CARDIAC ANATOMY. David McGiffin Director of Cardiothoracic Surgery and Transplantation Alfred Health, Melbourne

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1 CARDIAC ANATOMY David McGiffin Director of Cardiothoracic Surgery and Transplantation Alfred Health, Melbourne

2 Outline The aorto-ventricular unit The mitral valve Interior of the right ventricle

3

4 Aorto-ventricular unit

5 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

6 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

7 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

8 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

9 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

10 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

11 The aorto-ventricular membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

12 The aorto-ventricular membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

13 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

14 The Aorto-Ventricular Membrane Source: McAlpine WA, Heart and Coronary Arteries (1975)

15 The mitral valve

16 Mitral valve

17 Mitral valve

18 Mitral valve chordae Source: Rabbah J-P.M. et.al (2013) J Biomechanical Engineering

19 Non-planar structure of the mitral annulus Source: Yoshida K. & Obase K. (2012) J Cardiovascular Ultrasound

20 The interior of the right ventricle

21 Right ventricular cavity Two part inflow (sinus) and outflow (infundibulum or conus) Three part (Goor and Lillehei) inlet, apical trabecular and outlet

22 Right ventricular outflow tract Infundibular, conal or outlet septum Crista supraventricularis Parietal and septal bands Ventriculoinfundibular fold Trabecula septomarginalis Moderator band Source: Yoo SJ Powerpoint presentation

23 Terminology confusion

24 Crista supraventricularis Wolff (1781): Muscular crest between the tricuspid and pulmonary valves in the normal right ventricle Source: Yoo SJ Powerpoint presentation

25 Crista supraventricularis Crista supraventricularis = Parietal band + Septal band Source: Yoo SJ Powerpoint presentation

26 Crista supraventricularis Crista supraventricularis = Ventriculoinfundibular fold + Outlet septum + Trabecula septomarginalis Source: Yoo SJ Powerpoint presentation

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

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

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

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

31 Relation of RVOT and Ao Root

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

33 Interior of the right ventricle Trabecula septomarginalis Moderator band Septal band Infundibular septum Parietal band Ventriculoinfundibular fold Source: Kirklin/Barratt-Boyes (2012) Cardiac Surgery

34 Trabecula septomarginalis Trabecula septomarginalis (Y-shaped) = body + anterior and posterior limbs Source: Yoo SJ Powerpoint presentation

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

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

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

38 Crista supraventricularis? Source: Anderson RH & Becker AE, Cardiac Anatomy (1980)

39

40 Tricuspid valve structure Source: Ton-Nu T-T. et.al (2006) Circulation

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

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