Meta-analysis of the histopathological features of surgically removed aortas classified according to the SCVP and AECVP consensus documents.

The Society for Cardiovascular Pathology (SCVP) and the Association for European Cardiovascular Pathology (AECVP) published consensus statements on the surgical pathology of the aorta to unify nomenclature and provide a new classification scheme to systematically evaluate the degenerative and inflammatory lesions of the thoracic aorta. The aim of this meta-analysis was to determine the histopathological features of thoracic aneurysmatic aortas, thoracic dissected aortas, and thoracic aortas in patients with a bicuspid aortic valve (BAV). Additionally, the aim was to map how consensus documents and classification schemes is used in practice and research. Articles for analysis were identified while searching for references to the SCVP and AECVP consensus documents, resulting in 174 articles. After applying the exclusion and inclusion criteria, 10 articles were included in the analysis. Four cohorts were analysed: the whole cohort, the aneurysm cohort, the dissection cohort, and the BAV cohort. Medial degeneration was found in all cohorts. The dissection cohort showed more severe medial degeneration than the aneurysm cohort or the BAV cohort. The BAV cohort showed the mildest medial degeneration compared to the other cohorts. More prevalent smooth muscle cell nuclei loss was linked to dissection. The BAV cohort showed milder changes in elastic fibers. Atherosclerosis was comparable among all cohorts. Medial degeneration represents the pathological process of several aortic diseases. All studied components of medial degeneration were present in aneurysms, dissections, and BAV aortas. The consensus documents have been useful tools and assist with the systematic evaluation of resected aortas, although their use in the complexity is limited.