Morphophysiopathological correlations in pulmonary hypertension of cardiac origin.

100 patients with congenital malformation and acquired cardiac diseases were studied on preoperatory pulmonary biopsies to estimate the pulmonary hypertension by correlating the data obtained by modern multidisciplinary investigation: histological, histoenzymological, ultrastructural, physiological and clinical techniques. The morphological pictures show a range of vascular lesions similar to those found in Heath and Edwards' classification and they are especially thickenings of the intima, hypertrophies of the media, narrowings of vascular lumen and later some plexiform lesions and hemosiderosis. Progressive fibrosis processes as well as immune pulmonary reactions were made evident. The electron microscopical examinations provided new data regarding the thickening of the capillary and alveolary basal lamina, the activity of pneumocytes and macrophages that were also certified from the histoenzymological point of view by increase of peroxidases and acid phosphatases activity. The investigation carried out proved the importance of the cardiac preoperatory catheterism in order to establish the grade of the pulmonary hypertension while the concordance index is more increased than in the cases that were investigated only by non-bleeding techniques.