Study Of Hemomicrocirculatory Bed Among Newborns With Congenital Heart Anomalies
Background Changes of the hemomicrocirculatory bed play important role in diagnosis, assessment of severity and character of pathological processes. Few data exist concerning changes of the hemomicrocirculatory system in congenital heart anomalies and the problem remains unsettled. Objectives The aim of this research was to investigate pathomorphological changes of the hemomicrocirculatory bed of the heart in newborns dying within the first 7 days of postnatal life from congenital heart disease. Methods The hemomicrocirculatory bed of the hearts of corpses of 48 newborns who died of congenital heart anomalies has been studied. As a control group, hearts of corpses of 20 newborns that died of other diseases has been studied. The hemomicrocirculatory bed has been examined by means of Ca 2+ ATP method (Chilingaryan A. M.) and modified method of Gomory (Sisakyan C. A.). Results It was revealed that the hemomicrocirculatory system of newborn’s heart that was died not of congenital heart anomalies, but because of other diseases, during the first 7 days of postnatal life, sufficiently differentiated, but at the same time, in the terminal part of the hemomcirculatory system non integrated vascular loops, connecting and main capillaries were found. In newborns that died of congenital heart disease in the early postnatal period pathologic alterations in the hemomicrocirculatory bed of the heart were revealed. Activity of growth and making anastomosis of the vascular buds were decreased. Inhibition of integration processes of vascular loops. The growth portion of these loops underwent pathological atrophy and finally disappeared, venous knee of these loops became tortuous. Major part of the connecting and main capillaries contained short and long vascular protrusions with signs of pathological atrophy, and the tip of the dome of these protrusions was expanded. Many of connecting and main capillaries were devoid of buds of growth or there were a few of them. Inhibition of processes of formation of true capillaries in microcirculatory system was revealed. More common changes in congenital heart anomalies characterized by collapses, sclerosis and reduction of microvessels, mostly true capillaries, they became tortuous. Configuration of loops also has changed: they lost their architecture, arterial and venous knees were located far from each other. As a result of the suppression of growth and progressive reduction of the true capillaries capillarotrophic failure of the microcirculation developed, leading to appearance of dystrophic, atrophic and sclerotic lesions. Conclusion Pathology of development of microcirculatory system is determined not only by reducing the activity, and then blocking formation of new portion of terminal part of vascular system, but also by collapse, progressive reduction and sclerosis of already developed microvessels. As a result, microvascular remodeling is revealed. The main manifestation of this is the true capillary deficiency in the hemomicrocirculatory system that results in centralization of tissue circulation and reduction of its metabolic efficiency.
Assistant Prof. Ruzanna Petrosyan
International Journal of Stroke, volum10,Issue Supplement S2,April 15. 2015