Morphological variability of the arterial valve in common arterial trunk and the concept of normality
File(s)Final version ms.pdf (506.08 KB)
Accepted version
Author(s)
Liguori, GR
Jatene, MB
Ho, SY
Aiello, VD
Type
Journal Article
Abstract
OBJECTIVE: Until now, no study established a morphometric evaluation of the truncal valve dysplasia and a description of its different presentation patterns. Thus, authors conducted an anatomopathological study describing the gross features and histological findings of the truncal valve. METHODS: 50 common arterial trunk (CAT) specimens were examined. The number of valvar leaflets was determined and valvar dysplasia was classified as absent, mild, moderate or severe. Selected leaflets were sectioned and submitted to histological analysis and linear measurements (thickness, length and area), besides quantification of collagen area fraction. RESULTS: 28 (56%) valves presented three, 15 (30%) four and 7 (14%) two leaflets. Valvar dysplasia was absent in 13 (26%) cases, mild in 19 (38%), moderate in 6 (12%) and severe in 12 (24%). A significant association was found between the presence of four leaflets and valvar dysplasia (p<0.001). Single coronary ostium was more common in two-leaflet cases than in three-leaflet cases (p=0.037). Leaflets medial thirds were thicker in the more dysplastic valves (p=0.006) and in those presenting anarchic collagen distribution (p=0.002). CONCLUSIONS: CAT semilunar valves present two main patterns. The first characterised by three leaflets and absent or mild dysplasia and the second by four leaflets and severe dysplasia. Still, great variability regarding thickness, microscopic organisation of the extracellular matrix and proportions of leaflets' dimensions exists, which may impact on the surgical outcomes.
Date Issued
2016-11-24
Date Acceptance
2016-11-01
Citation
Heart, 2016, 103, pp.848-855
ISSN
1468-201X
Publisher
BMJ Publishing Group
Start Page
848
End Page
855
Journal / Book Title
Heart
Volume
103
Copyright Statement
© 2016 BMJ Publishing Group. This article has been accepted for publication in Heart following peer review. The definitive copyedited, typeset version is available online at: http://dx.doi.org/10.1136/heartjnl-2016-310505
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/27885047
PII: heartjnl-2016-310505
Subjects
Cardiovascular System & Hematology
1102 Cardiovascular Medicine And Haematology
Publication Status
Published
Coverage Spatial
England