Coarctation, tubular hypoplasia, and the ductus arteriosus. Histological study of 35 specimens.

Abstract

SUMMARY A histological study has been made in an attempt to study further the relation between the ductus arteriosus, coarctation, and tubular hypoplasia of the aortic arch. Thirty-five aortic arch systems were studied using serial sectioning techniques. Twelve were from patients with coarctation and/or tubular hypoplasia. The other 23 hearts were from patients without aortic obstructive lesions, 7 from anatomically normal hearts, and the others from malformed hearts with anomalies elsewhere from the aortic arch. The anatomical study of the hearts with obstructive aortic lesions emphasised the necessity of distinguishing 'coarctation' from 'tubular hypoplasia', since the curtain lesion of coarctation was found to coexist with tubular hypoplasia in some cases. The histological study showed that the ductus was easily distinguished from the walls of the aorta or pulmonary artery. In all these cases with coarctation or tubular hypoplasia a sling of ductal tissue was located around the aortic isthmal orifice. In 6 hearts a diaphragm of ductal tissue was seen to form the coarctation lesion.

Timing of presentation and postnatal outcome of infants suspected of having coarctation of the aorta during fetal life

“…2 3 A variety of theories have been proposed for the development of coarctation of the aorta including subnormal flow around the aortic arch or that a sling of ductal tissue around the aorta causes the coarctation to develop at the time of ductal closure. [4][5][6] Data regarding patterns of familial recurrence of congenital heart disease confirm the importance of genetic factors. 7 There has been no large series in the literature to date documenting the postnatal course of infants who had fetal echocardiographic signs suggestive of coarctation of the aorta.…”

Histological characteristics and classifications of coarctation of the aorta

“…У старијем узра-сту дуктално ткиво показује фиброзне про-мене и више га није могуће патохистолошки доказати. На препаратима после аутопсије неонатуса може се и макроскопски уочити ширење дукталног ткива 41 . Дуктално ткиво не захвата пуну дебљину аортног зида већ се најчешће описује као интралуминални обруч на месту преласка истмуса у десцендентну аорту 27 .…”

“…At older ages ductal tissue shows fibrous changes and it cannot be proven histologically any more. At autopsy preparations of neonates the expansion of ductal tissue can be observed macroscopically 41 . Ductal tissue does not comprise the full thickness of the aortic wall, but is most often described as intraluminal ring at the crossing of the isthmus to the descending aorta 27 .…”

Coarctation repair—redo challenges in the adults: what to do?

“…It was first described by Morgagni in 1760 (1). Coarctation can occur as a solitary pathology limited to the aortic isthmus, or can present as a more complex lesion including long segment hypoplasia of the transverse aortic arch, or stenosis of the abdominal aorta (2)(3)(4). Other associated cardiac pathologies include bicuspid aortic valve, ventricular septal defect, patent ductus arteriosus, transposition of the great arteries, atrioventricular canal defects and hypoplastic left heart syndrome (5-9).…”