Vaideeswar Pradeep, Udayaravi Sujit
Department of Pathology (Cardiovascular and Thoracic Division), Seth GS Medical College, Mumbai, Maharashta, India.
Department of Pathology, Seth GS Medical College, Mumbai, Maharashta, India.
Indian J Pathol Microbiol. 2025 Jan 1;68(1):130-136. doi: 10.4103/ijpm.ijpm_1008_22. Epub 2024 Jul 5.
Aortopathy is a non-inflammatory and non-atherosclerotic disease of aorta that results from significant 'degenerative' changes in the media. This often leads to thoracic aortic aneurysms and/or dissections in young individuals.
This study aimed to analyze the clinical and pathological features of aortic resections performed for aortopathy.
Over the span of 15 years (2008-2022), all surgically resected specimens of aorta showing aortopathy in all age groups were studied. Particular attention was paid to the changes in the media to assess the extent, grade and severity of aortopathy.
During the 15-year study period, 73 surgically resected specimens of the ascending aorta showed features of aortopathy. There were 48 males and 25 females, who had chief complaints of dyspnea, chest pain and palpitation. The aortopathic manifestations observed were ascending aortic aneurysms (36 patients, 49.3%), aortic dissections (21 patients, 28.8%) and aneurysms with dissections (16 patients, 21.9%). Bicuspid aortic valve (24 cases), Marfan syndrome (13 cases) and hypertension (12 cases) were commonly identified. There was one case each of Loeys-Dietz syndrome, and aortopathy possibly related to blunt chest trauma. In a significant proportion of patients (22 cases), the cause remained elusive. Moderate to severe aortopathy was observed in 60 cases (82.2%).
This study helps in standardizing the histological parameters of aortopathy. In patients where the cause is uncertain despite of detailed clinico-radiological assessment, there is a need for molecular and genetic studies.
主动脉病变是一种主动脉的非炎症性、非动脉粥样硬化性疾病，由中膜显著的“退行性”改变引起。这常导致年轻个体发生胸主动脉瘤和/或主动脉夹层。
本研究旨在分析因主动脉病变而行主动脉切除术的临床和病理特征。
在15年（2008 - 2022年）期间，对所有年龄组中所有显示主动脉病变的手术切除主动脉标本进行了研究。特别关注中膜的变化，以评估主动脉病变的程度、分级和严重程度。
在15年的研究期间，73例手术切除的升主动脉标本显示出主动脉病变特征。有48例男性和25例女性，主要症状为呼吸困难、胸痛和心悸。观察到的主动脉病变表现为升主动脉瘤（36例，49.3%）、主动脉夹层（21例，28.8%）和动脉瘤合并夹层（16例，21.9%）。常见的有二叶式主动脉瓣（24例）、马方综合征（13例）和高血压（12例）。各有1例洛伊茨 - 迪茨综合征和可能与钝性胸部创伤相关的主动脉病变。在相当比例的患者（22例）中，病因仍不明确。60例（82.2%）观察到中度至重度主动脉病变。
本研究有助于规范主动脉病变的组织学参数。对于尽管进行了详细的临床 - 放射学评估但病因仍不确定的患者，需要进行分子和遗传学研究。
