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Pathology of the Aorta and Aorta as Homograft

The aorta is not a rigid tube, it is an “organ” with lamellar units, consisting of elastic fibers, extracellular matrix and smooth muscle cells in between as parenchyma. Several diseases may occur in the natural history of the aorta, requiring replacement of both semilunar cusps and ascending aorta....

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Autores principales: Thiene, Gaetano, Basso, Cristina, Della Barbera, Mila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304113/
https://www.ncbi.nlm.nih.gov/pubmed/34209632
http://dx.doi.org/10.3390/jcdd8070076
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author Thiene, Gaetano
Basso, Cristina
Della Barbera, Mila
author_facet Thiene, Gaetano
Basso, Cristina
Della Barbera, Mila
author_sort Thiene, Gaetano
collection PubMed
description The aorta is not a rigid tube, it is an “organ” with lamellar units, consisting of elastic fibers, extracellular matrix and smooth muscle cells in between as parenchyma. Several diseases may occur in the natural history of the aorta, requiring replacement of both semilunar cusps and ascending aorta. They may be congenital defects, such as bicuspid aortic valve and isthmal coarctation with aortopathy; genetically determined, such as Marfan and William syndromes; degenerative diseases, such as atherosclerosis and medial necrosis with aortic dilatation, valve incompetence and dissecting aneurysm; inflammatory diseases such as Takayasu arteritis, syphilis, giant cell and IgM4 aortitis; neoplasms; and trauma. Aortic homografts from cadavers, including both the sinus portion with semilunar cusps and the tubular portion, are surgically employed to replace a native sick ascending aorta. However, the antigenicity of allograft cells, in the lamellar units and interstitial cells in the cusps, is maintained. Thus, an immune reaction may occur, limiting durability. After proper decellularization and 6 months’ implantation in sheep, endogenous cell repopulation was shown to occur in both the valve and aortic wall, including the endothelium, without evidence of inflammation and structural deterioration/calcification in the mid-term. The allograft was transformed into an autograft.
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spelling pubmed-83041132021-07-25 Pathology of the Aorta and Aorta as Homograft Thiene, Gaetano Basso, Cristina Della Barbera, Mila J Cardiovasc Dev Dis Review The aorta is not a rigid tube, it is an “organ” with lamellar units, consisting of elastic fibers, extracellular matrix and smooth muscle cells in between as parenchyma. Several diseases may occur in the natural history of the aorta, requiring replacement of both semilunar cusps and ascending aorta. They may be congenital defects, such as bicuspid aortic valve and isthmal coarctation with aortopathy; genetically determined, such as Marfan and William syndromes; degenerative diseases, such as atherosclerosis and medial necrosis with aortic dilatation, valve incompetence and dissecting aneurysm; inflammatory diseases such as Takayasu arteritis, syphilis, giant cell and IgM4 aortitis; neoplasms; and trauma. Aortic homografts from cadavers, including both the sinus portion with semilunar cusps and the tubular portion, are surgically employed to replace a native sick ascending aorta. However, the antigenicity of allograft cells, in the lamellar units and interstitial cells in the cusps, is maintained. Thus, an immune reaction may occur, limiting durability. After proper decellularization and 6 months’ implantation in sheep, endogenous cell repopulation was shown to occur in both the valve and aortic wall, including the endothelium, without evidence of inflammation and structural deterioration/calcification in the mid-term. The allograft was transformed into an autograft. MDPI 2021-06-29 /pmc/articles/PMC8304113/ /pubmed/34209632 http://dx.doi.org/10.3390/jcdd8070076 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Thiene, Gaetano
Basso, Cristina
Della Barbera, Mila
Pathology of the Aorta and Aorta as Homograft
title Pathology of the Aorta and Aorta as Homograft
title_full Pathology of the Aorta and Aorta as Homograft
title_fullStr Pathology of the Aorta and Aorta as Homograft
title_full_unstemmed Pathology of the Aorta and Aorta as Homograft
title_short Pathology of the Aorta and Aorta as Homograft
title_sort pathology of the aorta and aorta as homograft
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304113/
https://www.ncbi.nlm.nih.gov/pubmed/34209632
http://dx.doi.org/10.3390/jcdd8070076
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