DOCSLIB.ORG

Morphologic Expression of the Left Coronary Artery in Pigs. an Approach in Relation to Human Heart Expressão Morfológica Da Artéria Coronária Esquerda Em Porcos

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Morphologic Expression of the Left Coronary Artery in Pigs. an Approach in Relation to Human Heart Expressão Morfológica Da Artéria Coronária Esquerda Em Porcos Gómez FA & ORIGINALBallesteros LE ARTICLE - Morphologic expression of the left coronary Rev Bras Cir Cardiovasc 2014;29(2):214-20 artery in pigs. An approach in relation to human heart Morphologic expression of the left coronary artery in pigs. An approach in relation to human heart Expressão morfológica da artéria coronária esquerda em porcos. Abordagem em relação ao coração humano Fabian Alejandro Gómez1, MSc; Luis Ernesto Ballesteros1, MSc DOI: 10.5935/1678-9741.20140027 RBCCV 44205-1542 Abstract tricular artery occurred in 89.9% of the hearts. A left marginal Introduction: In spite of its importance as an experimental branch was observed in 87.9% of the cases with a diameter of model, the information on the left coronary artery in pigs is 2.25±0.55 mm. sparse. Conclusion: Compared with humans, pigs have shorter Objective: To determine the morphologic features of the left left coronary artery trunks and branches; even the circumflex coronary artery in pigs. artery never reaches the posterior interventricular sulcus. Our Methods: We evaluated 158 pig hearts. The left coronary ar- findings are useful for the design of experimental hemodynamic tery was perfused with synthetic resin after their ostia had been and procedural models. catheterized. Diameters and courses of the vascular beds were measured with an electronic caliper (Mitutoyo®). Descriptors: Coronary Vessels. Coronary Circulation. Heart Results: The diameter of left coronary artery was 6.98 ± 1.56 mm and its length was 3.51±0.99 mm. It was found to end up by bifurcating itself into the anterior interventricular artery and Resumo the circumflex artery in 79% of the cases, and by trifurcating in Introdução: Apesar de sua importância como modelo expe- 21% of the cases, with the presence of the diagonal artery. The rimental, a informação sobre a artéria coronária esquerda em anterior interventricular artery ended up at the apex in 79.7% suínos é escassa. of the cases, and the circumflex artery at the posterior aspect of Objetivo: Determinar as características morfológicas da ar- the left ventricle in 64% of the case, this artery never reached téria coronária esquerda em suínos. the posterior interventricular sulcus. An anastomosis between Métodos: Foram avaliados 158 corações de porcos. A artéria the terminal branches of the anterior interventricular artery and coronária esquerda foram perfundidos com resina sintética após a the posterior interventricular artery was found in 7.6% of the sua óstios foram cateterizados. Diâmetros e cursos dos leitos vascu- specimens. The antero-superior branch of the anterior interven- lares foram medidos com um paquímetro eletrônico (Mitutoyo®). 1Universidad Industrial de Santander, Bucaramanga, Colombia. Work carried out at Universidad Industrial de Santander Bucaramanga, Colombia. Correspondence address: Luis Ernesto Ballesteros No financial support. Universidad Industrial de Santander Departamento de Ciencias Básicas, Facultad de Salud Article received on January 28th, 2013 Cra 32 # 29-31 - Bucaramanga, Colombia. Article accepted on July 11th, 2013 214 Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Gómez FA & Ballesteros LE - Morphologic expression of the left coronary Rev Bras Cir Cardiovasc 2014;29(2):214-20 artery in pigs. An approach in relation to human heart dos casos, sendo a artéria marginal na face posterior do ventrí- Abbreviations, acronyms & symbols culo esquerdo em 64% dos casos, esta artéria nunca chegou ao LCA Left coronary artery sulco interventricular posterior. Uma anastomose entre os ramos CXA Circumflex artery terminais da artéria interventricular anterior e artéria interven- AIA Anterior interventricular artery tricular posterior foi encontrado em 7,6% das amostras. O ramo LDA Left diagonal artery ântero-superior da artéria interventricular anterior ocorreu em LBC Left branch of the cone 89,9% dos corações. Um ramo marginal esquerda foi observado PIA Posterior interventricular artery em 87,9% dos casos, com diâmetro de 2,25±0,55 mm. LMB Left marginal branch Conclusão: Em comparação com os seres humanos, os por- cos têm troncos das artérias coronárias esquerdas mais curtos e Resultados: O diâmetro da artéria coronária esquerda foi ramos; até a artéria circunflexa nunca atinge o sulco interventri- 6,98±1,56 mm e seu comprimento era de 3,51±0,99 mm. Verificou- cular posterior. Nossos resultados são úteis para a concepção de se que acabam bifurcando-se no interior da artéria descendente hemodinâmica experimental e modelos processuais. anterior e da artéria circunflexa em 79 % dos casos, e dividindo-se em três em 21% dos casos, com a presença da artéria diagonal. Descritores: Vasos Coronários. Circulação Coronária. A