CARDIAC ANATOMY - ANZCA · •Infundibular, conal or outlet septum •Crista supraventricularis...

CARDIAC ANATOMY

David McGiffin Director of Cardiothoracic Surgery and Transplantation

Alfred Health, Melbourne

• The aorto-ventricular unit

• The mitral valve

• Interior of the right ventricle

Outline

Aorto-ventricular unit

The Aorto-Ventricular Membrane

Source: McAlpine WA, Heart and Coronary Arteries (1975)

The aorto-ventricular membrane

The mitral valve

Mitral valve

Mitral valve chordae

Source: Rabbah J-P.M. et.al (2013) J Biomechanical Engineering

Source: Yoshida K. & Obase K. (2012) J Cardiovascular Ultrasound

Non-planar structure of the mitral annulus

The interior of the right ventricle

• Two part – inflow (sinus) and outflow (infundibulum or conus)

• Three part (Goor and Lillehei) – inlet, apical trabecular and outlet

Right ventricular cavity

• Infundibular, conal or outlet septum

• Crista supraventricularis

• Parietal and septal bands

• Ventriculoinfundibular fold

• Trabecula septomarginalis

• Moderator band

Right ventricular outflow tract

Source: Yoo SJ – Powerpoint presentation

Terminology confusion

Crista supraventricularis

Wolff (1781): Muscular crest between the tricuspid and pulmonary valves in the normal right ventricle

Crista supraventricularis = Parietal band + Septal band

Crista supraventricularis = Ventriculoinfundibular fold + Outlet septum +

Trabecula septomarginalis

Infundbulum

Infundibulum

Infundbulum

Relation of RVOT and Ao Root

Infundibulum

Source: Friedman BA et.al (2010) Ann Pediatr Cardiol

Interior of the right ventricle

Source: Kirklin/Barratt-Boyes (2012) Cardiac Surgery

Infundibular septum

Ventriculoinfundibular

Parietal band

Septal band

Moderator band

Trabecula

septomarginalis

Trabecula septomarginalis (Y-shaped) = body + anterior and posterior limbs

Source: Anderson RH & Becker AE, Cardiac Anatomy (1980)

Source: Friedman BA et.al (2010) Ann Pediatr Cardiol

Ventriculoinfundibular fold

Crista supraventricularis?

Tricuspid valve structure

Source: Ton-Nu T-T. et.al (2006) Circulation

Mitral valve

CARDIAC ANATOMY - ANZCA · •Infundibular, conal or outlet septum •Crista supraventricularis...

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Transcript of CARDIAC ANATOMY - ANZCA · •Infundibular, conal or outlet septum •Crista supraventricularis...

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