兔心冠状动脉的解剖观察

本文用透明和软X线造影等技术对100例兔心的冠状动脉及其分支分布进行了解剖观察。兔心左冠状动脉前降支与旋支的夹角多为35°-65°(67.8％)。前降支短小,与心大静脉伴行。动物实验结扎前降支,以静脉为标志,在左心耳和动脉园锥之间进行较合适。左室支粗大,是旋支的直接延续,分支到左室前、后壁。左室支与心左缘静脉的关系以在左室支下1/3处交叉者多见。动物实验,单独结扎左室支,在其中1/3处进行为宜。兔心有独立的室间隔动脉供应室间隔的大部分。兔心冠状动脉仅4％形成后降支。窦房结动脉起于左冠状动脉者较多(48.3％);房室结动脉大多起于左冠状动脉(73.4％)。兔心冠状动脉分布类型以均衡型居多(77％),右优势型次之(17％),左优势型最少(6％)。     

家猪心壁冠状动脉观测及与人心壁冠状动脉的比较

目的探讨家猪心壁冠状动脉解剖学特征,为制备实验动物模型提供依据。方法40例家猪心塑化染料灌注,显示左、右冠状动脉及分支走行。10%甲醛溶液固定,大体解剖,暴露壁冠状动脉及其分支,观察并统计数据。结果40例猪心壁冠状动脉出现20例(50.0%);前室间支、后室间支出现壁冠状动脉的心分别有6例(15.0%)、11例(27.5%);壁冠状动脉在心肌桥下可发出1～4个分支,5例壁冠状动脉出现扭曲现象。结论猪心壁冠状动脉出现率及形态学结构与人相似,适合作为研究人心壁冠状动脉的动物模型。     

犬左冠状动脉前室间支心肌桥的形态学特征

目的探讨犬壁冠状动脉和心肌桥的形态学特点,为比较解剖学提供资料。方法取犬心41例,10%甲醛溶液固定,解剖显示冠状动脉及其分支,观测心肌桥及壁冠状动脉的出现率。结果犬冠状动脉心肌桥多出现于前室间支、后室间支和左室前支。心肌桥出现率70.7%,前室间支79.3%,心肌桥厚度为0.56±0.61 mm。前室间支前段内径1.64±0.46 mm,厚度0.18±0.06 mm;壁冠状动脉内径1.35±0.46 mm,厚度0.13±0.04 mm。心肌桥近段距第一对角支距离为19.78±8.20 mm,距前室间支起始部距离为24.49±12.37mm,距右冠起始部距离为24.21±5.80 mm。心肌桥纤维走向与壁冠状动脉夹角为68.94±14.38。结论犬冠状动脉心肌桥出现率及位置与人相似,可作为科研动物模型。     

狗,羊,猪,兔冠状动脉心肌桥的解剖学研究

为心肌桥比较前解剖学积累资料，并为研究心肌桥选择动物提供依据。方法；选用成年狗，羊，猪，兔心脏观察测量。结果；兔冠状动脉全程位于心肌内。狗，羊，猪心肌桥出现率分别为６０．８％，９０．１％和４２．４％。狗，羊心肌桥位于左冠冠状动脉者占各自肌桥数的８７．８％和９５．６％。狗心肌桥位于前室间支为７３．３％；羊心肌桥地左冠状动脉主干占４８．２％。     

国人的心房动脉(一)心房动脉的分支、口径和行径分布

1.本文对国人新鲜离体心脏50例(30例铸型标本,20例解剖标本)的心房动脉的分支起点、口径和行径分布进行了观察和测量。 2.窦房结动脉多数为第一或第二房前支。起于右冠状动脉者26例(52％),口径1.2～2.2mm。起于左冠状动脉24例(48％),口径1.1～2.0mm。行径均和房间前沟及房间肌束有关。左、右窦房结动脉以“逆时针”型终止于上腔静脉口的多见。以“逆时针”型绕上腔静脉口时多数在界沟附近有一下行袢,此袢在房间后沟内仅见2例,与McAlpine的观察结果不同。本文有6例为其它起点的窦房结动脉,其中4例起于左房旋支,2例为右冠状动脉末端终支的延伸。 3.Kugel动脉为左、右冠状动脉的近端分支,可来自左或右窦房结动脉或左、右房前支。从房间前沟下部入隔(入隔时口径为0.1～1.2mm)。在隔内的行径,分布较恒定,沿卵圆窝下缘后行,并可与心房后壁的左、右冠状动脉的分支吻合,为冠状动脉重要的侧副循环途径。 4.房室结动脉起于右冠状动脉占94％,起于左冠状动脉占6％。口径为0.4～1.9mm,多为1支。2例为双房室结动脉,均起自右冠状动脉。有2例房室结动脉起于左室后支,穿行左室后壁的心肌,经左、右房室口之间到达房室结。房室结动脉在房室交叉点处起于冠状动脉“U”形弯曲顶端的占44.23％,起于平直型冠状动脉的占36.5％,有“U”形弯曲但不起于“U”形顶端的占19.24％。此动脉行在左、右房室口之间的行径以中间型居多,左偏型及右偏型少见。 5.本文对心房动脉的某些形态特点及其与临床应用的意义进行了讨论。     

