Opera Medica et Physiologica

Histological Study of Pulmonary Artery Denervation

Abstract: 

Objectives: to evaluate the efficacy and safety of circular radiofrequency ablation of the pulmonary trunk and main pulmonary arteries in patients with severe pulmonary hypertension using a histological study. Materials and methods: for the analysis of autopsy material from non-operated patients, three study groups were identified. Experimental ­– with chronic pulmonary hypertension with mitral disease and radiofrequency ablation. Comparisons – with severe pulmonary hypertension and without radiofrequency ablation. Control – without pulmonary hypertension and radiofrequency ablation, who died from causes not associated with cardiovascular diseases. Hematoxylin and eosin staining according to Van Gieson was used to visualize the damage to the tissue samples of the vascular wall. The technique of impregnation with silver staining was used to determine the damage to the nerve plexuses and endings. Results: analysis of the results of optical density and the relative average area of argentophilic fibers revealed a decrease in these parameters in the ablation group. In patients of the comparison group, where a high level of pulmonary hypertension was also observed, there was a significant accumulation of argentophilic fibers. Conclusion: histological examination showed an increase in the formation of sympathetic nerves in the adventitia of the pulmonary arteries in severe pulmonary hypertension. The same pulmonary arteries denervation procedure is an effective and safe way of denervation of the sympathetic plexuses located in the adventitia layer of the pulmonary arteries, which is confirmed by histological studies.