artéria interventricular anterior acabou no ápice em 79,7% Coração. INTRODUCTION LCA in pigs have been conducted with small samples and are limited to qualitative descriptions[2,3,9]. The left coronary artery (LCA) in pigs is the main vessel The importance of the study of the LCA in pigs lies in that provides irrigation to the heart. The LCA irrigates most the utilization of this species as an experimental model for of the left ventricle and atrium, including the interventricular cardiovascular surgery, hemodynamics, and for compared septum. It emerges from the left aortic sinus, runs to the left anatomy teaching - learning processes[3,9,11]. Similarly, given behind of the pulmonary trunk, and ends up by bifurcating the large similarity existing between the hearts of humans into the anterior interventricular artery (AIA) and the circum- and pigs, this work intends to enrich the knowledge on the flex artery (CXA). Occasionally, the LCA trifurcates itself, coronary circulation in pigs to improve the applications using also giving origin to the left diagonal artery (LDA), charac- this animal species. teristic which has been described in humans with a frequency of 9-55% and in pigs at 20%[1-3]. METHODS The AIA descends through the homonym sulcus and emits septal branches, left branch of the cone (LBC), and right and This cross-over descriptive study assessed the LCA of left ventricular branches. The first left ventricular branch is 158 hearts of commercial stock pigs (Pietrain, Landrace Bel- called anterosuperior branch, and it usually has a good diam- ga and Large White mixed breeds) destined to sacrifice with eter and is projected towards the mid and lower thirds of the a mean age of 5 months, obtained from the Vijagual Refrig- obtuse margin of the heart, with a frequency of 81-82% in erating Plant of Bucaramanga - Colombia. The organs were humans. This branch has not been described in pigs. The AIA subjected to an exsanguination process in a water source for extends to the cardiac apex and commonly sends terminal 6 hours. After the LCA was marked with a silk suture at its branches to the posterior interventricular sulcus, which may origin, it was catheterized through its ostium and perfused anastomose with the posterior interventricular artery (PIA)[3]. with polyester resin (80% palatal GP41L and 20% styrene) The AIA ending in the apex has been described in a range of impregnated with red mineral. Then, the hearts were subject- 6-33%, while at the posteroinferior aspect has been described ed to a partial corrosion process with a 15% KOH (potassium in human hearts with a frequency of 42-80%[4-6]. hydroxide) in order to remove the subepicardial fat located at The CXA presents two segments: The first one runs along the interventricular and atrioventricular sulci. the left atrioventricular sulcus to the obtuse margin of the The diameters of the LCA and its branches were measured heart, whereas the second segment continues through the at their origins using a digital caliper (Mitutoyo®); lengths posterior atrioventricular sulcus and may occasionally ends were determined, and the finalization of the AIA was typified up at the crux cordis. The main branches of the CXA are at the lower third of the anterior interventricular sulcus, at the left marginal branch (LMB), left atrial branches and left the apex, or at the posterior aspect of the heart. Similarly, the ventricular branches[3]. In human hearts the CXA has been finalization of the CXA was assessed at the obtuse margin of described as ending up as the PIA (left dominance), with the heart, at the posterior aspect of the left ventricle, at the an incidence of 5-20%[7,8] whereas in pigs this morphologic crux cordis, or at the posterior interventricular sulcus. The feature occurs rarely[3,9,10]. The sparse studies referring to the branches anterosuperior (ASB) and LMB were characterized 215 Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Gómez FA & Ballesteros LE - Morphologic expression of the left coronary Rev Bras Cir Cardiovasc 2014;29(2):214-20 artery in pigs. An approach in relation to human heart with respect to diameters, lengths, and irrigated ventricular ended up more frequently (39.4%) at the mid third of the segments. obtuse margin of the heart (Table 3). The data were annotated in a physical matrix and record- The ACX length was 80±16.26 mm being lower with re- ed in a digital medium using Excel tables. Photographs of spect to the length of the AIA (P=0,6317). The CXA ended all of the pieces analyzed were taken to support the obser- up at the posterior aspect of the left ventricle in 101 hearts vations. (64%); in 55 samples (34.8%) it reached the crux cordis The continuous variables were analyzed using the t test, (Figure 4), whereas in two cases (1.2%) it was short and whereas the discrete variables were analyzed using Pearson’s ended up as the LMB. Its proximal diameter was 3.68±0.79 χ2 test and Fisher’s exact test. The results were evaluated us- mm; its mid diameter was 2.75±0.55 mm, and its distal di- ing the “Epi – Info 3.5.3” statistical program.
