PMC3203977_01
External macroscopic aspect of the ascending aorta segment.
cln-66-11-1995-g001.jpg
PMC3203977_01_cln-66-11-1995-g001.jpg
f1-cln_66p1995
After the pericardiotomy, we noticed an uncommon aspect of the ascending aorta, with an irregular surface and thinned dilated areas with soft superficial texture (Figure 1).
Internal macroscopic aspect of the ascending aorta segment. Note the multiple focal cavities of different sizes corresponding to the external dilations.
cln-66-11-1995-g002.jpg
PMC3203977_01_cln-66-11-1995-g002.jpg
f2-cln_66p1995
The internal aspect of the vessel was thickened, with multiple focal cavities of different sizes corresponding to the external dilatations; no thrombi were found (Figure 2).
A) Aorta segment on the level of the little saccular dilations on the aneurysmatic wall showing a severe lack of smooth muscle cells (Tricromic of Masson, 50x). B) "Proteoglycan lakes" are related to the areas of widespread loss of elastic fibers (Alcian Blue, 200x). C) Intense elastic fiber fragmentation area (Verhoeff, 200x).
cln-66-11-1995-g003.jpg
PMC3203977_01_cln-66-11-1995-g003.jpg
f3-cln_66p1995
Areas of medial cystic degeneration with saccular dilations were observed to be diffusely distributed; inflammation was absent (Figure 3-A,B,C).
Angiotomographic construction in three dimensions of the aorta and its branches. No evidence of further injury. Proper positioning of the aortic vascular Dacron graft and the aortic mechanic valve prosthesis.
cln-66-11-1995-g004.jpg
PMC3203977_01_cln-66-11-1995-g004.jpg
f4-cln_66p1995
Furthermore, the prosthetic graft in the ascending aorta and the mechanic valve prosthesis in the aortic position were properly positioned (Figure 4).