Diseases of the Aorta
Mary N. Sheppard in Practical Cardiovascular Pathology, 2022
With increasing age, the elastic lamellae reduplicate and slightly fragment with increased space between lamellae, so age is important in examining aortic specimens (see Fig. 8.8). The number of smooth muscle cells decrease, the mucoid ground substance becomes more prominent, and the number of collagen fibres increases. These medial changes alter the compliance of the aortic wall and result in dilatation with elongation, a process known as aortic ectasia, and lead to ‘unfolding’ of the aorta as seen in a chest X-ray. The increase in rigidity of the aorta leads to the widening of the pulse pressure in old age. The intima also thickens and develops layers of fine elastic laminae which make a clear distinction of intima from the media far from easy histologically. The aortic sinus area predominantly contains fibrous tissue without elastic, explaining why the sinuses bulge in systole.
Aortic Regurgitation
K. Gupta, P. Carmichael, A. Zumla in 100 Short Cases for the MRCP, 2020
Such a pulse is a reflection of a rapid aortic run-off and has the eponymous name of 'water hammer' or Corrigan's pulse. It may also be found in patients with: A large patent ductus arteriosus.An aortopulmonary window.A ruptured aneurysm of the aortic sinus.High fever, due to the marked peripheral vasodilatation.Widespread active Paget's disease.Pregnancy.Severe anaemia.
Specialization in individual circulations
Neil Herring, David J. Paterson in Levick's Introduction to Cardiovascular Physiology, 2018
The right coronary artery passes from the anterior aortic sinus in the atrioventricular (AV) groove to the inferior border of the heart. Seventy per cent of people have a right dominant circulation, where the posterior descending artery arises from the right coronary artery, whereas in 10%, this branch arises from the left circumflex artery (left dominant circulation). It is possible for both the right and left circumflex arteries to supply the posterior descending artery in a co-dominant system (20% of people). A branch of the right coronary artery supplies the AV node in 90% of people. The left main stem passes from the posterior aortic sinus and divides to give the left anterior descending artery and left circumflex artery. The left anterior descending artery supplies the septum (via septal branches), apex and anterior wall (via diagonal branches) of the left ventricle. The left circumflex artery supplies the lateral wall (via oblique marginal branches) and the inferior wall is supplied by either the left circumflex or right coronary artery depending on which artery is dominant.
Aggravation of atherosclerosis by pulmonary exposure to indium oxide nanoparticles
Published in Nanotoxicology, 2020
Dong-Keun Lee, Hyung Seok Jang, Hyunji Chung, Soyeon Jeon, Jiyoung Jeong, Jae-Hoon Choi, Wan-Seob Cho
For histological analysis, the lungs were fixed with neutral buffered formalin and routine histological techniques were applied. The heart tissue, including the aortic sinus, was perfused with ice-cold PBS via each ventricle and were fixed with 4% paraformaldehyde for 2 h. The tissues were then embedded in optimal cutting temperature (OCT) compound for frozen sectioning. The aortic sinus sites of the heart were cut into 5 µm-thick slices and stained with H&E (BBC Biochemical, Mount Vernon, WA, USA). The lesion score of lung tissues was assessed by the degree of inflammatory cell infiltration around the bronchioles, peribronchial arteries, and veins, and scored as follows: 0 for no infiltration; 1 for 1–2 layers of inflammatory cells; 2 for 3 layers; 3 for 4–5 layers; 4 for 6–7 layers; or 5 for more than 8 layers of inflammatory cells.
Bioprosthetic Valve Thrombosis: Insights from Transcatheter and Surgical Implants
Published in Structural Heart, 2020
George Dangas, Mauro Chiarito, Patrick O’Gara, Raj Makkar, Paul Gurbel, Jonathon Leipsic, Wayne Batchelor, David R. Holmes, Athena Poppas, John Carroll, Samir Kapadia, Michael Mack, Martin B. Leon, Vinod H. Thourani
While differences among transcatheter bioprostheses are mainly related to device components and shape, further differences should be taken into account to understand the differences in terms of risk for valve thrombosis between TAVR or SAVR.15 Leaflet preservation and lack of commissural alignment, with the latter being possible only with SAVR or a few special TAVR designs, are two factors that strongly contribute to limited washout in the neosinus and in turn to the potentially increased risk of SLT. Indeed, the possibility of leaflet removal and commissural alignment with SAVR allows for increased communication between neosinus and native sinus, resulting in high kinetic energy that powers all flow patterns within this stagnation zone. Valve orientation is involved in the way flow kinetic energy (in other words, blood flow vortex), enters into the neosinus, and indirectly dictates washout flow characteristics.15 In this context, the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction during TAVR (BASILICA) has emerged as a new option to improve flow and washout enhancement in the sinus and the neosinus (although it was conceived specifically to avoid coronary obstruction). Indeed, increased coronary flow and laceration of the barrier (i.e., the bulky native leaflets) that isolates the neosinus from the native aortic sinus has been shown to significantly improve washout in the neosinus.44 However, these promising results from an in vitro study remain hypothesis-generating and require further validation.
Sinus of Valsalva aneurysm presenting with chest pain
Published in Baylor University Medical Center Proceedings, 2021
Mostafa Abohelwa, Mohamed Elmassry, Ty Whisenant, Thanita Thongtan, Pooja Sethi
The aneurysm of the aortic sinus, also known as sinus of Valsalva aneurysm (SOVA), is a rare aortic root defect that can be dangerous. The aorta normally has three small pouches that sit directly above the aortic valve (Valsalva’s sinuses), and an aneurysm of one of these sinuses results in a thin-walled swelling. An aneurysm may affect the right (65%–85%), noncoronary (the posterior sinus) (10%–30%), or rarely the left (<5%) coronary sinus.1 It usually occurs due to the elastic lamina’s weakness at the media’s junction and the annulus fibrosis. It functions to prevent coronary artery ostia occlusion during systole when the aortic valve opens. Here, we present a case of a young man who had atypical chest pain and was found to have an unruptured SOVA of the noncoronary sinus.2,3
Related Knowledge Centers
- Aorta
- Aortic Valve
- Ascending Aorta
- Exercise
- Left Coronary Artery
- Myocardial Infarction
- Right Coronary Artery
- Ischemia
- Ventricle
- Coronary Arteries