Load more

Recommended publications
  • The Ventricles
    Guest Editorial Evolution of the Ventricles Solomon Victor, FRCS, FRCP We studied the evolution of ventricles by macroscopic examination of the hearts of Vijaya M. Nayak, MS marine cartilaginous and bony fish, and by angiocardiography and gross examination of Raveen Rajasingh, MPhil the hearts of air-breathing freshwater fish, frogs, turtles, snakes, and crocodiles. A right-sided, thin-walled ventricular lumen is seen in the fish, frog, turtle, and snake. In fish, there is external symmetry of the ventricle, internal asymmetry, and a thick- walled left ventricle with a small inlet chamber. In animals such as frogs, turtles, and snakes, the left ventricle exists as a small-cavitied contractile sponge. The high pressure generated by this spongy left ventricle, the direction of the jet, the ventriculoarterial ori- entation, and the bulbar spiral valve in the frog help to separate the systemic and pul- monary circulations. In the crocodile, the right aorta is connected to the left ventricle, and there is a complete interventricular septum and an improved left ventricular lumen when compared with turtles and snakes. The heart is housed in a rigid pericardial cavity in the shark, possibly to protect it from changing underwater pressure. The pericardial cavity in various species permits move- ments of the heart-which vary depending on the ventriculoarterial orientation and need for the ventricle to generate torque or spin on the ejected blood- that favor run-off into the appropriate arteries and their branches. In the lower species, it is not clear whether the spongy myocardium contributes to myocardial oxygenation. In human beings, spongy myocardium constitutes a rare form of congenital heart disease.
    [Show full text]
  • 4B. the Heart (Cor) 1
    Henry Gray (1821–1865). Anatomy of the Human Body. 1918. 4b. The Heart (Cor) 1 The heart is a hollow muscular organ of a somewhat conical form; it lies between the lungs in the middle mediastinum and is enclosed in the pericardium (Fig. 490). It is placed obliquely in the chest behind the body of the sternum and adjoining parts of the rib cartilages, and projects farther into the left than into the right half of the thoracic cavity, so that about one-third of it is situated on the right and two-thirds on the left of the median plane. Size.—The heart, in the adult, measures about 12 cm. in length, 8 to 9 cm. in breadth at the 2 broadest part, and 6 cm. in thickness. Its weight, in the male, varies from 280 to 340 grams; in the female, from 230 to 280 grams. The heart continues to increase in weight and size up to an advanced period of life; this increase is more marked in men than in women. Component Parts.—As has already been stated (page 497), the heart is subdivided by 3 septa into right and left halves, and a constriction subdivides each half of the organ into two cavities, the upper cavity being called the atrium, the lower the ventricle. The heart therefore consists of four chambers, viz., right and left atria, and right and left ventricles. The division of the heart into four cavities is indicated on its surface by grooves. The atria 4 are separated from the ventricles by the coronary sulcus (auriculoventricular groove); this contains the trunks of the nutrient vessels of the heart, and is deficient in front, where it is crossed by the root of the pulmonary artery.
