Optical coherence tomography for observing development of pulmonary arterial vasa vasorum after bidirectional cavopulmonary connection in children

• Published in: PloS one Vol. 14; no. 4; p. e0215146
• Main Authors: Hayabuchi, Yasunobu, Homma, Yukako, Kagami, Shoji
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 08.04.2019; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Blood; Blood flow; Blood vessels; Case-Control Studies; Child, Preschool; Children; Congenital diseases; Cross-Sectional Studies; Diagnosis; Female; Fontan Procedure - methods; Health aspects; Heart Defects, Congenital - surgery; Heart surgery; Hemodynamics; Humans; Hypertension, Pulmonary - surgery; Hypoxia; Infant; Lung diseases; Male; Medical imaging; Medicine and Health Sciences; Morphology; Optical Coherence Tomography; Optical tomography; Patients; Physical Sciences; Prospective Studies; Pulmonary artery; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - physiopathology; Pulmonary Circulation; Research and Analysis Methods; Tomography; Tomography, Optical Coherence - methods; Vasa Vasorum - diagnostic imaging; Vasa Vasorum - physiopathology; Veins & arteries; Wall thickness; United States > US; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0215146

Hypoxia and low pulmonary arterial (PA) blood flow stimulate the development of systemic-to-pulmonary collateral blood vessels, which can be an adverse factor when performing the Fontan operation. The aim of this study was to use optical coherence tomography (OCT) to elucidate the morphological changes in PA vasculature after creation of a bidirectional cavopulmonary connection (BCPC) in children. This prospective study evaluated PA wall thickness and development of PA vasa vasorum (VV) in the distal PA of eight patients (BCPC group, 1.3 ± 0.3 years) and 20 age-matched children with normal pulmonary artery hemodynamics and morphology (Control group, 1.4 ± 0.3 years). VV development was defined by the VV area ratio, defined as the VV area divided by the adventitial area in cross-sectional images. There was no significant difference in PA wall thickness between the BCPC and control groups (0.12 ± 0.03 mm vs. 0.12 ± 0.02 mm, respectively). The VV area ratio was significantly greater in the BCPC group than in the Control group (14.5 ± 3.5% vs. 5.3 ± 1.6%, respectively; p<0.0001). OCT is a promising new tool for evaluating PA pathology, including the development of VV in patients after BCPC.