ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Anna F. Merrick
Magdi H. Yacoub
Robert H. Anderson
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Merrick, A. F.
Right arrow Articles by Anderson, R. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Merrick, A. F.
Right arrow Articles by Anderson, R. H.

Ann Thorac Surg 2000;69:556-561
© 2000 The Society of Thoracic Surgeons

Original Articles

Anatomy of the muscular subpulmonary infundibulum with regard to the Ross procedure

Anna F. Merrick, FRCSa, Magdi H. Yacoub, FRCSa, Siew Yen Ho, PhDa, Robert H. Anderson, MDa

a Departments of Paediatrics and Surgery, Royal Brompton Campus, National Heart and Lung Institute, Imperial College School of Medicine, London, England, United Kingdom

Address reprint requests to Dr Ho, Imperial College School of Medicine, Department of Paediatrics, National Heart and Lung Institute, Dovehouse St, London SW3 6LY, England
e-mail: yen.ho{at}ic.ac.uk

Background. To clarify the precise anatomical relationship of the muscular subpulmonary infundibulum.

Methods. Eleven hearts were dissected, and microscopic sections taken through the arterial trunks of a 37- week-old fetus and of a neonate. The anatomy was also investigated during operative Ross procedures.

Results. The sinotubular junctions of the pulmonary and aortic roots cross obliquely. The leaflets of the pulmonary valve are lifted away from the ventricular septum by the free-standing subpulmonary infundibulum, whereas the aortic valve is deeply wedged between the atrioventricular junctions. The muscular infundibulum spirals around the aortic root, being longest below the right-facing aortic sinus and shortest below the left. The first septal perforating artery pierces the septum below the shortest part of the infundibulum, sometimes within a millimeter of the pulmonary valvar hinge, but a muscular sleeve lifts the pulmonary leaflets from the septal musculature.

Conclusions. The pulmonary valvar leaflets are supported entirely by free-standing musculature, having no direct relationship with the ventricular septum. This makes possible the Ross procedure.




This article has been cited by other articles:


Home page
 Eur J Cardiothorac SurgHome page
A.-R. Hosseinpour, T. J. Jones, D. J. Barron, W. J. Brawn, and R. H. Anderson
An appreciation of the structural variability in the components of the ventricular outlets in congenitally malformed hearts
Eur J Cardiothorac Surg, May 1, 2007; 31(5): 888 - 893.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
A. F. Corno, M. J. Kocica, and F. Torrent-Guasp
The helical ventricular myocardial band of Torrent-Guasp: potential implications in congenital heart defects
Eur J Cardiothorac Surg, April 1, 2006; 29(Supplement_1): S61 - S68.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
E. Lansac, H. S. Lim, Y. Shomura, K. H. Lim, W. Goetz, N. T. Rice, C. Acar, and C. M. G. Duran
Aortic and pulmonary root: are their dynamics similar?
Eur J Cardiothorac Surg, February 1, 2002; 21(2): 268 - 275.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
V. T. Tsang, T.-Y. Hsia, R. W.M. Yates, and R. H. Anderson
Surgical repair of supposedly multiple defects within the apical part of the muscular ventricular septum
Ann. Thorac. Surg., January 1, 2002; 73(1): 58 - 62.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. N. Ross
The morphology of the pulmonary root in relation to the human heart
Ann. Thorac. Surg., September 1, 2001; 72(3): 976 - 976.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The Society of Thoracic Surgeons.