    [Show full text]
  • Endocardial Cushion and Myocardial Defects After Cardiac Myocyte-Specific Conditional Deletion of the Bone Morphogenetic Protein Receptor ALK3
    Endocardial cushion and myocardial defects after cardiac myocyte-specific conditional deletion of the bone morphogenetic protein receptor ALK3 Vinciane Gaussin*†, Tom Van de Putte‡, Yuji Mishina§, Mark C. Hanks¶, An Zwijsen‡, Danny Huylebroeck‡, Richard R. Behringerʈ, and Michael D. Schneider*,** *Center for Cardiovascular Development, Baylor College of Medicine, Houston, TX 77030; ‡Flanders Interuniversity Institute for Biotechnology (VIB07), K.U. Leuven, 3000 Leuven, Belgium; §National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709; ¶Procter and Gamble Pharmaceuticals Health Care Research Center, 8700 Mason Montgomery Road, Mason, OH 45040; and ʈUniversity of Texas–M. D. Anderson Cancer Center, Houston, TX 77030 Edited by Eric N. Olson, University of Texas Southwestern Medical Center, Dallas, TX, and approved December 31, 2001 (received for review July 26, 2001) Receptors for bone morphogenetic proteins (BMPs), members of velopment, whereas ALK6 is absent from the heart at mid- the transforming growth factor-␤ (TGF␤) superfamily, are persis- gestation (17). The developing heart also expresses ALK2͞ tently expressed during cardiac development, yet mice lacking type ActRIA (5, 18), which can function as a type I BMP receptor II or type IA BMP receptors die at gastrulation and cannot be used with preference for BMP6 and -7 (19). ALK3, ALK2, and to assess potential later roles in creation of the heart. Here, we BMPR-II are each essential for gastrulation and mesoderm used a Cre͞lox system for cardiac myocyte-specific deletion of the formation (18, 20, 21); mice lacking just BMP4 also fail to type IA BMP receptor, ALK3. ALK3 was specifically required at progress, typically, beyond the egg cylinder stage (22).
    [Show full text]
  • Ventricular Septal Defect (VSD)
    Ventricular Septal Defect (VSD) Ventricular Septal Defect. Flow of blood through a normal heart. What is a Ventricular Septal Defect?Your pet has been diagnosed with a Ventricular Septal Defect (VSD). A VSD is a malformation of the wall (interventricular septum) between the two pumping chambers (ventricles) allowing an abnormal communication. A VSD is a type of congenital defect, which means it is present from birth. VSDs are classified based upon whether they are restrictive or non-restrictive. In order to understand how this disease may affect your dog, it is important to understand normal circulation in the heart. Blood drains from the body into the right collecting chamber (called “atrium”) where it passes through the tricuspid valve and into the right pumping chamber (called “ventricle”). From here, blood is pumped into the pulmonary artery and subsequently to the lungs where it picks up oxygen. The oxygenated blood then drains passively into the left atrium, through the mitral valve, and into the left ventricle. The left ventricle then pumps the blood through the aorta and back to the body. Restrictive VSD: A restrictive VSD is a smaller diameter VSD that provides resistance of blood flow. These are the most common VSDs that we diagnose in dogs and cats. Due to normally higher pressures in the left side of the heart compared to the right side of the heart, most have blood flow from left-to-right through the hole. The amount of blood shunted depends on size of the VSD and the pressure difference across the VSD. Therefore, restrictive VSDs are further classified based on whether they are “hemodynamically significant” or not.
    [Show full text]
  • The Interventricular Septum by E
    Thorax: first published as 10.1136/thx.12.4.304 on 1 December 1957. Downloaded from Thorax (1957), 12, 304. THE INTERVENTRICULAR SEPTUM BY E. W. T. MORRIS From the Anatomy Department, St. Thomas's Hospital Medical School, Londoni (RECEIVED FOR PUBLICATION JULY 26, 1957) It is difficult to find in the literature a clear and between the tips of its two horns where the concise account of the development and form of boundary is formed by the fused atrioventricular the interventricular septum. Moreover, some of cushion (A, in Fig. 4). This septum does not lie the accounts in the clinical literature are at vari- in one plane and the main part of its free border ance with that generally accepted by embryo- forms a spiral (Figs. 4 and 5). logists. For this reason and in view of the recent (2) While the muscular part is forming. changes technical advances in the surgery of the heart, it are taking place in the relative positions of the seems opportune to describe the development and bulbus cordis and the ventricles. Earlier the heart anatomy of the interventricular septum and to tube is flexed at the bulboventricular junction so correlate this knowledge as far as possible with that the bulbus cordis comes to lie ventrally and the sites of interventricular septal defects. to the right of the ventricle (Fig. 2). Their con- At an early stage the heart consists of the sinus tiguous walls form a septum-the bulboven- venosus, the common atrium, the common ven- tricular septum-around the lower free border tricle, and the bulbus cordis, serially arranged in of which the two cavities communicate (see Figs.copyright.
