Beckman C B, Moller J H, Edwards J E
Circulation. 1975 Sep;52(3):509-16. doi: 10.1161/01.cir.52.3.509.
In cardiac anomalies causing severe obstruction in the left side of the heart, such as aortic atresia, mitral atresia, or occasionally severe aortic stenosis, maintenance of circulation depends upon shunting of pulmonary venous blood into the right atrium. The usual pathway by which the shunt is achieved is across the atrial septum through the foramen ovale. When this route is closed or severely narrowed, alternate but less common pathways may exist. These involve either anomalous connections of pulmonary veins to systemic veins or communications with the coronary venous system. In the latter, as commonly occurs in aortic atresia, left ventricular myocardial sinusoids carry pulmonary venous blood from the left ventricular cavity and into the cardiac veins. In other instances of severe left-sided obstruction, a direct communication may exist between the left atrium and the coronary sinus.
在引起心脏左侧严重梗阻的心脏异常情况中，如主动脉闭锁、二尖瓣闭锁，或偶尔出现的严重主动脉狭窄，循环的维持依赖于肺静脉血分流至右心房。实现分流的通常途径是通过卵圆孔穿过房间隔。当这条途径关闭或严重狭窄时，可能存在其他少见的途径。它们包括肺静脉与体静脉的异常连接或与冠状静脉系统的交通。后者常见于主动脉闭锁，左心室心肌血窦将肺静脉血从左心室腔输送至心脏静脉。在其他严重左侧梗阻的情况下，左心房与冠状窦之间可能存在直接交通。
