CARDIAC ANATOMY - ANZCA · •Infundibular, conal or outlet septum •Crista supraventricularis...
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CARDIAC ANATOMY David McGiffin Director of Cardiothoracic Surgery and Transplantation Alfred Health, Melbourne
Transcript of 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
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The Aorto-Ventricular Membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The Aorto-Ventricular Membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The Aorto-Ventricular Membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The Aorto-Ventricular Membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The aorto-ventricular membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The aorto-ventricular membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The Aorto-Ventricular Membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The Aorto-Ventricular Membrane
Source: McAlpine WA, Heart and Coronary Arteries (1975)
The mitral valve
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
Source: Yoo SJ – Powerpoint presentation
Wolff (1781): Muscular crest between the tricuspid and pulmonary valves in the normal right ventricle
Crista supraventricularis
Source: Yoo SJ – Powerpoint presentation
Crista supraventricularis = Parietal band + Septal band
Crista supraventricularis
Source: Yoo SJ – Powerpoint presentation
Crista supraventricularis = Ventriculoinfundibular fold + Outlet septum +
Trabecula septomarginalis
Source: McAlpine WA, Heart and Coronary Arteries (1975)
Infundbulum
Source: McAlpine WA, Heart and Coronary Arteries (1975)
Infundibulum
Source: McAlpine WA, Heart and Coronary Arteries (1975)
Infundbulum
Source: McAlpine WA, Heart and Coronary Arteries (1975)
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
fold
Parietal band
Septal band
Moderator band
Trabecula
septomarginalis
Trabecula septomarginalis
Source: Yoo SJ – Powerpoint presentation
Trabecula septomarginalis (Y-shaped) = body + anterior and posterior limbs
Source: Anderson RH & Becker AE, Cardiac Anatomy (1980)
Trabecula septomarginalis
Source: Friedman BA et.al (2010) Ann Pediatr Cardiol
Ventriculoinfundibular fold
Source: Anderson RH & Becker AE, Cardiac Anatomy (1980)
Source: Anderson RH & Becker AE, Cardiac Anatomy (1980)
Crista supraventricularis?
Tricuspid valve structure
Source: Ton-Nu T-T. et.al (2006) Circulation
Mitral valve
Source: Anderson RH & Becker AE, Cardiac Anatomy (1980)
