Morphological variability of the arterial valve in common arterial trunk and the concept of normality

Author(s)

Liguori, Gabriel Romero ; Jatene, Marcelo Biscegli ; Ho, Siew Yen ; Aiello, Vera Demarchi

• Document type: Journal article
• Source: HEART; v. 103, n. 11, p. 848-855, JUN 2017.
• Web of Science Citations: 1

Abstract

Objective Until now, no study established a morphometric evaluation of the truncal valve dysplasia and a description of its different presentation patterns. Thus, authors conducted an anatomopathological study describing the gross features and histological findings of the truncal valve. Methods 50 common arterial trunk (CAT) specimens were examined. The number of valvar leaflets was determined and valvar dysplasia was classified as absent, mild, moderate or severe. Selected leaflets were sectioned and submitted to histological analysis and linear measurements (thickness, length and area), besides quantification of collagen area fraction. Results 28 (56%) valves presented three, 15 (30%) four and 7 (14%) two leaflets. Valvar dysplasia was absent in 13 (26%) cases, mild in 19 (38%), moderate in 6 (12%) and severe in 12 (24%). A significant association was found between the presence of four leaflets and valvar dysplasia (p<0.001). Single coronary ostium was more common in two-leaflet cases than in three-leaflet cases (p=0.037). Leaflets medial thirds were thicker in the more dysplastic valves (p=0.006) and in those presenting anarchic collagen distribution (p=0.002). Conclusions CAT semilunar valves present two main patterns. The first characterised by three leaflets and absent or mild dysplasia and the second by four leaflets and severe dysplasia. Still, great variability regarding thickness, microscopic organisation of the extracellular matrix and proportions of leaflets' dimensions exists, which may impact on the surgical outcomes. (AU)

• FAPESP's process: 10/16663-0 - Histological morphology of the semilunar valves in common arterial trunk and its relationship with other morphological features of the anomaly
• Grantee: Vera Demarchi Aiello
• Support Opportunities: Regular Research Grants
• FAPESP's process: 10/16811-0 - Histological morphology of the semilunar valves in common arterial trunk and its relationship with other morphological features of the anomaly.
• Grantee: Gabriel Romero Liguori
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 12/06735-0 - Morphological features of the truncal valve and of the other associated abnormalities in common arterial trunk
• Grantee: Gabriel Romero Liguori
• Support Opportunities: Scholarships abroad - Research Internship - Scientific Initiation