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Pulmonary Hypertension in CHD (Morphometric analysis (Pulmonary vascular…
Pulmonary Hypertension in CHD
Heart defects + Increased pulmonary blood flow
Grades
I - II
Medial hypertrophy and intimal hyperplasia
Mild
Probably reversible
III-IV
Lumen occlusion
Intimal hyperplasia
Advanced arterial dilation
Grade III: Partially reversible
Grade IV: Irreversible
V-VI
Terminal changes
V: Angiomatoid formation
VI : Fibrinoid necrosis
Grades I-III frequently in older children,
exception
:
TGA with IVS
Large VSD
PDA
AVSD
Tabel faktor determinan penyebab PVD
Terms
Plexogenic arteriopathy
A.K.A: Plexiform lessions
Means: Lumen occlusion
Due to
intimal hyperplasia
Early to advanced arterial dilation
Pictured with expansion of
Smooth muscle
Endothelial-like cells
Morphometric analysis
Picture
Axial arteries
Dilated at hilum
Narrowed peripherally
Pulmonary vascular bed
Muscle extended to nonmuscular peripheral arteries
Regression of perinatal musculature
Medial hypertrophy
Arteriolar differentiation and multiplication: Normal