    [Show full text]
  • Myocardial Velocities, Dynamics of the Septum Primum, and Placental Dysfunction in Fetuses with Growth Restriction
    138 Myocardial Velocities, Dynamics of the Septum Primum, and Placental Dysfunction in Fetuses with Growth Restriction Alexandre Antonio Naujorks, MD, PhD, Paulo Zielinsky, MD, PhD, Caroline Klein, MD, Luiz Henrique Nicoloso, MD, PhD, Antonio Luis Piccoli Jr, MD, PhD, Eduardo Becker, MD, PhD, Renato Frajndlich, MD, PhD, Patricia Pizzato, MD, Carolina Barbisan, MD, Stefano Busato, MD, and Mauro Lopes, MD Fetal Cardiology Unit, Instituto de Cardiologia/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil ABSTRACT Introduction. Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IUGR) and may be assessed by myocardial tissue Doppler (MTD). We previously have shown that excursion index of the septum primum (EISP) is reduced in IUGR fetuses over 30 weeks because of a higher left atrial pressure. Patients, Setting, and Design. The sample was made up of 14 fetuses with IUGR. MTD examination was carried out with the sample volume placed at the basal lateral wall of the left ventricle (LV), interventricular septum (IVS), and free wall of the right ventricle (RV) to determine E′/A′ ratios. EISP was calculated as the ratio between the maximal excursion of the septum primum into the left atrium during diastole and the maximal diastolic diameter of the left atrium. Mitral and tricuspid flows were assessed by the conventional Doppler method. Outcome Measures. Pearson’s correlation test was used to analyze the correlations between the parameters. Results. A positive correlation was observed between UARI and E′/A′ ratios for RV (r = 0.63, P = .02), IVS (r = 0.59, P = .03), and LV (r = 0.41, P = .15).
    [Show full text]
  • Redalyc.Conduction System in the Swine Heart: Essential Landmarks
    Red de Revistas Científicas de América Latina, el Caribe, España y Portugal Sistema de Información Científica Mingsakul, Thaworn; Surachon, Preeyaporn; Somana, Reon Conduction System in the Swine Heart: Essential Landmarks for Gross Dissection Acta Scientiae Veterinariae, vol. 42, núm. 1, enero, 2014, pp. 1-8 Universidade Federal do Rio Grande do Sul Porto Alegre, Brasil Available in: http://www.redalyc.org/articulo.oa?id=289029240048 Acta Scientiae Veterinariae, ISSN (Printed Version): 1678-0345 [email protected] Universidade Federal do Rio Grande do Sul Brasil How to cite Complete issue More information about this article Journal's homepage www.redalyc.org Non-Profit Academic Project, developed under the Open Acces Initiative Acta Scientiae Veterinariae, 2014. 42: 1211. RESEARCH ARTICLE ISSN 1679-9216 Pub. 1211 Conduction System in the Swine Heart: Essential Landmarks for Gross Dissection Thaworn Mingsakul1, Preeyaporn Surachon1 & Reon Somana2 ABSTRACT Background: The components of the cardiac conduction system (CCS) were discovered almost two centuries and presented in the diagrammatic forms. This should be due to the diffi culty in distinguishing the CCS from the surrounding cardiac tissues and the lack of information concerning the precise landmarks for gross dissection. Furthermore the CCS in pig, the animal regarded as a suitable model for the assessment of catheter based intervention, has not been reported. The aims of the present study were to demonstrate the gross anatomic architecture of CCS in the swine heart, and to provide the valuable landmarks for the gross anatomic dissection of the CCS. Materials, Methods & Results: Twenty hearts of adult Large White pigs (Sus Scrofa domesticus) were used.
