HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert H. Anderson Yasunaru Kawashima Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Uemura, H. Articles by Kawashima, Y. Search for Related Content PubMed PubMed Citation Articles by Uemura, H. Articles by Kawashima, Y.

J Thorac Cardiovasc Surg 1995;110:436-444
© 1995 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

THE SURGICAL ANATOMY OF CORONARY VENOUS RETURN IN HEARTS WITH ISOMERIC ATRIAL APPENDAGES

London and Liverpool, United Kingdom, Osaka, Japan, and Pittsburgh, Pa.

H.U. is a visiting fellow at the National Heart and Lung Institute from NCVC. R.H.A. is a visiting professor at CHP and RLCH from the National Heart and Lung Institute. They and S.Y.H. are supported by the British Heart Foundation.

Received for publication June 3, 1994. Accepted for publication Dec. 22, 1994. Address for reprints: Hideki Uemura, MD, National Heart and Lung Institute, Department of Paediatrics, Dovehouse St., London SW3 6LY, United Kingdom.

Abstract

Although absence of the coronary sinus is widely recognized in hearts with isomerism of the right atrial appendages, little attention has been paid to the fashion of the venous return from the heart itself. In this study, the arrangement of coronary venous return was investigated in 99 specimens with isomeric right and 49 with isomeric left appendages. In the normal heart, the coronary veins consist of a circumflex component within the atrioventricular groove and longitudinal components on the ventricular mass. The circumflex venous system was seen in 44 hearts with isomerism of left appendages (90%), but 23 of these hearts lacked the anatomic features of the coronary sinus. Circumflex veins were entirely lacking in the other 10% of hearts with isomeric left appendages and in all those with isomeric right appendages. In these hearts, longitudinal veins drained independently into the atria in three patterns. The first was a direct connection, with the venous orifice opening between the trabeculations of the atrial wall immediately having crossed the atrioventricular groove. The second was a crooked return, with the vein running an intramural course along the atrioventricular groove. The third was a distant connection, reaching superiorly to the smooth-walled atrial component after running an intramural course. Intramural courses were seen in 19% of the longitudinal veins, such veins being found in 62% of all hearts with no circumflex venous system. These findings, which to the best of our knowledge have never previously been recognized in detail, almost certainly have potential surgical significance. (J THORAC CARDIOVASC SURG 1995;110:436-44)

This article has been cited by other articles:

				H. Uemura, T. Yagihara, R. Hattori, Y. Kawahira, S. Tsukano, and K. Watanabe Redirection of hepatic venous drainage after total cavopulmonary shunt in left isomerism Ann. Thorac. Surg., November 1, 1999; 68(5): 1731 - 1735. [Abstract] [Full Text] [PDF]

				H. Uemura, S. Y. Ho, R. H. Anderson, and T. Yagihara Ventricular morphology and coronary arterial anatomy in hearts with isomeric atrial appendages Ann. Thorac. Surg., May 1, 1999; 67(5): 1403 - 1411. [Abstract] [Full Text] [PDF]

				R. H. Anderson, H. Uemura, and W. A. Devine Venoarterial connections in visceral heterotaxy J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1106 - 1107. [Full Text]

				M. Rubino, S. V. Praagh, K. Kadoba, R. Pessotto, and R. V. Praagh Venoarterial connections in visceral heterotaxy J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1107 - 1109. [Full Text]