{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:22:34Z","timestamp":1778923354512,"version":"3.51.4"},"reference-count":8,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1047951125101595_as1\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>The Ross procedure offers several advantages for adolescents requiring aortic valve replacement, but progressive pulmonary autograft dilation is a well-described risk. To provide novel insight into the pre-Ross histology in an adolescent with bicuspid aortic valve (BAV)-associated aortopathy, we describe the extracellular architecture of the pulmonary artery (PA) compared to the native ascending aorta.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1047951125101595_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>A 15-year-old with BAV, symptomatic moderate aortic insufficiency and aortic stenosis, and ascending aortic dilation underwent Ross. Intraoperative specimens included the main PA and ascending aorta. Tissue specimens were fixed, stained using 1) haematoxylin and eosin, 2) Verhoeff\u2019s van Gieson, and 3) trichrome, and compared using light microscopy.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1047951125101595_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Elastin van Gieson stain revealed that the aortic media in the dilated ascending aorta contained a greater concentration of dense elastin weaves and a regular distribution of collagen compared to the PA. In contrast to the dense and organised compaction of elastic fibres in the media of the aortic specimen, the PA, though grossly normal, demonstrated extensive disruption and fragmentation. Trichrome staining revealed minimal fibrosis in both specimens.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1047951125101595_as4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Notable pre-Ross histological differences include marked disruption of elastin in the PA compared to the aorta. Age-based differences in Ross outcomes suggest that adolescents may experience proportionally more significant autograft dilation over time, so future studies should include prospective collection and histological analysis of specimens across the age spectrum, both pre- and post-Ross, to allow comparison to age-matched controls.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1047951125101595","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T06:50:57Z","timestamp":1756191057000},"page":"1-4","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Histological examination of the pulmonary artery and aorta in an adolescent undergoing the Ross procedure"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9865-0228","authenticated-orcid":false,"given":"Hannah L.","family":"McMullen","sequence":"first","affiliation":[{"name":"Stanford University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhea","family":"Birusingh","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Rossi","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amer","family":"Heider","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Miles","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D.","family":"Wearden","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer S.","family":"Nelson","sequence":"additional","affiliation":[{"name":"University of Central Florida College of Medicine"},{"name":"Nemours Children\u2019s Hospital Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"S1047951125101595_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.03.185"},{"key":"S1047951125101595_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.07.083"},{"key":"S1047951125101595_ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2018.00030"},{"key":"S1047951125101595_ref5","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2020.04.006"},{"key":"S1047951125101595_ref8","first-page":"1","article-title":"Microstructure of the aortic valve: implications for valvular mechanics and function","volume":"1","author":"Tseng","year":"2009","journal-title":"Advances in Cardiovascular Research"},{"key":"S1047951125101595_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.02.068"},{"key":"S1047951125101595_ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-59554-7"},{"key":"S1047951125101595_ref3","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.829120"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951125101595","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T06:50:58Z","timestamp":1756191058000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951125101595\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":8,"alternative-id":["S1047951125101595"],"URL":"https:\/\/doi.org\/10.1017\/s1047951125101595","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,26]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}