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. 2020 Dec;160(6):e239–e257. doi: 10.1016/j.jtcvs.2019.08.094

Figure 5.

Figure 5

Quantitative analysis of elastin microstructure within control (n = 8), BAV-A (n = 15) and tricuspid aortic valve idiopathic DA (n = 15) aortic tissues. Quantitative analysis of elastin microstructure within bicuspid aortic valve aneurysm aortic tissues with normal valve function (Norm; n = 1), AI (n = 2), AS (n = 7), and a mixture of AI and AS (Mix; n = 5) are also shown F-J. Data in A-C and F-H were represented as box plots and data overlaid with upper and lower borders of the box to represent the upper and lower quartiles, and the middle horizontal line to represent the median. The upper and lower whiskers represent 5th and 95th percentile of the data. A, The number of elastin lamellar units; B, the lamellar spacing; and C, the thickness of the elastic lamellae were measured within the media. D, The number of elastin segments; and E, the length of the segments were measured over the entire tissue cross-section, expressed as mean ± standard error. Tissue cross-section was divided into 10 sections that covered innermost media (In), inner media (M1), middle media (M2), outer media (M3), and adventitia (Ad) layers. BAV-A had significantly more lamellar units with narrow lamellar spacing compared with DA. Control tissue had less lamellar units with wider lamellae spacing relative to BAV-A, although more units with narrower spacing relative to DA. DA had thinner lamellae compared with BAV-A and control. BAV-A and the control have similar elastin lamellae properties, although the number of segments differed between the groups. There were fewer short segments in DA relative to BAV-A and the control. Overall, we can note that although elastin segments were more uniformly distributed in the control, these segments were more compacted within the media of the aneurysmal tissues. All P values for elastin segments are presented in Tables E2 and E4. F-J, The same analysis as presented for A-E but within the BAV-A group only separating patients based on valve function. BAV-A, Bicuspid aortic valve aneurysm; DA, degenerative aneurysm; AI, aortic insufficiency; AS, aortic stenosis.