Ventricular morphology and coronary arterial anatomy in hearts with isomeric atrial appendages Hideki Uemura, MD, Siew Yen Ho, PhD, Robert H Anderson,

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Morphologic Spectrum of Ventriculoarterial Connection in Hearts With Double Inlet Left Ventricle: Implications for Surgical Procedures Hideki Uemura, MD,

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Presentation transcript:

Ventricular morphology and coronary arterial anatomy in hearts with isomeric atrial appendages Hideki Uemura, MD, Siew Yen Ho, PhD, Robert H Anderson, MD, Toshikatsu Yagihara, MD The Annals of Thoracic Surgery Volume 67, Issue 5, Pages 1403-1411 (May 1999) DOI: 10.1016/S0003-4975(99)00118-6

Fig 1 Isomerism of the atrial appendages is diagnosed on the basis of the extent of the pectinate muscles within the appendages relative to the atrial vestibules. In right isomerism (A), the pectinate muscles encircle the vestibules, but are confined anteriorly (B) in those with left isomerism (∗ = crux of the heart; Δ = os of appendage.) The Annals of Thoracic Surgery 1999 67, 1403-1411DOI: (10.1016/S0003-4975(99)00118-6)

Fig 2 In hearts with each atrium connected to its own ventricle (biventricular atrioventricular connections), ventricular topology of the ventricular mass is described as right- and left-hand patterns, corresponding to d- and l-ventricular loop, respectively. The heart shown on the upper panels has isomeric arrangement of the left atrial appendages, whereas the heart shown on the lower panels has isomeric right appendages. The Annals of Thoracic Surgery 1999 67, 1403-1411DOI: (10.1016/S0003-4975(99)00118-6)

Fig 3 In hearts with both atrial chambers connected predominantly to the same ventricle (double inlet ventricle), the dominant ventricle was of morphologically left (A), or of morphologically right (B) type. In rare instances, there was a solitary and morphologically indeterminate ventricle (C). The Annals of Thoracic Surgery 1999 67, 1403-1411DOI: (10.1016/S0003-4975(99)00118-6)

Fig 4 Coronary arterial branching and orifices. (A) Diagram of the coronary arteries in the normal heart and that of the most common pattern in complete transposition. (B) In hearts with the balanced morphologically left and right ventricles. (C) In hearts with a dominant morphologically right ventricle with a rudimentary and incomplete left ventricle. (D) In hearts with a dominant morphologically left ventricle with a rudimentary and incomplete right ventricle. (E) In hearts with a solitary and indeterminate ventricle. Arrows indicate unusual origins and courses of the major coronary arteries. Patterns in hearts with left-hand topology were described by mirror image projection. (LV = morphologically left ventricle; RV = morphologically right ventricle; indetV = solitary and indeterminate ventricle; PT = pulmonary arterial trunk; AIA = anterior interventricular artery; PIA = posterior interventricular artery; LVA = left ventricular arteries; RVA = right ventricular arteries.). The Annals of Thoracic Surgery 1999 67, 1403-1411DOI: (10.1016/S0003-4975(99)00118-6)