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Bielińska K, Butkiewicz AF, Ziemak H, Zdun M. Anatomy of the Right and Left Ventricular Subvalvular Apparatus of the Horse ( Equus caballus). Animals (Basel) 2024; 14:2563. [PMID: 39272348 PMCID: PMC11394058 DOI: 10.3390/ani14172563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 08/30/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
Due to the growing interest among veterinarians and the increasing market demands, the development of equine cardiology is necessary. Currently, veterinary medicine for companion animals needs to catch up to human medicine-equine medicine included. A common condition in older horses is aortic valve regurgitation resulting from fibrosis, while its more severe form occurs in younger horses or develops due to a bacterial infection. Mitral valve regurgitation, especially dangerous due to the possibility of sudden death, has a better prognosis if the horse has valve prolapse. Tricuspid valve regurgitation usually does not pose a clinical problem, although its severe cases may lead to heart failure. Some pathologies can be treated surgically, which requires excellent knowledge of anatomy. The object of this study consisted of twenty domestic horse hearts. The focus was on the normal and comparative anatomy of the left and right subvalvular apparatus. The number of muscular bellies of the papillary muscles and the type of connection of the muscles were analysed. Moreover, the height of muscle originating from the ventricle wall was determined, the morphological regularity of the papillary muscle was assessed, and the chordae tendineae originating from the papillary muscles were examined. The conducted research allowed for comparing domestic horses with different species through other studies, the authors of which described this particular aspect. Interspecies similarities which may be correlated with the evolutionary relatedness, as well as differences that could reflect adaptation to different lifestyles, environmental conditions, or metabolic requirements of the animals, have been found. This study expands the knowledge of animals' normal and comparative anatomy, and contributes to the development of veterinary surgery, internal medicine, and biology.
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Affiliation(s)
- Karolina Bielińska
- Department of Basic and Preclinical Sciences, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Lwowska 1, 87-100 Torun, Poland
| | - Aleksander F Butkiewicz
- Department of Basic and Preclinical Sciences, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Lwowska 1, 87-100 Torun, Poland
| | - Hanna Ziemak
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Szosa Bydgoska 13, 87-100 Torun, Poland
| | - Maciej Zdun
- Department of Basic and Preclinical Sciences, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Lwowska 1, 87-100 Torun, Poland
- Department of Animal Anatomy, Poznan University of Life Sciences, Wojska Polskiego 71C, 60-625 Poznan, Poland
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2
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Eishi K, Eishi J, Matsumaru I, Sumi M, Obase K, Miura T. Current management of tricuspid regurgitation: a focus on the spiral suspension approach. Gen Thorac Cardiovasc Surg 2024; 72:359-367. [PMID: 38642224 DOI: 10.1007/s11748-024-02024-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/10/2024] [Indexed: 04/22/2024]
Abstract
The indication for surgery for tricuspid regurgitation (TR) has reached a major turning point. It has become clear that the presence of moderate or severe TR alone worsens the prognosis of life, and the previous guidelines of Japanese Circulation Society, in which the indication for surgery was recommended at the timing of "right heart failure difficult to treat medically," now recommends surgery with a trigger of "repeated right heart failure" in the 2020 edition. In addition, a new repair technique targeting at subvalvular structure has been developed for end-stage TR to overcome a high TR recurrence rate that is associated with severe right ventricular enlargement and leaflet tethering. This review focuses on the spiral suspension technique, in which the papillary muscles are spirally suspended towards the septal leaflet annulus to correct tethering and enhances the understanding of its application in the context of TR management.
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Affiliation(s)
- Kiyoyuki Eishi
- Department of Cardiovascular Surgery, Nagasaki University, Nagasaki, Japan.
- Heart/Valve Center, Hakujyuji Hospital, 4-3-1 Ishimaru, Nishi-ku, Fukuoka, 819-8511, Japan.
