HISTOLOŠKE KARAKTERISTIKE I KLASIFIKACIJE KOARKTACIJE AORTE

  • Marina Miletić Kovačević Fakultet Medicinskih nauka, Kragujevac
  • Slobodan Ilić Univerzitetska dečja klinika, Medicinski fakultet, Univerzitet u Beogradu
  • Irena Tanasković Fakultet Medicinskih nauka, Kragujevac
  • Vesna Rosić Fakultet Medicinskih nauka, Kragujevac
  • Nemanja Jovičić Fakultet Medicinskih nauka, Kragujevac
  • Maja Sazdanović Fakultet Medicinskih nauka, Kragujevac
DOI: https://doi.org/10.5937/racter5-2632
Ključne reči: Congenital Heart Diseases||, ||Urodjene srcane mane, Aorta||, ||Aorta, Coarctation||, ||Koartikacija,

Sažetak


Koarktacija torakalne aorte predstavlja urođeno suženje gornjeg dela descendente aorte, neposredno uz pripoj arterijskog kanala ili veze, koje uzrokuje razliku u pritisku iznad i ispod mesta suženja. Jedna od najšire prihvaćenih klasifikacija koarktacije je podela prema uzrastu pacijenta. Prema ovoj klasifikaciji, koarktacija može da bude neonatalnog ili adultnog tipa.

Neonatalni tip koarktacije karakteriše prisustvo duktalnog sling-a i koarktacionog shelf-a (zadebljanja) koji je postavljen proksimalno u odnosu na ušće duktusa. Kod novorođenčadi i mlađe odojčadi, shelf i susedni delovi koarktacionog segmenta sadrže duktalno tkivo. Duktalno tkivo u zidu aorte obrazuje sling koji u popunosti okružuje jukstaduktalnu aortu. Kliničke karakteristike neonatalnog tipa koarktacije su srčana insuficijencija u detinjstvu, difuzno suženje aortnog luka ili tubularna hipoplazija, kao i često prisustvo otvorenog duktusa i drugih kongenitalnih srčanih mana.

U adultnom tipu koarktacije prisutna je cistična medijalna nekroza. Karakteriše je nekroza glatkih mišićnih ćelija, prisustvo cisti u elastičnim lamelama ispunjenih bazofilnim mukopolisaharidima i fibroza sa iregularnim rasporedom fibroelastičnog vezivnog tkiva u mediji. Adultni tip koarktacije karakteriše jasno ograničeno spoljašnje suženje u obliku peščanog sata, obično na mestu pripoja duktusa ili ligamenta, ili neposredno distalno od njega. Udružene srčane mane se ređe sreću u ovom tipu koarktacije.

 

Biografije autora

Marina Miletić Kovačević, Fakultet Medicinskih nauka, Kragujevac
Saradnik u nastavi,

Katedra za Histologiju i embriologiju, Fakultet Medicinskih nauka, Univerzitet u Kragujevcu

Slobodan Ilić, Univerzitetska dečja klinika, Medicinski fakultet, Univerzitet u Beogradu
Docent, 

Dečja hirurgija, Medicinski fakultet, Univerzitet u Beogradu

Irena Tanasković, Fakultet Medicinskih nauka, Kragujevac
Vanredni profesor,

Katedra za Histologiju i embriologiju, Fakultet Medicinskih nauka, Univerzitet u Kragujevcu

Vesna Rosić, Fakultet Medicinskih nauka, Kragujevac
Asistent,

Katedra za Histologiju i embriologiju, Fakultet Medicinskih nauka, Univerzitet u Kragujevcu

Nemanja Jovičić, Fakultet Medicinskih nauka, Kragujevac
Saradni u nastavi,

Katedra za Histologiju i embriologiju, Fakultet Medicinskih nauka, Univerzitet u Kragujevcu

Maja Sazdanović, Fakultet Medicinskih nauka, Kragujevac
Saradni u nastavi,

Katedra za Histologiju i embriologiju, Fakultet Medicinskih nauka, Univerzitet u Kragujevcu

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