{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:44:35Z","timestamp":1791917075652,"version":"4.3.4"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T00:00:00Z","timestamp":1659830400000},"content-version":"vor","delay-in-days":128,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003The study aims to investigate aortic histopathologic differences among patients undergoing aortic valve reimplantation, suggest different mechanisms of aortic root aneurysm pathogenesis, and identify factors associated with long-term success of reimplantation.<\/jats:p><jats:p>\n          Methods\u2003From 2006 to 2017, 568 adults who underwent reimplantation for repair of aortic root aneurysm, including patients with tricuspid aortic valves with no connective tissue disease (TAV\/NoCTD, n\u2009=\u2009314\/568; 55.3%), bicuspid aortic valves (BAVs, n\u2009=\u200986\/568; 15.1%), or connective tissue disease (CTD, n\u2009=\u2009177\/568; 31.2%), were compiled into three comparison groups. Patients with both BAV and CTD (n\u2009=\u20099\/568; 1.6%) were omitted to increase study power. Patient records were analyzed retrospectively, focusing on pathology reports, which were available for 98.42% of patients, and were classified based on their descriptions of aortic tissue samples, primarily from the noncoronary sinus. Mean follow-up time available for patients was 2.97 years.<\/jats:p><jats:p>\n          Results\u2003Aortitis, medial fibrosis, and smooth muscle loss were more common histopathologic findings in patients with TAV\/NoCTD than in patients with BAV and CTD (p\u2009&lt;\u20090.05). Cystic medial degeneration was most often found in patients with CTD, then TAV\/NoCTD, and least in BAV (p\u2009&lt;\u20090.01). Increases in mucopolysaccharides were found more often in the BAV group than in the TAV\/NoCTD and CTD groups (p\u2009&lt;\u20090.01). There were no differences in the frequency of elastic laminae fragmentation\/loss across these three groups. Among all patients, 1.97% (n\u2009=\u200911\/559) had an unplanned reintervention on the aortic valve after reimplantation, but no significant demographic or histopathologic differences were identified.<\/jats:p><jats:p>\n          Conclusion\u2003Despite some common histopathologic features among patients undergoing aortic valve reimplantation, there were enough distinguishing features among aortic tissue samples of TAV\/NoCTD, BAV, and CTD patients to suggest that these groups develop root aneurysms by different mechanisms. No histopathologic features were able to predict the need for late reintervention on the aortic valve.<\/jats:p>","DOI":"10.1055\/s-0042-1743536","type":"journal-article","created":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T22:30:25Z","timestamp":1659911425000},"page":"69-76","source":"Crossref","is-referenced-by-count":4,"title":["Differences in Aortic Histopathology in Patients Undergoing Valve Reimplantation Surgery for Various Clinical Syndromes"],"prefix":"10.1055","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8480-6623","authenticated-orcid":false,"given":"Nicholas J.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0811-6871","authenticated-orcid":false,"given":"Tal","family":"Eitan","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3387-3508","authenticated-orcid":false,"given":"Justin G.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4114-1964","authenticated-orcid":false,"given":"Bradley F.","family":"Rosinski","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Rene","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-7549","authenticated-orcid":false,"given":"Carmela D.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5749-4588","authenticated-orcid":false,"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,7]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"E21","DOI":"10.3390\/jcdd5020021","article-title":"Enlightening the association between bicuspid aortic valve and aortopathy","volume":"5","author":"F Sophocleous","year":"2018","journal-title":"J Cardiovasc Dev Dis"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.jtcvs.2015.10.068","article-title":"Long-term outcomes of aortic root operations for Marfan syndrome: a comparison of Bentall versus aortic valve-sparing procedures","volume":"151","author":"J Price","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.carpath.2016.03.002","article-title":"Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. 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