Attié F, Bassotti R, Arteaga M, Kuri J, Zamora C
Arch Inst Cardiol Mex. 1976 Nov-Dec;46(6):671-95.
The relationship of the great arteries with their respective ventricles in the three toncoconal morphologies depends on the orientation and rotation of the septum of the trunk and cone. In this work we study a case of crossed great arteries and another of partial distortion of the great arteries and one of transposition of the great arteries, all with arterioventricular concordance. In the anatomic and angiocardiographic examples an analysis is made of the arterioventricular relation in each type of arterial pedicle. We say that arterioventricular concordance exists with crossed great arteries when the pulmonary originated from the anterior infundibulum and its direction of right to left or from left to right in the frontal plane shows the spacial position of the anatomically right ventricle. In the transposition of the great arteries or in the partial distortion of the great arteries with arterioventricular concordance the aorta in the frontal plane shows the spacial position of the anatomically right ventricle. In the first group the aorta originates from the anterior infundibulum while in the second, from the posterior infundibulum. We review the examples of arterioventricular discordance diagnosed by necropsy or by laboratory studies. We study 5 cases; 1 with crossed great arteries, 3 with transposition of great arteries and the last with partial distortion of the great arteries. In the arterioventricular discordances with crossed great arteries in the lateral position, we observe that the pulmonary artery originates from the anterior infudnibulum whereas in the transposition, the aorta emerges from the anterior infundibulum. In the partial distortion of the great arteries the vessels are side by side or the aorta a little bit anterior to the pulmonary which is connected with the anterior infundibulum. In the posteroanterior incidence when there exists an arterioventricular discordance with crossed great arteries, the direction of the pulmonary does not indicate the spacial position of the anatomically right ventricle. In the same way, in the transposition and in the partial distortion of the great arteries the aorta does not indicate the spacial position of the anatomically right ventricle. On the basis of the evidence obtained by experimental and descriptive embriology, the morphogenetic processes responsible for the arterioventricular relations are presented. The anatomic specimens of each example is analyzed and the adequate parameter for the diagnosis of the distinct varieties of arterioventricular relations are presented. Finally a review is made of the few cases found in the literature and the differential diagsis between the concordant and discordant troncoconal malformation is established.
在三种圆锥干形态中，大动脉与各自心室的关系取决于动脉干和圆锥间隔的方向及旋转。在本研究中，我们分析了1例大动脉交叉、1例大动脉部分扭曲和1例大动脉转位的病例，所有病例均为房室一致。在解剖学和心血管造影学实例中，对每种类型动脉蒂的房室关系进行了分析。当肺动脉起源于前漏斗部，且其在额平面从右向左或从左向右的方向显示了解剖学右心室的空间位置时，我们称大动脉交叉时存在房室一致。在大动脉转位或大动脉部分扭曲且房室一致的情况下，主动脉在额平面显示了解剖学右心室的空间位置。在第一组中，主动脉起源于前漏斗部，而在第二组中，起源于后漏斗部。我们回顾了通过尸检或实验室研究诊断出的房室不一致的实例。我们研究了5个病例，1例大动脉交叉，3例大动脉转位，最后1例大动脉部分扭曲。在侧位大动脉交叉的房室不一致中，我们观察到肺动脉起源于前漏斗部，而在大动脉转位中，主动脉从前漏斗部发出。在大动脉部分扭曲时，血管并列或主动脉略位于与前漏斗部相连的肺动脉前方。在后前位投照时，当大动脉交叉存在房室不一致时，肺动脉的方向并不显示解剖学右心室的空间位置。同样，在大动脉转位和大动脉部分扭曲时，主动脉也不显示解剖学右心室的空间位置。基于实验性和描述性胚胎学获得的证据，阐述了负责房室关系的形态发生过程。分析了每个实例的解剖标本，并提出了用于诊断不同类型房室关系的适当参数。最后，回顾了文献中发现的少数病例，并确立了一致和不一致的圆锥干畸形之间的鉴别诊断。