冠状动脉的解剖学观察 六、左、右冠状动脉在心室独立壁的分布范围和吻合

<正> 一、左、右冠状动脉在心室独立壁的分布范围(表一) 最单纯的是左室前壁,除了3例靠近钝缘的小部分地区接受右冠状动脉的终支分布外,全受左冠状动脉分布。右室前、后壁和左室后壁多数由左、右冠状动脉共同分布。其中76例右室前壁除受右冠状动脉分布外,其接近前室间沟的小部分地区受前降冠状动脉的室支分布;71例右室后壁除受右冠状动脉分布外,有60例其接近心尖的小部分地区受前降冠状动脉的末支分布,有11例其接近后室间沟的部分地区受左旋冠状动脉或左横冠状动脉的分支分布;81例左室后壁除受左旋冠状动脉的纯缘支和前降冠状动脉的末支     

山羊与家猪肺静脉心肌袖比较解剖学观测及临床意义

羊心、猪心与人心在形态学有相似之处,制备羊心或猪心心脏的病变模型,可为研究人心的各种病变提供有价值的参考,查阅近十年文献,未见羊心和猪心肺静脉心肌袖比较大体解剖的有关报道。本研究对30例山羊和30例家猪肺静脉心肌袖的长度和厚度进行了测量和对比,旨在为临床选择较适宜的实验模型动物提供参考。     

大鼠冠状动脉的解剖观察

本文用透明和解剖剥离等方法观察了207例大鼠的冠状动脉。大鼠左冠状动脉主干和前降支始段与伴行静脉的关系极为密切。复制心肌梗塞模型时,结扎左冠状动脉可在动脉圆锥与左心耳之间进行。左室支粗大,是前降支(或旋支)的主要分支,分布到左室前、后壁的大部分。大鼠有独立的室间隔动脉(53.6％起于右冠状动脉,46.4％起于左冠状动脉)供应室间隔的大部分。25.1％的大鼠有上间隔动脉(起于右冠状动脉)供应室间隔的上部。后降支的出现率为13.5％。冠状动脉的分布类型以均衡型居多(72.0％),右优势型次之(25.1％),左优势型最少(2.9％)。以上结果与兔、狗、猴等动物及人的资料作了比较讨论。     

山羊心肌缺血后再灌恶性心律失常和缺血心肌重量的关系

作者结扎了32只正常山羊的左冠状动脉分支,经30～180分钟后解除结扎,其后数分钟内出现室性心动过速(VT)8只,心室纤颤(VF)11只。发生VT和VF的缺血心肌,其左右心室相对重量大于未发生VT和VF的缺血心肌相对重量。经logistic曲线拟合VT或VF发生的可能性与缺血心肌相对重量间的关系呈正相关。     

山羊与人各心腔内主要结构形态学比较

目的　通过对 4 6例山羊心脏的形态学观测 ,并与人心腔结构进行比较 ,为羊心能否用于人心脏移植提供形态学依据。方法　用解剖方法切开山羊心脏 ,对其心腔结构进行形态学观察比较。结果　羊心脏隔缘肉柱较人类粗大 ,有四种形态类型。室间隔膜部较人明显小 ,且出现率较低 ,4 6例仅有 9例有室间隔膜部 (1 9% )。结论　羊心脏右心室和室间隔与人有一定差别 ,其余三腔和人类相似     

The anatomy of the coronary sinus and its tributaries

The coronary sinus and its tributaries were studied by anatomical dissection in 37 adult human cadaveric hearts, which had been fixed in formalin solution. An anastomosis of approximately 1.0mm in calibre was observed between the anterior and posterior interventricular veins in 19% of specimens. Myocardial bridges were detected above the anterior interventricular vein or its tributaries in 8% of specimens. The great cardiac vein formed the base of the arteriovenous trigone of Brocq and Mouchet with the bifurcating branches of the left coronary artery in 89% of specimens and formed an angle accompanying these arterial branches in 11%. In the trigone the anterior interventricular and great cardiac veins were superficial to the arteries in 73% of specimens. The left marginal vein was present in 97% of specimens, emptying into the great cardiac vein in 81% of cases and into the coronary sinus in the remaining 19%. The small cardiac vein was present in 54% of specimens. In the coronary sulcus the great cardiac vein was adjacent to the circumflex branch of the left coronary artery in 76% of specimens and to the right coronary artery in 5% in 19% there was no relationship with either artery. The coronary sinus maintained a relationship with the right coronary artery in 46% of specimens and with the left coronary artery in 32% in 22% it had no relationship with these vessels.     

