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The Journal of Thoracic and Cardiovascular Surgery, Vol 85, 911-916, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
A Rendas and L Reid
In a previous article we described the functional and structural changes
produced in the pulmonary arterial circulation of the growing pig by an
aorta-pulmonary shunt. The present work describes the hemodynamic and
morphologic adaptation that follows correction of the shunt. In four
piglets, aged 5 weeks, an anastomosis was made between the thoracic
descending aorta and the pulmonary trunk and left patent for 5 weeks. At
the end of that time the mean pulmonary artery pressure (PAP) was 20 +/-
3.8 mm Hg (mean +/- SD), compared with 9 +/- 2.1 mm Hg in a group of four
age-matched sham-operated control piglets. The shunt was then surgically
closed. After 10 weeks' recovery, the PAP was similar and normal in the two
groups. We have already shown that pulmonary hypertension of similar degree
and duration to that at the end of the patent shunt period produces the
following structural changes, assessed by quantitative techniques: (1)
preacinar arteries of normal external diameter but with a thicker medial
coat than normal and (2) intra-acinar arteries in normal concentration, of
smaller external diameter than normal, but with a medial coat appropriate
to the external diameter: Smooth muscle is found in more peripheral
arteries than is normal. In the present study, at the end of the recovery
period, the shunt animals were compared with the sham-operated animals and
had thicker medial coats in preacinar and intra-acinar arteries, muscle in
more peripheral arteries than is normal, and an increased arterial and
alveolar concentration for unit lung area. These results indicate that, in
the growing porcine lung, "recovery" from an aorta- pulmonary shunt that
was associated with moderate pulmonary hypertension restores external
arterial diameter to normal but leaves a thicker medial coat at the
preacinar and intra-acinar levels and muscle more peripheral in the
arterial bed. In addition, after shunt correction, multiplication of
alveoli and arteries proceeds at a faster rate than normal, at least during
the first 10 weeks of recovery.
ARTICLES
Pulmonary vasculature of piglets after correction of aorta-pulmonary shunts
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