Bhatnagar Kunwar P, Nettleton G S, Campbell Ferrell R, Wagner Charles E, Kuwabara Nobuyuki, Muresian Horia
Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA.
Clin Anat. 2006 Sep;19(6):510-6. doi: 10.1002/ca.20195.
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.
在人类右心房中，奇阿里异常现象表面上很少见。文献中仅有零星提及这些下腔静脉、冠状窦的有孔网状瓣膜，或连接这些瓣膜与右心房其他结构的各种条索。此类结构异常对心脏功能的影响尚不清楚。我们在此报告对213例尸体、38例尸检及11例胎儿心脏的右心房网进行的大体观察。对下腔静脉和冠状窦瓣膜的组织学和超微结构检查表明，只有异常的冠状窦瓣膜含有心肌。奇阿里异常通常指与下腔静脉瓣膜以及可能与冠状窦瓣膜相关的穿孔或组织条索。虽然尚无研究支持，但该异常现象通常被认为在2%的个体中出现。我们在213例尸体心脏中的13.6%以及所检查的尸检心脏中的10.5%中观察到了奇阿里畸形。在这些畸形中，冠状窦瓣膜出现有孔的情况最为频繁。对于涉及下腔静脉瓣膜和冠状窦瓣膜以及右心房内连接这些瓣膜与界嵴、右心房壁或房间隔的条索的异常，我们建议用“右心房网”来取代“奇阿里网”这一术语。
