infusão da solução de manutenção, através de cateter de 4,0 mm no átrio direito, as veias cavas e o tronco pulmonar foram pinçados e passou-se a aspirar a aorta. Todos os pacientes saíram de circulação extracorpórea sem qualquer dificuldade ou suporte inotrópico. Não houve registro de infarto agudo do miocárdio. Dois pacientes com fibrilação atrial apresentaram ritmo sinusal já no centro cirúrgico.
This study presents the results in a group of fifteen patients submitted to cardiac surgery, using continuous atrial retrograde warm blood cardioplegia for myocardial protection. Eleven patients were submitted to myocardial revascularization and four were submitted to valvular transplantation. There was no need for inotropic drugs or intraaortic balloon pump support during or after the procedure, and no myocardial infarction was detected in this group. When the heart was arrested, the cardioplegia line was switched to the atrial cannula. The aortic root was vented throughout the cross-clamp period, and retrograde perfusion was assured by noting the engorged exygenated cardiac veins as well as the return of dark blood through the vent in the aortic root. The patients presented good clinical and laboratory course. No right ventricular dysfunction was detected. Two patients were in atrial fibrillation before the surgery, one of them returned to this cardiac rhythm three days after the procedure
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.