下腔静脉瓣与冠状窦口的应用解剖

检查了100个已固定的心脏标本。冠状窦瓣和下腔静脉瓣的形状多变,其中以半月状瓣最多,分别为39.0％和53.3％。下腔静脉瓣与冠状窦口的位置关系可分为三种:窦口位于瓣的左前方者最多,占90.2％;位于后下方者占6.5％;位于后上方者占3.3％。本文就心导管检查的有关应用解剖学进行了讨论。     

与布加氏综合征有关的局部解剖学研究

本文用７具新鲜尸体，观察并测量了下腔静脉瓣的大小及形态、肝右、中、左静脉的口径、肝右、中、左静脉与下腔静脉的夹角，肝后下腔静脉内短肝静脉开口数，测得的结果对临床研究及治疗布加氏综合征有一定意义。     

右心静脉导管检查的临床应用解剖

为心导管检查技术提供必要的解剖学数据,本文在98例心脏标本上,对下腔静脉瓣、冠状窦口及冠状窦瓣进行了观测,并对心导管检查的有关应用解剖问题进行了讨论。     

足月新生儿正常心脏和大血管的形态定量研究

对１００例足月新生儿正常心脏的心房，室壁厚度，上，下腔静脉入口周径和冠状窦口的最大径，卵园的长，短径，左右心室流入，流出道的长度，房室瓣环和动脉瓣环的周径以及大动脉各段的长度和周径等进行了认真的测量和研究。     

单心房合并体静脉畸形引流1例

患者,女,17岁,因自幼发绀,活动力差入院。体查:唇甲发绀明显,BP95/50mmHg,心率82次/min,齐,SLB2-3Ⅲ/6级SM期较粗糙杂音,心电图示I°AVB。胸片示心脏扩大,C/T=0.6。心彩超检查提示单心房,二尖瓣前瓣裂。于2005年10月4日在全麻低温体外循环下施术。术中心表探查:主动脉稍粗于肺动脉,肺动脉压力为主动脉压的1/3。右上腔为左上腔静脉的2/3,双下腔静脉并列,右侧为左侧的两倍,左、右心耳并裂畸形。右房切口探查:房间隔缺如,仅有嵴为分界标志,右上、下腔静脉开口于右心房,左上、下腔静脉分别开口于左心房顶部和底部,4个肺静脉口开口于左心房…     

大鼠肾移植模型技术的改进

目的对大鼠异体肾移植模型技术进行改进,为开展器官移植实验研究提供依据。方法使用Wistar大鼠分别作为供者和受者,供者主动脉、下腔静脉分别与受者主动脉、下腔静脉进行端侧吻合,在受者膀胱上剪去一个与供者相同大小的圆瓣,然后进行一层膀胱吻合。结果手术成功率为90％左右,动物死亡的原因主要为血管吻合口出血、麻醉过深、休克、血栓形成以及膀胱漏尿致弥漫性腹膜炎。结论通过技术改进建立大鼠异体肾移植模型不需要特殊的器械或设备,可在常规条件的实验室开展。     

超声联合解剖、铸型诊断右侧异构1例

正孕妇,26岁,孕23周,孕1产0。超声见:右位胃,左侧优势肝。心房后方见四支肺静脉汇入一静脉干,见其向下走形迂曲汇入脐静脉门静脉支。左、右侧上腔静脉及下腔静脉均汇入心房偏左侧。十字交叉消失,房间隔与室间隔之间可见宽约0.8 cm的连续中断。可见共同房室瓣启闭活动。主动脉起自右侧心室,肺动脉起自右侧心室(主动脉下方)。肺动脉主干及左右肺动脉狭窄。动脉导管纤细,内经约0.12 cm。超声诊断:内脏反位;肺静脉异位引流(心下型);完全性心内膜     

下腔静脉滤器回收后血管形态改变的CT静脉造影研究

目的 探讨下腔静脉滤器回收后肾下段下腔静脉CT静脉造影(CTV)血管壁形态的改变,并分析相关影响因素。方法 回顾性研究。纳入2015年1月-2018年2月在北京积水潭医院血管外科下腔静脉滤器回收后规范抗凝治疗70例患者的下腔静脉CTV图像为滤器组,男34例、女36例,年龄17~79(48.11±13.86)岁;在北京积水潭医院下腔静脉CTV数据库中随机抽取40例非血栓性疾病患者为对照组,男23例、女17例,年龄18~70(46.70±12.16)岁。在下腔静脉CTV图像上测量并比较两组下腔静脉最小直径和肾静脉开口下方1 cm平面参考直径的差异;观察滤器组肾下段下腔静脉壁有无增厚,应用logistic回归分析其影响因素。结果 两组患者的性别、年龄差异均无统计学意义(P值均＞0.05)。滤器组和对照组下腔静脉参考直径分别为(16.0±2.6)、(20.2±2.4) mm,最小直径分别为(13.0±3.6)、(19.3±2.3)mm,差异均有统计学意义(t=8.267、10.032,P值均＜0.01)。滤器组35.7%(25/70)的患者血管壁局限性或环状增厚,下腔静脉最小直径为(10.3±3.6)mm; 64.3%(45/70)患者没有血管壁增厚,下腔静脉最小直径为(14.5±2.5)mm,差异有统计学意义(t=5.330, P＜0.01)。血管壁增厚患者与无增厚患者的下腔静脉血栓形成、下腔静脉参考直径差异均有统计学意义(χ²=6.459, t=3.794, P值均＜0.05);logistic多因素分析显示,下腔静脉血栓形成和下腔静脉参考直径是下腔静脉壁增厚的独立影响因素(OR=5.410、1.500,P值均＜0.01)。结论 滤器回收后下腔静脉会出现不同程度的狭窄和血管壁增厚,下腔静脉血栓形成和较小的下腔静脉参考直径明显增加下腔静脉壁增厚的风险。     

