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ID:40506926
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页数:15页
时间:2019-08-03
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1、Understandingcardiacanatomyisfundamentaltosuccessincardiacsurgery.Thefollowingdrawingsshowthecardiacsurgeon’sviewoftheheartfromtherightsideofasupinepatientthroughamidsternalincision.Photographsillustratetheanatomicpositionasiflookingatanuprightpatient,unlessotherwisenoted.Fi
2、gure1-1AThecardiacstructuresmostaccessibletoviewarethesuperiorvenacava,rightatrium,rightventricle,mainpulmonaryartery,andaorta.Onlyasmallportionoftheanteriorwalloftheleftventricleisvisible.Medialdisplacementoftherightatriumexposestheleftatriumandrightpulmonaryveins.BTheright
3、coronaryarteryispartlyvisibleinthefatoftheatrioventriculargroove,withtheventricularbranchesandtheacutemarginalbranchinfullview.Theposteriordescendingarteryoriginatesfromtherightcoronaryarterynearthecruxoftheheart.Thecruxisdefiedasthecrosspointorjunctionoftheatrioventriculars
4、eptumandtheatrioventriculargroove.Initscourseintheatrioventriculargroove,therightcoronaryarteryisincloserelationtotheanteriorportionoftheannulusofthetricuspidvalve.Thedistalportionoftherightcoronaryarterysuppliesbloodtotheatrioventricularnodeandisincloseproximitytotheannulus
5、ofthemitralvalve.Theleftcoronaryarteryoriginatesposteriorlyfromtheaortaand,afterashortdistance,dividesintotheanteriordescendingandcircumflxbranches.Theanteriordescendingcoronaryarterydeviatesfromtheatrioventriculargrooveontotheleftventricle,lateraltothepulmonaryartery.Onceit
6、isontheanteriorwalloftheheartovertheventricularseptum,theleftanteriordescendingcoronaryarterybecomesvisible.Thecircumflxcoronaryarteryliesintheatrioventriculargrooveposteriorly,incloserelationtotheannulusofthemitralvalve.Marginalbranchesofthecircumflxcoronaryarterysupplythep
7、osterolateralsurfaceoftheleftventricle.CVisualizationofthedistalportionoftherightcoronaryarteryrequiresdisplacementoftheacutemarginofthehearttoexposethediaphragmaticsurface.Theposteriordescendingcoronaryarterytakesacourseovertheventricularseptumonthediaphragmaticsurfaceofthe
8、heart.Anexceptiontothisanatomicconfiurationoccurswhentheposteriordescending
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