A correlative histopathological study in aneurysms of the ascending aorta with special emphasis on Marfan’s syndrome

Introduction

Clinical diagnosis of Marfan’s syndrome follows defined criteria whereas there are limited studies focusing on morphological features in aneurysms, which would allow differentiation from other underlying pathologies.

Material and Methods

The database was searched for patients with Marfan’s syndrome who underwent reconstructive aortic surgery for aneurysms of the ascending aorta (1999-2014, n=29) which were matched with patients with atherosclerotic aneurysms (n=29) and aorta from tissue donors (n=30). The aortic specimens were morphologically reassessed and semiquantitative analysis was performed on Elastica von Gieson stained slides for collagen content and on Alcian blue/PAS stained slides for mucopolysaccharides using a purpose built digital software solution. Group comparisons were tested with the Kruskal-Wallis test followed by Mann-Whitney test using the Dunn-Bonferroni adjustment for multiple comparisons.

Results

The morphological structure of the aorta was to a variable extend altered in and within both investigated patient groups. The full spectrum of Marfan-related changes was found in four patients only. Statistical analysis revealed significant differences (p<0,001) in all investigated parameters, but subgroup analysis failed to show significant differences in collagen content between both investigated patient groups and minimum quantity of mucopolysaccharides between healthy individuals and Marfan patients.

Conclusions

The severity and distribution of aortic wall changes predisposing to development of aortic aneurysms vary considerably between and in different patient groups. Our findings merit further investigations oin a larger subset of patients.

Vergleicht man jeweils 2 Gruppen ergibt sich:

Donor vs. Arteriosklerose

Alle Fibrosewerte und min Muko unterscheiden sich signifikant.

Donor vs. Marfan:

Alle Werte bis auf min Muko unterscheiden sich signifikant.

Marfan vs. Arteriosklerose:

Fibrose : keine Unterschiede

Muko : sign Unterschiede