双下腔静脉三例报告

作者在184具中国人尸体中,发现3例双下腔静脉,都属于胚胎发育阶段的左、右上主静脉存留发育而成。对已报导的中国人双下腔静脉和日本人、欧美人双下腔静脉的资料进行了统计分析。中国人双下腔静脉的平均发生率为1.16±0.29％(1292:15);与日本人、欧美人的平均发生率比较,皆无显著性的种族差异。作者初步认为,人类双下腔静脉的发生率为1.14±0.18％(3357:38)。     

借奇静脉回流的异常下腔静脉一例

借奇静脉回流的异常下腔静脉一例韩景茹，周庭永，姜均本重庆医科大学重庆６３００４６本文用断面解剖学方法，观测了一例异常的下腔静脉，其表现为下腔静脉的肝段和肾前段缺如，而借粗大的奇静脉导下肢、盆和肾脏的血液入上腔静脉。在选取的６个主要横断面上，描述了此种...     

Porcine vena cava as an alternative to bovine pericardium in bioprosthetic percutaneous heart valves

Percutaneous heart valves are revolutionizing valve replacement surgery by offering a less invasive treatment option for high-risk patient populations who have previously been denied the traditional open chest procedure. Percutaneous valves need to be crimped to accommodate a small-diameter catheter during deployment, and they must then open to the size of heart valve. Thus the material used must be strong and possess elastic recoil for this application. Most percutaneous valves utilize bovine pericardium as a material of choice. One possible method to reduce the device delivery diameter is to utilize a thin, highly elastic tissue. Here we investigated porcine vena cava as an alternative to bovine pericardium for percutaneous valve application. We compared the structural, mechanical, and in vivo properties of porcine vena cava to those of bovine pericardium. While the extracellular matrix fibers of pericardium are randomly oriented, the vena cava contains highly aligned collagen and elastin fibers that impart strength to the vessel in the circumferential direction and elasticity in the longitudinal direction. Moreover, the vena cava contains a greater proportion of elastin, whereas the pericardium matrix is mainly composed of collagen. Due to its high elastin content, the vena cava is significantly less stiff than the pericardium, even after crosslinking with glutaraldehyde. Furthermore, the vena cava’s mechanical compliance is preserved after compression under forces similar to those exerted by a stent, whereas pericardium is significantly stiffened by this process. Bovine pericardium also showed surface cracks observed by scanning electron microscopy after crimping that were not seen in vena cava tissue. Additionally, the vena cava exhibited reduced calcification (46.64 ± 8.15 μg Ca/mg tissue) as compared to the pericardium (86.79 ± 10.34 μg/mg). These results suggest that the vena cava may provide enhanced leaflet flexibility, tissue resilience, and tissue integrity in percutaneous heart valves, ultimately reducing the device profile while improving the durability of these valves.     

Chiari anomalies in the human right atrium

Chiari anomalies in the human right atrium ostensibly are encountered rarely. There is only sporadic mention in the literature of these fenestrated, net-like valves of the inferior vena cava, coronary sinus, or various strands connecting these with other right atrial structures. The effects of such structural anomalies on heart function are unknown. We report here gross observations of the right atrial net from among 213 cadavers, 38 autopsied, and 11 fetal hearts. Histological and ultrastructural examination of inferior vena cava and coronary sinus valves demonstrated that only the anomalous coronary sinus valves contained cardiac muscle. Chiari anomalies typically have referred to perforations or tissue strands related to the inferior vena cava valve and possibly the coronary sinus valve. The anomaly commonly is cited as occurring in 2% of individuals, although there has been no study to support this. We observed Chiari malformations in 13.6% of the 213 cadaver hearts, and 10.5% of the autopsied hearts examined. Of these malformations, the coronary sinus valve was fenestrated most frequently. We propose the term "right atrial net" for "Chiari net," for anomalies involving valves of the inferior vena cava and coronary sinus, and strands within the right atrium connecting these valves with the crista terminalis, right atrial wall, or interatrial septum.     