Observation of root variations in human coronary arteries

In dissection courses conducted from 1999 through to 2003, five specimens were found to have coronary arteries with variant roots and branches, as follows: in specimens 1-4, roots of the right coronary artery (RCA) and right conus branch arose independently from the right aortic sinus (RAS); in specimen 5, the RCA and left coronary artery (LCA) originated from the RAS. The LCA pierced the upper part of the muscular interventricular septum and appeared on the surface, then dividing into the anterior interventricular and the circumflex branches. In the present study, we considered that the right conus arteries in specimens 1-4 were the remnant blood capillaries around the aorta towards the RAS in the embryonic stage. In specimen 5, the vessel near the left aortic sinus was poorly developed as a small thin artery. Instead, the LCA was developed from the anterior and posterior interventricular septal branches.     

Anatomical study of a left single coronary artery with special reference to the various distribution patterns of bilateral coronary arteries

A left single coronary artery of heart was observed during anatomy practice at Kumamoto University School of Medicine in a 73-year-old female cadaver who died from a thalamic hemorrhage. The left single coronary artery, having a single orifice in the left aortic sinus, bifurcated into the anterior interventricular (IVa) and circumflex (CIR) arteries. No orifice of the right coronary artery was found on the aortic wall. Giving off a branch which traversed the upper part of the infundibulum to supply the anterior upper region of the right ventricle, the IVa descended in the anterior interventricular sulcus to supply the apex of the heart. The CIR curved leftwards in the atrioventricular sulcus to reach the posterior surface, after which it continued to emerge again into the anterior surface. The atrial arteries showed no anomalous distribution pattern and histological observation revealed no pathological abnormality other than a slightly thickened tunica intima. Furthermore, we observed the distribution patterns of bilateral coronary arteries in 377 hearts dissected during anatomical practice over 13 years at Kanazawa University (1980–1986) and Kumamoto University (1993–1998). Although the reason why only the right coronary artery was absent is left unexplained, it was concluded that the left single coronary artery in this study, having the developed left conal and circumflex branches, was an extreme case of the left dominant series of coronary arteries. The formation of single coronary arteries can be explained embryologically by the change of flow in the capillary plexus established on the ventricle wall.     

Intersection patterns of human coronary veins and arteries

Intersections between the coronary veins (CV) and arteries (CA) of 103 adult human hearts were mapped on the heart surface. Then the correlations of these intersection patterns to their localization were studied. Eight spots were selected where one of four major CV (anterior cardiac vein, middle cardiac vein, left posterior ventricular vein, and great cardiac vein) intersected with one of CA and their branches (right coronary artery, posterior interventricular branch, left posterior ventricular branch, circumflex branch, diagonal branch, and anterior interventricular branch). The great cardiac vein (GCV) ran beneath the anterior interventricular branch in 56 specimens out of 103, beneath the diagonal branch in 75 specimens out of 103, and beneath the circumflex branch in 36 specimens out of 103, while the other CV mostly ran over CA. The present observations suggest that the CV on the right side may be formed prior to CA, while the CV on the left side may be formed simultaneously with CA.     

左冠脉主干和三大主粥样硬化与心机梗塞的对比调查（附128例尸检分析）

对128例心肌梗塞尸检进行了分析，其中60岁以上92例（71．9％）、59岁以下36例（28．1％），左冠脉主干动脉粥样硬化（As）Ⅳ级共21例（16．4％），年龄在60岁以上仅有15例（11．7％），59岁以下6例94．7％）。但在前降支AsⅣ级有106例（82．8％），左旋支71例（55．5％），右冠脉主干88例（68．7％），说明左主干AsⅣ级狭窄明显轻于三大主支。左主干AsⅣ级狭窄的出现也较三大主支为晚。左主干AsⅣ级狭窄发生陈旧性透壁心肌梗塞多于急性透壁性心肌梗塞，其心肌梗塞范围也较广泛。左主干As狭窄程度与心肌梗塞并发症的产生虽无直接相关，但有加重作用。左主干无1例在As基础上并发新鲜血栓，而三大主支并发血栓有66例（51．6％）。     