| | - Junichiro Eishi
- Department of Cardiovascular Surgery, Nagasaki University, Nagasaki, Japan
- Heart/Valve Center, Hakujyuji Hospital, 4-3-1 Ishimaru, Nishi-ku, Fukuoka, 819-8511, Japan
| | - Ichiro Matsumaru
- Department of Cardiovascular Surgery, Nagasaki University, Nagasaki, Japan
| | - Mizuki Sumi
- Heart/Valve Center, Hakujyuji Hospital, 4-3-1 Ishimaru, Nishi-ku, Fukuoka, 819-8511, Japan
| | - Kikuko Obase
- Department of Cardiovascular Surgery, Nagasaki University, Nagasaki, Japan
- Heart/Valve Center, Hakujyuji Hospital, 4-3-1 Ishimaru, Nishi-ku, Fukuoka, 819-8511, Japan
| | - Takashi Miura
- Department of Cardiovascular Surgery, Nagasaki University, Nagasaki, Japan
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3
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Wang L, Cai C, Ju W, Chen M. Right ventricular false tendon-originating premature ventricular complexes triggering ventricular tachycardia: Identification and ablation. HeartRhythm Case Rep 2024; 10:418-421. [PMID: 38983892 PMCID: PMC11228068 DOI: 10.1016/j.hrcr.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Affiliation(s)
- Linlin Wang
- Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Cheng Cai
- Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Weizhu Ju
- Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Minglong Chen
- Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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4
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Haq IU, Shabtaie SA, Tan NY, Lachman N, Asirvatham SJ. Anatomy of the Ventricular Outflow Tracts: An Electrophysiology Perspective. Clin Anat 2024; 37:43-53. [PMID: 37337379 DOI: 10.1002/ca.24083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
Outflow tract ventricular arrhythmias are the most common type of idiopathic ventricular arrhythmia. A systematic understanding of the outflow tract anatomy improves procedural efficacy and enables electrophysiologists to anticipate and prevent complications. This review emphasizes the three-dimensional spatial relationships between the ventricular outflow tracts using seven anatomical principles. In turn, each principle is elaborated on from a clinical perspective relevant for the practicing electrophysiologist. The developmental anatomy of the outflow tracts is also discussed and reinforced with a clinical case.
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Affiliation(s)
- Ikram U Haq
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Samuel A Shabtaie
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicholas Y Tan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nirusha Lachman
- Department of Anatomy, Mayo Clinic, Rochester, Minnesota, USA
| | - Samuel J Asirvatham
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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5
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Carrasco M, Cabrito TMS, Montalbano MJ, Hołda MK, Walocha J, Tubbs RS, Loukas M. Cardiac ventricular false tendons: A meta-analysis. Clin Anat 2024; 37:114-129. [PMID: 37819143 DOI: 10.1002/ca.24116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
Ventricular false tendons are fibromuscular structures that travel across the ventricular cavity. Left ventricular false tendons (LVFTs) have been examined through gross dissection and echocardiography. This study aimed to comprehensively evaluate the prevalence, morphology, and clinical importance of ventricular false tendons using a systematic review. In multiple studies, these structures have had a wide reported prevalence ranging from less than 1% to 100% of cases. This meta-analysis found the overall pooled prevalence of LVFTs to be 30.2%. Subgroup analysis indicated the prevalence to be 55.1% in cadaveric studies and 24.5% in living patients predominantly studied by echocardiography. Morphologically, left and right ventricular false tendons have been classified into several types based on their location and attachments. Studies have demonstrated false tendons have important clinical implications involving innocent murmurs, premature ventricular contractions, early repolarization, and impairment of systolic and diastolic function. Despite these potential complications, there is evidence demonstrating that the presence of false tendons can lead to positive clinical outcomes.
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Affiliation(s)
- Mark Carrasco
- Department of Family Medicine, HealthQuest, Rhinebeck, New York, USA
| | | | | | - Mateusz K Hołda
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
- Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, West Indies
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, West Indies
- Department of Anatomy, University of Warmia and Mazury, Olsztyn, Poland
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6
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Vasilakis GM, Lakhani DA, Adelanwa A, Hogg JP, Kim C. Atypical imaging presentation of a massive intracavitary cardiac thrombus: A case report and brief review of the literature. Radiol Case Rep 2021; 16:2847-2852. [PMID: 34401011 PMCID: PMC8350016 DOI: 10.1016/j.radcr.2021.06.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/08/2023] Open
Abstract
Intracavitary cardiac thrombi, uncommonly found in the right chambers, have been shown to form secondary to endocardial and myocardial diseases. The differential diagnosis for an intracavitary cardiac mass is broad, including primary cardiac tumors, cardiac metastases, anatomic variants, vegetations, and thrombi. Here we present a unique case with a large calcified intracavitary cardiac thrombus in a 26-year-old woman with obesity, immune thrombocytopenic purpura, and a new diagnosis of systemic lupus erythematosus. Initial imaging presentation in this case masqueraded as a tumor, delaying the true diagnosis. A combination of cardiac imaging techniques, including transthoracic and transesophageal echocardiograms, cardiac CT, and cardiac MRI were required to correctly diagnose this calcified bland thrombus.
