Aortic Adventitial Pathology, Ascending Aortic Aneurysm, Borderline Aortic Dilatation, Coronary Artery Bypass Grafting (CABG)
Conditions
Keywords
Aortic Dissection Risk Prediction, Borderline Aortic Dilatation, Ascending Aortic Aneurysm, Coronary Artery Bypass Grafting (CABG)
Brief summary
This prospective study investigates microscopic changes in the outer layer (adventitia) of the ascending aorta in patients undergoing coronary artery bypass grafting (CABG) surgery. The study includes two groups of patients: (1) those with borderline ascending aortic dilatation (4.0-5.0 cm), and (2) a control group with normal aortic diameter (\<4.0 cm), all undergoing the same surgical procedure. During CABG, a small circular punch is routinely made in the ascending aorta for the proximal saphenous vein graft anastomosis. The tissue removed from this punch site is collected and used for histopathological and immunohistochemical analysis. The study aims to determine whether adventitial changes correlate with aortic size and whether these changes can help identify patients at risk for future aortic dissection or rupture. The findings may guide surgical decision-making in patients with borderline aortic enlargement.
Interventions
None listed
Sponsors
Samsun University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Adults aged between 20 and 70 years 2. Patients scheduled for elective open-heart coronary artery bypass grafting (CABG) 3. Patients undergoing their first cardiac surgery 4. Metabolically stable patients 5. Aortic diameter: 1. Observational aortic dilatation group: between 4.0 cm and 5.0 cm 2. Control group: less than 4.0 cm 6. Written informed consent obtained from the patient
Exclusion criteria
1. History of previous cardiac surgery 2. History of aortic dissection or rupture 3. Known genetic syndromes (e.g., Marfan, Loeys-Dietz, Ehlers-Danlos) 4. Known systemic vasculitis 5. Presence of acute infection or systemic inflammatory disease 6. Inadequate biopsy material for pathological analysis 7. Patients not undergoing any aortic intervention during surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Association Between Histopathological Findings and Aortic Diameter | Postoperative period (within 1 month) | Comparison of adventitial tissue samples between patients with borderline ascending aortic dilatation (4.0-5.0 cm) and those with normal-sized aortas (\<4.0 cm). Pathological evaluation includes staining for Carbonic Anhydrase IX (CA9), Smooth Muscle Actin (SMA), D2-40, Verhoeff-Van Gieson elastin, and Prussian blue. The presence of fibrosis, inflammation, neovascularization, and hypoxia-related markers will be recorded. Analysis of the correlation between the degree of histopathological changes and the measured ascending aortic diameter. Metrics include inflammatory cell infiltration, vasa vasorum density, and adventitial fibrosis severity. |
Countries
Turkey (Türkiye)
Outcome results
None listed