Coarctation, tubular hypoplasia, and the ductus arteriosus. Histological study of 35 specimens

A histological study has been made in an attempt to study further the relation between the ductus arteriosus, coarctation, and tubular hypoplasia of the aortic arch. Thirty-five aortic arch systems were studied using serial sectioning techniques. Twelve were from patients with coarctation and/or tubular hypoplasia. The other 23 hearts were from patients without aortic obstructive lesions, 7 from anatomically normal hearts, and the others from malformed hearts with anomalies elsewhere from the aortic arch. The anatomical study of the hearts with obstructive aortic lesions emphasised the necessity of distinguishing 'coarctation' from 'tubular hypoplasia', since the curtain lesion of coarctation was found to coexist with tubular hypoplasia in some cases. The histological study showed that the ductus was easily distinguished from the walls of the aorta or pulmonary artery. In all these cases with coarctation or tubular hypoplasia a sling of ductal tissue was located around the aortic isthmal orifice. In 6 hearts a diaphragm of ductal tissue was seen to form the coarctation lesion.