    [Show full text]
  • Chapter Twenty
    Chapter 22 Outline • Overview of the Cardiovascular System • Anatomy of the Heart • Coronary Circulation • How the Heart Beats: Electrical Properties of Cardiac Tissue • Innervation of the Heart • Tying It All Together: The Cardiac Cycle • Aging and the Heart • Development of the Heart Overview of the Cardiovascular System • The heart propels blood to and from most body tissues via two basic types of blood vessels called ______ and ______. • Arteries are defined as blood vessels that carry blood away from the heart. • Veins are defined as blood vessels that carry blood back to the heart. • The arteries and veins entering and leaving the heart are called ______ vessels. General Characteristics and Functions of the Heart • Blood flow through the heart is ______ because of four valves within the heart. • The heart is functionally two side-by-side pumps that work at the same rate and pump the same volume of blood. – One pump directs blood to the lungs. – One pump directs blood to most body tissues. General Characteristics and Functions of the Heart • The heart generates ______ pressure through alternate cycles of the heart wall’s contraction and relaxation. • Blood pressure is the force of the blood pushing against the inside walls of blood vessels. • A minimum blood pressure is essential to circulate blood throughout the body. Pulmonary and Systemic Circulations The cardiovascular system consists of two circulations: 1. ______—right side of the heart and the pulmonary arteries and veins; conveys blood to the lungs and back to the left side of the heart 2. ______—left side of the heart and arteries and veins; conveys blood to most body tissues and back to the right side of the heart Cardiovascular System Figure 22.1 Position of the Heart • Slightly left of midline deep to the sternum in a compartment of the thorax known as the mediastinum Figure 22.2 Position of the Heart • During development, the heart rotates such that the right side or right border (primarily formed by the right atrium and ventricle) is located more anteriorly.
    [Show full text]
  • Embryology-1.Pdf
    EMBRYOLOGY COURSE CONTENT COMPETENCIES The first year medical student should be able to understand and explain the principles of fertilization, contraception, stages of early development of the embryo, development of various organ systems; developmental basis of congenital defects, twinning and teratology. GENERAL EMBRYOLOGY INTRODUCTION Stages of human life Prenatal – Zygote, pre-embryonic, embryonic, foetal, birth events Postnatal – Neonatal, infancy, childhood, prepubertal, pubertal, adolescent, adult - young, middle age, old age, death events Ontogeny, trimester, viability, abortion, miscarriage, medical termination of pregnancy, conceptus, abortus Terms of reference — Cranial, rostral, caudal, dorsal, ventral, lateral, medial, median, planes of section Level 3: Ontogeny in relation to phylogeny – The law of recapitulation; “Critical period”; Congenital vs. hereditary malformations; Investigations - USG, amniocentesis, chorionic villus biopsy, fetoscopy, teratology and its significance with respect to obstetrics, paediatrics; Intrauterine surgery; History of embryology GAMETOGENESIS AND FERTILISATION Menstrual cycle with reference to other reproductive cycles, concept of “first day of last menstrual period”, germ cell transport and fertilisation, sperm capacitation, acrosome reaction, zona reaction, methods of contraception, sex determination Level 2: Reference to genetics, abnormal gametogenesis, abnormal germ cells – morphology, abnormal chromosomal contents, biological significance, conception, assisted reproductive techniques
    [Show full text]
  • Development of Heart Notes
    Formation of heart tube: 3rd week Heart beat: 22nd –23rd day (beginning of fourth week) USG detection of heart beat: 7th week Foetal ECG: 11th week Endocardium from original heart tube Myocardium from surrounding mesoderm & epicardium (myoepicardial mantle) (visceral pericardium) Lining of pericardium epithelium of pericardial cavity Transverse sinus formed by disappearance of dorsal mesocardium (Present between arterial and venous ends of the heart tube) FATE Of SINUS VENOSUS Left horn of sinus venosus, along with medial part of common cardinal vein forms coronary sinus Lateral part of common cardinal vein forms oblique vein of left atrium Left venous valve merges with septum secundum. Right venous valve is divided in three parts by appearance of two transverse muscular bands, called limbic bands. i) The part above superior limbic band forms crista terminalis ii) The part between the two bands forms valve of inferior vena cava iii) The part below the inferior limbic band forms valve of coronary sinus INTERATRIAL SEPTUM i) Upper, thicker part is formed by septum secundum ii) Lower, thin part (floor of fossa ovalis) is formed by septum primum iii) Sharp margin of fossa ovalis is formed by lower, curved margin of septum secundum DEVELOPMENT OF RIGHT ATRIUM It develops from 1. Right half of primitive atrial chamber (rough part); 2. Absorption of right horn of sinus venosus (smooth part) and 3. Right atrioventricular canal. DEVELOPMENT OF LEFT ATRIUM It develops from 1. Left half of primitive atrial chamber (rough part – confined to the auricle); 2. Absorption of pulmonary veins (smooth part) and 3. Left atrioventricular canal.