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Affiliation(s)
- Georgia M Vasilakis
- School of Medicine, West Virginia University School of Medicine, WV, 26506, USA
| | - Dhairya A Lakhani
- Department of Radiology, West Virginia University, Morgantown, WV, 26506, USA
| | - Ayodele Adelanwa
- Department of Pathology, West Virginia University, Morgantown, WV, 26506, USA
| | - Jeffery P Hogg
- Department of Radiology, West Virginia University, Morgantown, WV, 26506, USA
| | - Cathy Kim
- Department of Radiology, West Virginia University, Morgantown, WV, 26506, USA.,Section of Cardiothoracic Imaging, Department of Radiology, West Virginia University, Morgantown, WV, 26506, USA
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7
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Wang JM, Rai R, Carrasco M, Sam-Odusina T, Salandy S, Gielecki J, Zurada A, Loukas M. An anatomical review of the right ventricle. TRANSLATIONAL RESEARCH IN ANATOMY 2019. [DOI: 10.1016/j.tria.2019.100049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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8
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Cope LA. Multiple ventricular bands and the associated trabecula septomarginalis dextra in the right ventricle of the domestic dog (
Canis familiaris
). Anat Histol Embryol 2019; 48:397-403. [DOI: 10.1111/ahe.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 02/18/2019] [Accepted: 04/26/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Lee Anne Cope
- Division of Biomedical Sciences Mercer University School of Medicine Macon Georgia
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9
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Resembling Left Ventricular False Tendon in a Father and His Daughter. Case Rep Cardiol 2019; 2018:9543098. [PMID: 30627451 PMCID: PMC6304888 DOI: 10.1155/2018/9543098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/07/2018] [Accepted: 11/01/2018] [Indexed: 11/17/2022] Open
Abstract
Left ventricular false tendons (LVFTs) are linear fibrous or fibromuscular bands stretching across left ventricular cavity. Although LVFTs have been associated with various heart pathologies and investigated embryologically and histologically, there is only one report in the literature connoting possible hereditary transmission of this entity. We reported a father and his daughter having similar types of LVFTs with regard to location and thickness. With this report, we will contribute in the literature in respect to potential genetic inherence of LVFTs.
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10
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Cope LA. Morphology and Classification of Right Ventricular Bands in the Domestic Dog (Canis familiaris
). Anat Histol Embryol 2017; 46:464-473. [DOI: 10.1111/ahe.12291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- L. A. Cope
- Division of Basic Medical Sciences; Mercer University School of Medicine; 1550 College Street Macon GA 31207-0001 USA
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11
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Cope LA. Atypical Chordae Tendineae of the Canine (Canis familiaris) Right Atrioventricular Valve. Anat Histol Embryol 2016; 45:485-489. [PMID: 27027271 DOI: 10.1111/ahe.12231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/06/2016] [Indexed: 11/30/2022]
Abstract
The canine right atrioventricular valve cusps are anchored to papillary muscles by chordae tendineae. During ventricular systole, these tendineae keep the cusps from being pushed into the atrium. While this is the general description for chordae tendineae, several researchers have briefly documented chordae tendineae in animal and human hearts that do not attach to papillary muscles. In the 39 canine hearts examined, atypical chordae tendineae were observed in two hearts. In both dogs, a single stranded chordae tendineae extended from the free edge of the parietal cusp of the right atrioventricular valve to the ventricular free wall. While the discovery of these atypical tendineae provides additional information on canine cardiac anatomy, their presence may also be clinically significant. A review of the veterinary and biomedical literature showed entanglement in normal chordae tendineae can be a complication during cardiac catheterization or pacemaker lead placement. Given this issue with normal chordae tendineae, it seems logical to propose that these atypical tendineae could also cause catheter or pacemaker lead entanglement and therefore warrant further study and documentation.
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Affiliation(s)
- L A Cope
- Division of Basic Medical Sciences, Mercer University School of Medicine, 1501 Mercer University Drive, Macon, GA, 31207, USA.
