Morphological features of brachiocephalic arteries in patients with aortic arch hypoplasia

Objective. The study was designed to assess the morphology and structural changes in the walls of the left subclavian artery in neonates and infants with coarctation and aortic arch hypoplasia. Methods. The study included 27 patients with hypoplasia of the aortic arch at the age of 64 (27; 89) days, average body weight of 3.6±1.1 (from 1.8 to 6.9 kg), who were operated at the Center of Pediatric Surgery of Academician Ye. Meshalkin Research Institute of Circulation Pathology in the period from 2013 to 2014. All patients underwent off-pump surgery of hypoplasia of the aortic arch by using modified reverse plasty with a patch from the left subclavian artery. The patch was taken intraoperatively to determine the ratio of elastin and collagen. The results were compared with those of the control group. Results. Significant differences were found in the content of collagen and elastic fibers in patients with aortic arch hypoplasia. Patients with hypoplasia had a significantly higher content of thin collagen and a lower content of elastic fibers in the wall of the subclavian artery. Conclusion. The morphology of the subclavian artery in children with aortic arch hypoplasia is characterized by an increase of collagen and a decrease of elastic fibers due to the proliferation of smooth muscle cells, myofibroblasts, fibroblasts and the change in their relationship. These features determine the changes in elastic characteristics of the vascular wall, i.e. increased rigidity.