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Deposition of collagen in the alveolar wall of lungs from patients with tetralogy of Fallot and pulmonary atresia with major aortopulmonary collateral arteries—an ultrastructural study

Published online by Cambridge University Press:  19 August 2008

Hikaru Matsuda ,
Tohru Kuratani ,
Yasuhisa Shimazaki ,
Keishi Kadoba ,
Jyunjiro Kobayashi ,
Shigeaki Ohtake ,
Masahiro Nakayama  and
Takeshi Nakada
Hikaru Matsuda*
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Tohru Kuratani
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Yasuhisa Shimazaki
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Keishi Kadoba
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Jyunjiro Kobayashi
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Shigeaki Ohtake
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Masahiro Nakayama
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
Takeshi Nakada
Affiliation:
From the First Department of Surgery, Osaka University Medical School and the Divisions of Cardiovascular Surgery and Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka
*
Dr. Hikaru Matsuda, First Department of Surgery, Osaka University Medical School, Yamada-oka 2-2, Suita, Osaka 565, Japan. Tel. 6-879-3150; Fax.81-6-879-3159.
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Abstract

Abstract Lung biopsies were taken at surgery from five patients (age 2–13, average 7.6 years) with tetralogy of Fallot and pulmonary atresia with major aortopulmonary collateral arteries. The biopsies were then processed for ultrastructural study, comparing paired samples taken, on the one hand, from a segment connected to central pulmonary arteries and, on the other hand, from a segment supplied directly by collateral arteries. Specimens from patients with isolated ventricular septal defect, and from those without cardiac disease, were used as controls. In the patients with tetralogy of Fallot and pulmonary atresia, all biopsies taken from segments supplied by the major collateral arteries showed marked deposition of collagen in the alveolar wall, with an increase in the thickness of the basement membrane (3.6±1.2 µm, mean±SD) greater than seen in those taken from segments connected to central pulmonary arteries (0.9±0.6, p<0.05). The proportional fibrosis of the alveolar interstitial space was also significantly greater in the biopsies from the segments supplied by collateral arteries (30±9%) compared to those from segments fed by central pulmonary arteries (15±8%, p<0.05). No significant differences were found in these indices between the biopsies from segments connected to the central pulmonary arteries in patients with tetralogy of Fallot and pulmonary atresia and those from patients with isolated ventricular septal defect or normal controls. There was no apparent relation to the pulmonary arterial pressure in these findings. The results suggest that the pulmonary segments fed directly by major aortopulmonary collateral arteries in patients with tetralogy of Fallot and pulmonary atresia seem likely to be afflicted by alveolar wall fibrosis, although the etiology and clinical implications of this finding remain unclear.

Keywords

Tetralogy of Fallot with pulmonary atresiaalveolar wall fibrosisaortopulmonary collateral arteriesultrastructure of the lung
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 3 , July 1994 , pp. 277 - 284
Copyright
Copyright © Cambridge University Press 1994

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References

McGoon, DC, Baird, DK, Davis, GD.Surgical management of large bronchial collateral arteries with pulmonary stenosis or atresia. Circulation 1975; 52: 109–118.CrossRefGoogle ScholarPubMed
Alfieri, O, Blackstone, EH, Kirklin, JW, Pacífico, AD, Bargeron, LM Jr. Surgical treatment of tetralogy of Fallot with pulmonary atresia. J Thorac Cardiovasc Surg 1978; 76: 321–335.CrossRefGoogle ScholarPubMed
Piehler, JM, Danielson, GK, McGoon, DC.Management of pulmonary atresia with ventricular septal defect by right ventricular outflow construction. J Thorac Cardiovasc Surg 1980; 80: 552–557.CrossRefGoogle ScholarPubMed
Shimazaki, Y, Kawashima, Y, Hirose, H.Operative results in patients with pseudotruncus arteriosus. Ann Thorac Surg 1983; 35: 294–299.CrossRefGoogle ScholarPubMed
Matsuda, H, Hirose, H, Nakano, S, Shimazaki, Y, Kishimoto, H, Kobayashi, J, Arisawa, J, Kawashima, Y.Management of large aortopulmonary collateral arteries in patients with ventricular septal defect and pulmonary atresia: simultaneous ligation through median sternotomy during intracardiac repair. Ann Thorac Surg 1985; 40: 593–598.CrossRefGoogle ScholarPubMed
Sawatari, K, Imai, Y, Kurosawa, H, Isomatsu, Y, Momma, K.Staged operation for pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries. New technique for complete unifocalization. J Thorac Cardiovasc Surg 1989; 98: 738–750.CrossRefGoogle ScholarPubMed
Haworth, SG, Macartney, FJ.Growth and development of pulmonary circulation in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Br Heart J 1980; 44: 14–24.CrossRefGoogle ScholarPubMed
Haworth, SG, Rees, PG, Taylor, JFN, Macartney, FJ, De Leval, M, Stark, J.Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries, effect of systemic anastomosis. Brit Heart J 1981; 45: 13–41.CrossRefGoogle Scholar
Johnson, RJ, Sauer, U, Buhlmeyer, K, Haworth, SG.Hypoplasia of the intrapulmonary arteries in children with right ventricular outflow tract obstruction, ventricular septal defect, and major aortopulmonary collateral arteries. Pediatr Cardiol 1985; 6: 137–143.CrossRefGoogle ScholarPubMed
Haworth, SG, Hislop, AA.Pulmonary vascular development: normal values of peripheral vascular structure. Am J Cardiol 1983; 52: 578–583.CrossRefGoogle ScholarPubMed
Rabinovitch, M, Castañeda, AR, Reid, L.Lung biopsy with frozen section as a diagnostic aid in patients with congenital heart defects. Am J Cardiol 1981; 47: 77–84.CrossRefGoogle ScholarPubMed
Rabinovitch, M, Herrera-DeLeon, V, Castañeda, AR, Reid, L.Growth and development of the pulmonary vascular bed in patients with tetralogy of Fallot with or without pulmonary atresia. Circulation 1981; 64: 1234–1249.CrossRefGoogle ScholarPubMed
Thiene, G, Frescura, C, Bini, RM.Histology of pulmonary arterial supply in pulmonary atresia with ventricular septal defect. Circulation 1979; 60: 1066–1074.CrossRefGoogle ScholarPubMed
Jefferson, K, Rees, S, Somerville, J.Systemic arterial supply to the lungs in pulmonary atresia and its relation to pulmonary artery development. Br Heart J 1972; 34: 418–427.CrossRefGoogle Scholar
Heath, D, Edwards, JE.The pathology of hypertensive pulmonary vascular disease. Circulation 1958; 18: 533–538.CrossRefGoogle ScholarPubMed
Toritaka, C, Villiger, B, Kuhn, C, McDobald, JA.Ultrastructural distribution of fibronectin in normal and fibrotic lung. Lab Invest 1985; 52: 399–408.Google Scholar
Johnson, RJ, Haworth, SG.Pulmonary vascular and alveolar development in tetralogy of Fallot: a recommendation for early correction. Thorax 1882; 37: 893–901.CrossRefGoogle Scholar
Puga, FJ, Leoni, FE, Julsrud, PR, Mair, DD.Complete repair of pulmonary atresia, ventricular septal defect, and severe peripheral arborization abnormality of the central pulmonary arteries. J Thorac Cardiovasc Surg 1989; 98: 1018–1029.CrossRefGoogle ScholarPubMed