[Systematic quantification of the arteries in lung biopsies of patients with congenital heart defects and its contribution to the therapeutic management].
OBJECTIVE
To determine the value of the quantitative analysis of lung biopsies from patients with congenital cardiac defects.


METHODS
Fourty nine biopsies were examined, from patients: 43 patients increased pulmonary blood flow, 3 with pulmonary atresia and large systemic-to-pulmonary collateral vessels, and 3 with decreased pulmonary flow. The degree of lesion was determined as in Heath-Edwards and of Rabinovitch and col.


RESULTS
The Heath and Edwards grade was determined in 41 cases; I in nine; II in 23; III in eight; IV in one; 3 biopsies showed evidence of reduced pulmonary flow and 5 had no signs of vascular disease. The Down patients (7) presented a greater proportion of severe lesions. Quantitative evaluation was obtained in 35 biopsies: 11 had grade B and 24 had grade C. Wall atrophy and dilatation of intraacinar arteries were detected in 7 cases, what suggested the existence of obstructive lesions in proximal vessels, even if not sampled. Medical thickness greater than 2 times the normal were observed in pre-acinar arteries from 14 biopsies.


CONCLUSIONS
The morphometric approach allowed us to detect severe lesions which the qualitative analysis alone would not indicate adequately. In the patients presenting decreased pulmonary flow, morphometry made possible to assess if the degree of arterial wall hypertrophy was compatible with a surgery of atrio-pulmonary anastomosis.
Aiello
V D
VD
Instituto do Coração do Hospital das Clínicas, FMUSP e Hospital do Coração do Sanatório Sírio, São Paulo.
Fukasawa
S
S
da Silva
M J
MJ
Azeka
E
E
Bosisio
I B
IB
Ebaid
M
M
Higuchi
M L
ML
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000473:pathology; D007223:Infant; D008168:Lung / Q000473:pathology*; D008297:Male; D011651:Pulmonary Artery / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index