Revisiting the Anatomy of the Living Heart

Mori, Shigeo; Spicer, Diane E.; Anderson, Robert H.

doi:10.1253/circj.cj-15-1147

Cited by 61 publications

(56 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It reinforces previous findings in the settings of the normal adult heart,[22232425] valvar diseases,[26] and in some structurally abnormal hearts. [272829] The utility of three-dimensional imaging techniques has already been demonstrated in the setting of congenitally cardiac disease, including isomerism.…”

Section: Discussionsupporting

confidence: 90%

Isomerism in the setting of the so-called “heterotaxy”: The usefulness of computed tomographic analysis

et al. 2017

Self Cite

View full text Add to dashboard Cite

The most complex combinations of congenital cardiac malformations are found in the setting of bodily isomerism. The question remains, however, as to whether evidence of cardiac isomerism is always to be found in the setting of bodily isomerism, also known as “heterotaxy.” We have previously shown that, when assessed on the basis of the extent of the pectinate muscles relative to the atrioventricular junctions, there is always isomerism of the atrial appendages in this setting. Doubt has been remained, however, as to whether these cardiac features can accurately be recognized during life. We have now encountered two patients showing features of the left and right bodily isomerism. Examinations of these patients made using computed tomography show that all features of isomerism, no matter how complex, can now be visualized during life. The images currently presented show, furthermore, that the features of the so-called “heterotaxy” can be seen during life, not only within the heart but also in all the thoracic and abdominal organs, albeit that the isomeric features are confined to the thoracic organs. Based on the images presented, we argue that if each system of organs is analyzed and described in independent fashion; then it is possible for clinicians to exclude any suggestion of ambiguity and to provide accurate descriptions of the overall arrangement. We further discuss the appropriate terminology to describe the entity we prefer to call isomerism, along with the indications and usefulness of computed tomography in revealing the anatomic features of the congenitally malformed heart.

show abstract

Section: Discussionsupporting

confidence: 90%

Isomerism in the setting of the so-called “heterotaxy”: The usefulness of computed tomographic analysis

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is axiomatic that accurate understanding of the anatomy of the aortic root is fundamental for optimal TAVI (Piazza et al ; Mori et al , ). By analyzing a large number of living datasets, we have shown marked variation of its superior margin relative to the plane of the virtual basal ring.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the membranous septum and the virtual basal ring of the aortic root in candidates for transcatheter implantation of the aortic valve

et al. 2018

Self Cite

View full text Add to dashboard Cite

Knowledge of the anatomy of the membranous septum, as a surrogate to the location of the atrioventricular conduction axis, is a prerequisite for those undertaking transcatheter implantation of the aortic valve (TAVI). Equally important is its relationship of the virtual basal ring. This feature, however, has yet to be adequately described in the living heart. We analyzed computed tomographic angiographic datasets from 107 candidates (84.1 ± 5.2 years, 68% women) for TAVI. Using multiplanar reconstructions, we measured the height and width of the membranous septum, and the distances of its superior and inferior margins from the virtual basal ring plane. We also assessed the extent of wedging of the aortic root between the mitral valve and the ventricular septum. Mean heights and widths of the membranous septum were 6.6 ± 2.0, and 10.2 ± 3.1 mm, respectively, with its size significantly associated with that of the aortic root (P < 0.05). Its superior and inferior margins were 4.5 ± 2.3 and 2.1 ± 2.1 mm, respectively, from the plane of the basal ring. The inferior distance, the surrogate for the adjacency of the atrioventricular conduction axis, was ≤ 5mm in 91% of the patients. Deeper wedging of the aortic root was independently correlated with a shorter inferior distance (β = 0.0569, P = 0.0258). The membranous septum is appreciably closer to the virtual basal ring than previously appreciated. These findings impact on estimations of the risk of damage to the atrioventricular conduction axis during TAVI. Clin. Anat. 31:525-534, 2018. © 2018 Wiley Periodicals, Inc.

show abstract

“…Although both sites should be classified as the basal ventricular septum anatomically, the ventricular septum located apical to the membranous septum does not directly correspond to the ventricular septum located apical to the right coronary aortic sinus (Figures ). As the branching portion of the bundle of His is usually located at the inferior rim of the interventricular portion of the membranous septum, granulomatous degeneration in the ventricular septum located apical to the membranous septum would be responsible for conduction disturbances typically observed in cases of cardiac sarcoidosis…”

Section: Discussionmentioning

confidence: 99%

Circumferential extent of thinning of the basal muscular ventricular septum in a case of cardiac sarcoidosis

et al. 2018

Self Cite

View full text Add to dashboard Cite

Focal thinning of the basal muscular ventricular septum is a characteristic morphological finding in cases of cardiac sarcoidosis, usually detected on the parasternal long‐axis image during echocardiography. Surprisingly, however, its circumferential extent has rarely been demonstrated and discussed. We present a case showing typical thinning of the basal ventricular septum. The extent of circumferential wall thinning was evaluated using both echocardiography and cardiac computed tomography. The present case highlights the importance of detailed multiplanar and three‐dimensional evaluation of this characteristic abnormality, more so because its mechanism as well as the precise impact on conduction has not yet been elucidated.

show abstract

Revisiting the Anatomy of the Living Heart

Cited by 61 publications

References 45 publications

Isomerism in the setting of the so-called “heterotaxy”: The usefulness of computed tomographic analysis

Isomerism in the setting of the so-called “heterotaxy”: The usefulness of computed tomographic analysis

Relationship between the membranous septum and the virtual basal ring of the aortic root in candidates for transcatheter implantation of the aortic valve

Circumferential extent of thinning of the basal muscular ventricular septum in a case of cardiac sarcoidosis

Contact Info

Product

Resources

About