Rusu M C, Petrescu Codruţa Ileana, Niculescu V, Ionescu N, Vlad M
Department of Anatomy and Embryology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest.
Rom J Morphol Embryol. 2006;47(1):63-6.
The aim of the present study was to bring macroscopic and microscopic evidence on the left papillary muscles blood supply in human hearts. For the study were used human adult hearts from patients without clinically known cardiac ischemic history. Ten hearts were used for injecting China ink in the coronary arteries and other twenty hearts were dissected to evidence the characteristics of the main arteries of the left papillary muscles. Pieces - left papillary muscles - were drawn from the injected hearts and diaphanised. In all dissected hearts the left anterolateral papillary muscles were supplied by the left coronary system: anterior interventricular artery, second diagonal branch and left (obtuse) marginal artery. In 70% the left posteromedial papillary muscles were supplied by the right coronary system (posterior interventricular artery, left retroventricular artery) and in 30% by the left coronary system (circumflex artery). The left papillary muscles were supplied each by one or two main arteries that penetrated the muscles longitudinally. The ventricular wall attaching the papillary muscles was supplied by the subepicardial vessel sending the main arteries of the papillary muscles but also by neighbor subepicardial vessels distributed in that wall. The mural vessels were finer than the papillary muscles main arteries. Injected papillary muscles presented each with two systems of blood perfusion: one represented by segmental centers of arterial branching and distribution of the main arteries of the muscle and other represented by capillary extensions of the mural networks at that level. From the segmental branching centers were perfused the neighbor segments of the papillary muscles and intrasegmental anastomoses were recognized. The microvascular study of the left papillary muscles proves the usual overlapping of sources for segmental supply; this overlapping is reinforced by the high capillary density to ensure the vascularisation of the papillary muscles.
本研究的目的是提供关于人类心脏左乳头肌血液供应的宏观和微观证据。该研究使用了无临床已知心脏缺血病史患者的成人心脏。十颗心脏用于向冠状动脉注射中国墨汁，另外二十颗心脏进行解剖以明确左乳头肌主要动脉的特征。从注射过的心脏中取出左乳头肌组织块并进行透明处理。在所有解剖的心脏中，左前外侧乳头肌由左冠状动脉系统供血：前室间动脉、第二对角支和左（钝）缘动脉。70%的左后内侧乳头肌由右冠状动脉系统（后室间动脉、左室后动脉）供血，30%由左冠状动脉系统（回旋动脉）供血。左乳头肌各由一条或两条纵向贯穿肌肉的主要动脉供血。附着乳头肌的心室壁由发出乳头肌主要动脉的心外膜下血管供血，也由分布在该壁的相邻心外膜下血管供血。壁内血管比乳头肌的主要动脉细。注射后的乳头肌呈现出两种血液灌注系统：一种以肌肉主要动脉的节段性分支和分布中心为代表，另一种以该水平壁内网络的毛细血管延伸为代表。从节段性分支中心向乳头肌的相邻节段供血，并可识别节段内吻合。对左乳头肌的微血管研究证明了节段性供血来源通常存在重叠；这种重叠因高毛细血管密度而加强，以确保乳头肌的血管化。