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12
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Vigmond EJ, Stuyvers BD. Modeling our understanding of the His-Purkinje system. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2015; 120:179-88. [PMID: 26740015 DOI: 10.1016/j.pbiomolbio.2015.12.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 01/25/2023]
Abstract
The His-Purkinje System (HPS) is responsible for the rapid electric conduction in the ventricles. It relays electrical impulses from the atrioventricular node to the muscle cells and, thus, coordinates the contraction of ventricles in order to ensure proper cardiac pump function. The HPS has been implicated in the genesis of ventricular tachycardia and fibrillation as a source of ectopic beats, as well as forming distinct portions of reentry circuitry. Despite its importance, it remains much less well characterized, structurally and functionally, than the myocardium. Notably, important differences exist with regard to cell structure and electrophysiology, including ion channels, intracellular calcium handling, and gap junctions. Very few computational models address the HPS, and the majority of organ level modeling studies omit it. This review will provide an overview of our current knowledge of structure and function (including electrophysiology) of the HPS. We will review the most recent advances in modeling of the system from the single cell to the organ level, with considerations for relevant interspecies distinctions.
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Affiliation(s)
- Edward J Vigmond
- LIRYC, Institute of Electrophysiology and Cardiac Modeling, Hôpital Xavier Arnozan, avenue Haut-Lévèque, 33600 Pessac, France; Institut de Mathématiques de Bordeaux, Université de Bordeaux, 351, cours de la Libération, F 33 405 Talence, France; Department of Electrical and Computer Engineering, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
| | - Bruno D Stuyvers
- LIRYC, Institute of Electrophysiology and Cardiac Modeling, Hôpital Xavier Arnozan, avenue Haut-Lévèque, 33600 Pessac, France; Université de Bordeaux, 351, cours de la Libération, F 33 405 Talence, France; Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Phillip Drive, St. John's, NL A1B 3V6, Canada.
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13
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Cope LA. Morphological Variations in the Canine (Canis familiaris) Right Ventricle Trabecula Septomarginalis Dextra and a Proposed Classification Scheme. Anat Histol Embryol 2015; 45:437-442. [DOI: 10.1111/ahe.12217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 10/07/2015] [Indexed: 12/01/2022]
Affiliation(s)
- L. A. Cope
- Division of Basic Medical Sciences; Mercer University School of Medicine; 1501 Mercer University Drive Macon GA 31207 USA
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14
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Syed FF, Hai JJ, Lachman N, DeSimone CV, Asirvatham SJ. The infrahisian conduction system and endocavitary cardiac structures: relevance for the invasive electrophysiologist. J Interv Card Electrophysiol 2013; 39:45-56. [PMID: 24322419 DOI: 10.1007/s10840-013-9858-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 10/24/2013] [Indexed: 01/27/2023]
Affiliation(s)
- Faisal F Syed
- Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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15
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Tubbs RS, Chern JJ, Muhleman M, Loukas M, Shoja MM, Oakes WJ. Lateral compression of the foramen magnum with the Chiari I malformation: case illustrations. Childs Nerv Syst 2013; 29:495-8. [PMID: 22526444 DOI: 10.1007/s00381-012-1750-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 03/28/2012] [Indexed: 10/28/2022]
Affiliation(s)
- R Shane Tubbs
- Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South ACC 400, Birmingham, AL 35233, USA.
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16
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Gulyaeva AS, Roshchevskaya IM. Morphology of moderator bands (septomarginal trabecula) in porcine heart ventricles. Anat Histol Embryol 2012; 41:326-32. [PMID: 22348232 DOI: 10.1111/j.1439-0264.2012.01139.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 01/01/2012] [Indexed: 11/29/2022]
Abstract
The morphology of moderator bands in both heart ventricular cavities was examined on macro- and microscopic levels in 14 six-month-old Landrace pigs. One transverse moderator band, measuring 2.9 ± 0.6 mm in diameter, was located between the septum and the free wall of the right ventricular cavity. On cross-section, clumps of conductive cells were found at the periphery of the moderator band and in its central part around the blood vessels. Large amounts of muscle fibres were identified. The left ventricular cavity contained moderator bands in the form of thin cords, measuring 1.05 ± 0.09 mm in diameter and located mostly between the interventricular septum and the papillary muscles. Conductive tissue was represented by clumps of Purkinje cells, surrounded by myocardial fibres. The proportion of conductive cells and muscle fibres in the moderator bands was approximately the same. Owing to different amounts of conductive cells and muscle fibres in the bands, we assume that moderator bands in the right and left ventricles play different primary functional roles. Our results were compared with previous data on pigs and other ungulate animal species.
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Affiliation(s)
- A S Gulyaeva
- Laboratory of Comparative Cardiology, Komi Science Center of the Russian Academy of Sciences, Kommunisticheskaya, 24, 167982, Syktyvkar, Komi Republic, Russia.
