Structural Abnormalities of the Pulmonary Trunk in Tetralogy of Fallot and Potential Clinical ImplicationsA Morphological Study
Elisabeth Bédard, MD,
Karen P. McCarthy, BSc,
Konstantinos Dimopoulos, MD, MSc,
Georgios Giannakoulas, MD, PhD,
Michael A. Gatzoulis, MD, PhD and
Siew Yen Ho, PhD*
Adult Congenital Heart Centre/Centre for Pulmonary Hypertension and Unit of Cardiac Morphology, Royal Brompton Hospital and the National Heart and Lung Institute, Imperial College London, London, United Kingdom
View larger version (21K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 1 PT/LV Index and Ao/LV Index
Pulmonary trunk (A) and aortic root (B) circumferences indexed to left ventricle length in different subgroups of tetralogy of Fallot (TOF) hearts and in normal control hearts. Ao-LV = aortic circumference to left ventricle length; PA = pulmonary atresia; PS = pulmonary stenosis; PT-LV = pulmonary trunk circumference to left ventricle length.
|
|
View larger version (21K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 2 Histological Changes in the Aorta and PT
Histological changes of grade 2 or higher in the aortic root (A and C) and PT (B and D) of various tetralogy of Fallot (TOF) subgroups versus control. aETC = abnormal elastic tissue configuration; CLF = cystlike formation; ElFr = elastic fragmentation; FB = fibrosis; MN = medionecrosis; PT = pulmonary trunk.
|
|
View larger version (94K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 3 ETC and Histological Abnormalities in PT
Elastic tissue configuration (ETC) and histological abnormalities from the pulmonary trunk of tetralogy of Fallot specimens. Elastic van Gieson stain (A to D), Alcian blue stain (E); hematoxylin and eosin stain (F). Magnification x400 (A, B, D, E) and x200 (C and F). Aorta-like ETC (infant) (A); transitional ETC (infant) (B); adult pulmonary ETC (adult) (C); hypotensive ETC (adult) (D). Grade 3 fibrosis (D); grade 3 cystlike formation (adult) (E); grade 3 medionecrosis (adult) (F).
|
|
View larger version (13K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 4 Correlation Between PT/Ao MT Ratio and HGS/ETC
Correlation between pulmonary trunk-to-aortic media thickness (PT/Ao MT) ratio and pulmonary histology grade scores (HGS) (A) and elastic tissue configuration (ETC) (B) in both tetralogy of Fallot (TOF) and normal control hearts (n = 56).
|
|
|
