Histological regional analysis of the aortic root and thoracic ascending aorta: a complete analysis of aneurysms from root to arch

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dc.contributor.authorSurman, T.L.
dc.contributor.authorAbrahams, J.M.
dc.contributor.authorManavis, J.
dc.contributor.authorFinnie, J.
dc.contributor.authorO'Rourke, D.
dc.contributor.authorReynolds, K.J.
dc.contributor.authorEdwards, J.
dc.contributor.authorWorthington, M.G.
dc.contributor.authorBeltrame, J.
dc.date.issued2021
dc.description.abstractBackground: Although aortic root and ascending aortic aneurysms are treated the same, they differ in embryological development and pathological processes. This study examines the microscopic structural differences between aortic root and ascending aortic aneurysms, correlating these features to the macroscopic pathophysiological processes. Methods: We obtained surgical samples from ascending aortic aneurysms (n = 11), aortic root aneurysms (n = 3), and non-aneurysmal patients (n = 7), Aortic collagen and elastin content were examined via histological analysis, and immunohistochemistry techniques used to determine collagen I, III, and IV subtypes. Analysis was via observational features, and colour deconvolution quantification techniques. Results: Elastin fiber disruption and fragmentation was the most extensive in the proximal aneurysmal regions. Medial fibrosis and collagen density increased in proximal aneurysmal regions and aortic root aneurysms (p < 0.005). Collagen I was seen in highest quantity in aortic root aneurysms. Collagen I content was greatest in the sinus tissue regions compared to the valvular and ostial regions (p < 0.005) Collagen III and IV quantification did not vary greatly. The most susceptible regions to ultrastructural changes in disease are the proximal ascending aorta and aortic root. Conclusions: The aortic root differs histologically from the ascending aorta confirming its unique composition in aneurysm pathology. These findings should prompt further evaluation on the influence of this altered structure on function which could potentially guide clinical management.
dc.description.statementofresponsibilityTimothy Luke Surman, John Matthew Abrahams, Jim Manavis, John Finnie, Dermot O'Rourke, Karen Jane Reynolds, James Edwards, Michael George Worthington, and John Beltrame
dc.identifier.citationJournal of Cardiothoracic Surgery, 2021; 16(1):255-1-255-10
dc.identifier.doi10.1186/s13019-021-01641-5
dc.identifier.issn1749-8090
dc.identifier.issn1749-8090
dc.identifier.orcidManavis, J. [0000-0001-7381-7781] [0000-0003-1268-561X]
dc.identifier.orcidFinnie, J. [0000-0003-2277-1693]
dc.identifier.orcidBeltrame, J. [0000-0002-4294-6510]
dc.identifier.urihttps://hdl.handle.net/2440/146048
dc.language.isoen
dc.publisherBMC
dc.rights© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
dc.source.urihttps://doi.org/10.1186/s13019-021-01641-5
dc.subjectAortic root; Ascending aorta; Aneurysms; Histology; Immunohistochemistry
dc.subject.meshAorta
dc.subject.meshAorta, Thoracic
dc.subject.meshHumans
dc.subject.meshAortic Aneurysm
dc.subject.meshAortic Aneurysm, Thoracic
dc.subject.meshElastin
dc.titleHistological regional analysis of the aortic root and thoracic ascending aorta: a complete analysis of aneurysms from root to arch
dc.typeJournal article
pubs.publication-statusPublished

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