PT  - JOURNAL ARTICLE
AU  - M J Collins
AU  - V Dev
AU  - B H Strauss
AU  - P W M Fedak
AU  - J Butany
TI  - Variation in the histopathological features of patients with ascending aortic aneurysms: a study of 111 surgically excised cases
AID  - 10.1136/jcp.2006.046250
DP  - 2008 Apr 01
TA  - Journal of Clinical Pathology
PG  - 519--523
VI  - 61
IP  - 4
4099  - http://jcp.bmj.com/content/61/4/519.short
4100  - http://jcp.bmj.com/content/61/4/519.full
SO  - J Clin Pathol2008 Apr 01; 61
AB  - Background: Ascending aortic aneurysms (AA) are a common, though poorly understood medical condition.Aims: To document the histological changes in a large series of human ascending AA, and to correlate these changes with clinical variables.Methods: 111 ascending AA were excised at surgery over a 3 year period. Each aneurysm was received as a continuous ring of tissue. Sections were taken from the anterior, posterior, greater and lesser curvature of the aorta and graded in a semi-quantitative fashion for the degree of elastin fragmentation, elastin loss, smooth muscle cell (SMC) loss, intimal changes and inflammation.Results: Mean patient age at surgery was 58.7 (15.6) years; there were 70 men and 41 women. 12 patients had Marfan syndrome, 34 (30.6%) had a bicuspid aortic valve (BAV), while 71 (64.0%) had a tricuspid aortic valve (TAV). Inflammatory cells were present in 28 cases (25.2%) and were confined to the adventitia. No particular region of the aortic circumference was more severely affected, however a BAV was associated with significantly less intimal change, and less fragmentation and loss of elastic tissue compared with patients with a TAV. Advanced age (&amp;gt;65 years), female gender and Marfan syndrome were all associated with more severe elastin degeneration and smooth muscle cell loss (p&amp;lt;0.05 for all).Conclusion: Results indicate a wide variation in the histological appearance in ascending AA, depending on patient characteristics. They suggest that the underlying aneurysm pathogenesis may also be highly variable; this warrants further investigation.