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Original Article

AZJCVS. 2020; 1(1): 10-4


Features of angioarchitectonics and morphological structure of the vessels of the brachiocephalic trunk in patients with aortic arch hypoplasia

Yuriy Sinelnikov, Elnur Hasanov, Faig Mirzazada, Ilya Soynov.


Abstract

Aim: Make a comparative assessment of structural changes of the left subclavian artery in case of hypoplasia of the aortic arch in children of the first year of life..
Material and Methods: In the study were included 35 patients, with hypoplasia of the aortic arch, operated in the central pediatric surgery ННИИПК named. akad. Е.Н. Meshalkin during 2013-2015 years. Inclusion criteria: age 65.4 ± 83.9 days (from 1 tо 281 days), average body weight 3.3 ± 1.05 (from 1.85 tо 6.4 kg), All patients underwent surgical correction of congenital heart disease (CHD) - hypoplasia of the aortic arch with a modified reverse flap plasty left subclavian artery under normothermic conditations. Biomaterial was taken intraoperatively: a fragment of the subclavian artery for the study of angioarchitectonics, proportions of elastin and collagen fibers, also changes there proportions in the wall of the intact subclavian artery and of the subclavian artery of the patients with hypoplasia of the aortic arch. The contraol group consisted of patient at the same age, who died after surgery for other congenital heart defects (n=27).
Results: Comparative analysis revealed that the content of thin collagen fibers in patients of control group (normal subclavian artery) was significantly less, than in patients of this study. Also revealed the predominance elastin fibers in patients with pathologically unchanged subclavian artery, than in coarctation zone.
Conclusion: Structural changes in the vessels of the brachiocephalic trunk (subclavian artery) as CHD, hypoplasia of the aortic arch in children of the first year of life, characterized by a predominance of the number of collagen fibers over the number of elastin fibers. These changes associated with the proliferation of smooth myocytes, myofibroblasts and fibroblasts (changes of proportions between cell types). These structural changes able to decrease elasticity, resulting in the devolepment of hemodynamic dysorders.

Key words: Hypoplasia of the aortic arch, morphology, elasticity






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