    [Show full text]
  • Annular Insertion Levels of Atrioventricular Valves Along The
    142 Case Report Olgu Sunumu Annular insertion levels of atrioventricular valves along the interventricular septum alone can lead to misdiagnosis of ventricular morphology Atriyoventriküler kapaklar›n interventriküler septuma annuler yap›flma seviyesi ventrikül morfolojisini belirlemede yan›lt›c› olabilir Funda Öztunç, Ayfle Güler Eroglu, Tevfik Demir Division of Pediatric Cardiology, Department of Pediatrics,Cerrahpafla Medical Faculty Istanbul University, ‹stanbul, Turkey Introduction electrocardiogram showed right axis and right ventricular hypertrophy. It is known that, normally the tricuspid annulus has a lower At echocardiography, the cardiac apex was directed to the insertion site along the interventricular septum, as distinct from left. Usual atrial arrangement was found. The right-sided vent- the mitral annulus (1-5). ricle had coarse trabeculations (Fig 2a). The right-sided atri- Ebstein malformation is an abnormal location of some part oventricular valve had numerous chords, which were attached of the annular attachment of the leaflets of the tricuspid valve directly onto the septum, but its annulus had a higher septal in- away from the atrioventricular junction. In corrected transposi- sertion (Fig 2b). This ventricle was defined as morphologically tion patients with normal atrial arrangement left- sided (tricus- right ventricle. The left-sided ventricle had fine trabeculations. pid) atrioventricular valve annulus has lower insertion with atri- The left-sided atrioventricular valve did not have chordal at- oventricular discordance with or without displacement of the tachment onto the septum but its annulus had a lower (6mm) septal or posterior leaflets. Rarely Ebstein’s malformation can septal insertion. This ventricle was defined as morphologically affect the morphologically mitral valve (6-7).
    [Show full text]
  • Thorax-Heart-Blood-Supply-Innervation.Pdf
    Right coronary artery • Originates from the right aortic sinus of the ascending aorta. Branches: • Atrial branches sinu-atrial nodal branch, • Ventricular branches • Right marginal branch arises at the inferior margin of the heart and continues along this border toward the apex of the heart; • Posterior interventricular branch- lies in the posterior interventricular sulcus. The right coronary artery supplies • right atrium and right ventricle, • sinu-atrial and atrioventricular nodes, • the interatrial septum, • a part of the left atrium, • the posteroinferior one-third of the interventricular septum, • a part of the posterior part of the left ventricle. Left coronary artery • from the left aortic sinus of the ascending aorta. The artery divides into its two terminal branches: • Anterior interventricular branch (left anterior descending artery- LAD), descends obliquely toward the apex of the heart in the anterior interventricular sulcus, one or two large diagonal branches may arise and descend diagonally across the anterior surface of the left ventricle; • Circumflex branch, which courses in the coronary sulcus and onto the diaphragmatic surface of the heart and usually ends before reaching the posterior interventricular sulcus-a large branch, the left marginal artery, usually arises from it and continues across the rounded obtuse margin of the heart. Coronary distribution Coronary anastomosis Applied Anatomy • Myocardial infarction Occlusion of a major coronary artery leads to an inadequate oxygenation of an area of myocardium and cell death. The severity depends on: size and location of the artery Complete or partial blockage (angina) • Coronary angioplasty • Coronary artery bypass grafting Cardiac veins The coronary sinus receives four major tributaries: • Great cardiac vein begins at the apex of the heart.
    [Show full text]