下腔静脉滤器置入预防肺栓塞

背景：下腔静脉滤器置入预防肺栓塞是有效的,也为手术取栓提供了安全保障。 目的：探讨下腔静脉滤器临床应用的研究进展。 方法：由第一作者检索1985/2010 FMJS数据库及万方数据库有关下腔静脉滤器材料学的发展,置入的适应证、禁忌证,置入技术,并发症及置入后抗凝问题方面的文献。 结果与结论：下腔静脉滤器材料学发展迅速,其置入技术显著提高,但对其临床应用指针还没有统一的认识。对于置入后抗凝问题认识也存在差异,而滤网位置偏移、游走、成角及腔静脉穿孔和对周围脏器的损伤报道随着下腔静脉滤器应用的增多而相应增多。下腔静脉滤器置入预防肺栓塞的临床疗效是值得肯定的,但应该高度重视置入后的并发症及其严重性,相信随着下腔静脉滤器材料学的进一步发展及生物相容性的提高,其临床应用前景会越来越广阔。关键词：下腔静脉滤器;深静脉血栓;肺栓塞;置入;综述文献 doi:10.3969/j.issn.1673-8225.2012.16.033     

Dynamics of Nitroglycerin-Induced Changes in Vena Cava Flows and Right Atrial Pressure

In anesthetized cats, nitroglycerin increased blood flow in the superior vena cava and decreased the flow in the inferior vena cava and total venous return. Simultaneous changes in right atrial pressure could be either positive or negative. The shifts in the superior vena cava flow and right atrial pressure preceded the corresponding alterations in the inferior vena cava flow and venous return.     

胎儿眼上静脉瓣的观察

从医院收集到不同胎龄的胎尸５０例，在手术显微镜下用显微手术器械对１００条眼上静脉进行了解剖观察：发现有静脉瓣的眼上静脉１９条（左７、右１２条）均为双瓣，结构完整，与其他处静脉瓣无异，开口朝向后（海绵窦方向）：这些眼上静脉均发生在２５周（７个月）以后的胎尸；胎儿眼上静脉瓣的出现率与成人出现率比较（Ｐ＜０．００５）两组有显著性差别。据结果对胎儿眼上静脉瓣成因及左右侧出现率不等进行了讨论。     

Development of cardiac musculature in the cranial vena cava of rat embryos

Development of cardiac musculature in the rat cranial vena cava (common cardinal vein or duct of Cuvier) was examined by immunohistochemistry and transmission electron microscopy. Undifferentiated cardiac myocytes were detected in the cranial vena cava wall of rat embryos after 12.5 days post-coitum (dpc). The tunica media of the cranial vena cava was composed of cardiac myocytes after formation of the endothelium. Therefore, the cranial vena cava may be not only a part of the venous system but also of the heart. Myocytes in the cranial vena cava contained developing myofibrils, mitochondria and intercalated discs similar to those found in the myocytes in the heart. Striated myofibrils began to differentiate as soon as myocytes appeared in the vena cava wall, and myocytes with differentiating myofibrils occur in the wall as the first component of the tunica media at 12.5 dpc. We concluded that the cardiac musculature in the vena cava is not a secondary extension into the tunica media after birth only in the rat, but a basic structure formed in all mammals during early embryonic development.     

Primary leiomyosarcoma of the inferior vena cava with Budd-Chiari syndrome

A 44-year-old Japanese woman with leiomyosarcoma of the inferior vena cava is reported. She presented with Budd-Chiari syndrome and died of hepatic failure about 3 months after the onset of symptoms. The tumor arose from the middle segment of the inferior vena cava, occluded the inferior vena cava and projected into the right atrium. A total of 28 cases of Budd-Chiari syndrome due to primary leiomyosarcoma of the inferior vena cava are reviewed.     

Primary Leiomyosarcoma of the Inferior Vena Cava with Budd-Chiari Syndrome

A 44 year old Japanese woman with leiomyosarcoma of the inferior vena cava is reported. She presented with Budd Chiari syndrome and died of hepatic failure about 3 months after the onset of symptoms. The tumor arose from the middle segment of the inferior vena cava, occluded the inferior vena cava and projected into the right atrium. A total of 28 cases of Budd-Chiari syndrome due to primary leiomyosarcoma of the inferior vena cava are reviewed.     

Ieiomyosarcoma of the superior vena cava producing superior vena cava syndrome and heart tamponade

An autopsy case of primary leiomyosarcoma arising in the superior vena cava is presented. A 44 year old Japanese man presented with superior vena cava syndrome and eventually died due to heart tamponade and acute renal failure. Autopsy revealed that the superior vena cava was occluded with a tumor that had invaded the pericardium and right thoracic cavity. Primary caval venous leiomyosarcoma is a rare but lethal disease and most cases arise from the inferior vena cava. This case represents a very rare case of leiomyosarcoma with the rare clinical findings of superior vena cava syndrome and heart tamponade.