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17
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Loveday RK, Wanta BT, Nicolosi AC, Pagel PS. A large mass on a newly implanted pulmonary artery catheter: thrombus, vegetation, or an anatomic explanation? J Cardiothorac Vasc Anesth 2010; 26:175-7. [PMID: 20864360 DOI: 10.1053/j.jvca.2010.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Indexed: 11/11/2022]
Affiliation(s)
- Robert K Loveday
- Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA
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18
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Tubbs RS, Griessenauer CJ, Loukas M, Shoja MM, Cohen-Gadol AA. Morphometric Analysis of the Foramen Magnum. Neurosurgery 2010; 66:385-8; discussion 388. [DOI: 10.1227/01.neu.0000363407.78399.ba] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE
To further elucidate the importance of anatomic variations in morphology of the foramen magnum and associated clinical implications, we conducted a morphometric study.
METHODS
Seventy-two dry skulls were used for this study. Digital images were obtained of the foramen magnum from an inferior view. These images were studied using a computer-assisted image analysis system. Next, an image processor was used to calculate pixel differences between 2 selected points, which allowed accurate translation of pixel differences into metric measurements.
RESULTS
We found that the mean surface area of the foramen magnum was 558 mm2, the mean anteroposterior diameter was 3.1 cm, and the mean horizontal diameter was 2.7 cm. For comparison, surface areas were classified into 3 types based on size. Type I foramina were identified in 20.8% of the dry skulls (15 skulls) and exhibited a surface area of less than 500 mm2. Type II (66.6%, 48 skulls) was applied to foramina of an intermediate size with surface areas ranging between 500 to 600 mm2. Type III (12.5%, 9 skulls) was applied to large foramina with surface areas of more than 600 mm2.
CONCLUSION
These data may be of use as a morphometric database for description of “normal” variants of foramen magnum morphology.
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Affiliation(s)
- R. Shane Tubbs
- Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama (Tubbs) (Griessenauer)
| | | | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, Grenada (Loukas)
| | - Mohammadali M. Shoja
- Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, and Department of Neurosurgery, Indiana University, Indianapolis, Indiana (Shoja) (Cohen-Gadol)
| | - Aaron A. Cohen-Gadol
- Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, and Department of Neurosurgery, Indiana University, Indianapolis, Indiana (Shoja) (Cohen-Gadol)
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Abstract
Left ventricular (LV) myocardial bands or false tendons, which span the LV cavity to connect distant sites on the endocardium, are commonly visualized on echocardiography and at autopsy. However, this entity has not been described in the radiologic literature. In this article, we describe 4 cases of LV bands imaged using echocardiography, multidetector computed tomography, and magnetic resonance. We will also discuss the embryologic basis, anatomic findings, differential diagnosis, and clinical implications of this condition.
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20
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An endoscopic and anatomical approach to the septal papillary muscle of the conus. Surg Radiol Anat 2009; 31:701-6. [PMID: 19415160 DOI: 10.1007/s00276-009-0510-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 04/16/2009] [Indexed: 10/20/2022]
Abstract
Many authors have questioned the gross anatomy of the septal papillary muscle of the conus known as the papillary muscle complex (PMC) during the past century. An anatomical investigation was conducted to identify the morphology and the topography of the PMC. Our study involved 200 formalin fixed adult human hearts. The PMC was present in 82% of the hearts, while in the remaining 18% of specimens, it was replaced by tendinous chords. The PMC was connected with the septal (59.7%), anterior (20.7%), or both septal and anterior leaflets (19.5%) with single (29.8%) or multiple chordae tendinae (70.1%). The PMC was also found to be present as a single papilla (51.8%), double papilla (32.9%) or triple papilla (15.2%). In addition to the PMC, we observed accessory single septal papillary muscles 42 specimens, double septal papillary muscles 32 specimens and triple septal papillary muscles 26 specimens. In the right ventricular inflow tract, the location of the PMC was consistently found to be in a position below the junction of the anterior and septal leaflets of the tricuspid valve. In the right ventricular outflow tract, we were able to identify 73 specimens in which the PMC was located at the junction formed superiorly by the inferior border of the subpulmonary infundibulum and inferiorly by the superior-lateral border of the septal band, extending into the region of the subpulmonary infundibulum. In the remaining 27%, the PMC was located primarily at the area occupied by the superiolateral border of the septal band without extending to the subpulmonary infundibulum. The present study describes the topography of the PMC according to its surrounding anatomical structures such as the tricuspid valve, subpulmonary infundibulum and septal band of the right ventricle. This anatomical data could have important clinical significance for cardiac surgeons operating in this area.
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