Anomalous first septal perforator artery: Anatomic-clinical correlates

The interventricular septum is considered the most densely vascularized portion of the heart, containing important elements of the cardiac conduction system and providing mechanical support for both right and left ventricular function. Anatomically, this structure is perfused by the relatively small caliber anterior and posterior septal perforator branches arising from two large epicardial coronary vessels, the anterior interventricular (descending) branch of the left coronary artery and the posterior interventricular (descending) branch of the right coronary artery, respectively. In cases of significant atherosclerotic disease depriving flow in the major coronary vessels and their septal branches, an anomalous septal perforator artery can take over the task of supporting the function of the interventricular septum by supplementing essential collateral flow. © 1996 Wiley-Liss, Inc.     

带血管蒂肱骨中段骨膜瓣移位术的应用解剖

目的 :为带血管蒂肱骨中段骨膜瓣移位术提供解剖学依据。方法 :在 3 8侧经动脉灌注红色乳胶的成人尸体上肢标本上对肱骨中段前内侧面和部分前外侧面骨膜血管的来源、走行、分支、分布及吻合进行观测 ,并在 4侧标本上摹拟手术实验。结果 :旋肱前动脉主干行经喙肱肌和肱二头肌短头深面 ,绕肱骨外科颈外进至结节间沟外侧缘处分出升支和降支 ,升支上行分布于肱骨头及小结节部 ,降支有 2条分别沿胸大肌止腱内、外侧紧贴骨膜下行 ,为内侧降支和外侧降支。肱动脉肌间隙支自肱动脉发出后向外上走行至三角肌止端内侧发一升支即直接骨膜支上行连接旋肱前动脉的内侧降支。结论 :以旋肱前动脉内侧降支和肱动脉肌间隙支为蒂的肱骨中段骨膜瓣移位可用于修复肱骨头缺血性坏死和肱骨上、中段骨不连、骨缺损。     

A very rare anatomic variation of the right ventricular branch: right ventricular descending branch from the anterior interventricular branch

The anterior interventricular branch of the left coronary artery has the most constant distribution in the human heart and rarely gives off right ventricular branches. Here we report a case with a right ventricular branch which diverged from the anterior interventricular branch and descended on the anterior right ventricular wall parallel to the anterior interventricular sulcus; we termed it the right ventricular descending branch. This artery gave a collateral artery to the occluded anterior interventricular branch at the apex, and had prevented anterior myocardial infarction. The right ventricular descending branch should be precisely identified in order to perform successful myocardial revascularization procedures such as coronary artery bypass grafting and percutaneous coronary intervention, especially in a patient with anterior interventricular branch occlusion.     

旋肱前血管外侧降支为蒂肱骨上段骨膜瓣的应用解剖

目的：为带旋肱前动脉外侧降支为蒂的肱骨上段外侧面骨膜瓣痊术提供解剖依据：方法：在３８侧经动脉环绕色乳胶的成人上肢标本上对旋肱前上侧降支的来源、走行、分布进行了了解剖学观测,并在４侧标本上不幕拟手术实验。结果：旋肱前动脉经 肱肌和肱二头肌短头深面,绒上科颈外进至结节间沟外侧缘分别分出升支和降支。升支上行分布于肱骨头和小结节部。降支有２条分别沿胸大肌止腱内、个侧紧贴骨膜下行,为内侧降支和外侧降支。外侧     

Investigation of coronary arteries in the porcupine (Hystrix cristata) by latex injection and angiography

Coronary arteries were investigated in the porcupine by means of angiography performed on each of 5 adult porcupines (3 male, 2 female) which was followed by injection of a colored latex mixture from the aortic arch for the demonstration of these arteries. The results showed that the aorta branched out at the level of the cardiac outlet to form the left and right coronary arteries and right ramus coni arteriosi. Coronary arteries coursed and ramified in the myocardium. The left coronary artery divided to form the paraconal interventricular artery and left circumflex artery when it reached the coronary sulcus. The interventricular septum was vascularized by the septal branch of the paraconal interventricular artery and by the small septal branches. The left and right coronary arteries gave off all the branches reported in the literature for other species. When the ramus coni arteriosi originates from the right coronary artery, it is designated a third coronary artery. In conclusion, it was found that the coronary arteries of the porcupine had an "intramyocardial course" as in other rodents. The coronary supply of the heart represented a "left coronary type" which was similar to those of carnivores and ruminants. The results of this study may contribute to the data in this area of science.