DIFFERENTIAL DIAGNOSIS OF NON-INFLAMMATORY AORTOPATHIES: PATHOMORPHOLOGICAL COMPONENTS

The main challenge in the diagnosis and treatment of thoracic aortic aneurysm is the early detection of the disease, because it usually develops asymptomatically before the onset of acute aortic syndrome. However, difficulties remain in differential diagnosis of the already detected nosological forms of aortopathies of noninflammatory etiology. Objective. To determine the pathomorphological features of the ascending aorta wall for differential diagnosis of aortopathies. Material and methods. The analysis of morphological changes in aorta samples from 73 patients was performed. Results. Morphological changes in the aortic walls that can allow for differential diagnosis in non-inflammatory aortopathy were revealed: the extent and degree of dissection, hemorrhages, adventitial fibrosis and inflammation. Conclusions. Hereditary syndromes are the predominant causes of aortic disease in young-aged individuals. In patients with hereditary aortopathies, the absence of adventitial fibrosis and the predominance of leukocytes in the inflammatory infiltrate are more often detected. In aortopathies caused by arterial hypertension, marked dissection, hemorrhages, and fibrosis are noted. Inflammatory changes with a predominance of leukocytes are more frequent in infective endocarditis and chronic rheumatic heart disease.