Plunkett Mark D, Buckberg Gerald D
Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2007:68-75. doi: 10.1053/j.pcsu.2007.01.011.
This chapter describes the structure/function relationships of the right ventricle (RV), and shows how the geometry of the helical ventricular myocardial band model defines spatial geometry of the free wall and septum that underlie dynamic action. Myocardial fiber orientation is the keynote to performance in health and disease. The transverse geometry of the RV free wall allows constriction (bellows-type motion), whereas oblique septal fiber orientation and midline septal position is essential for ventricular twisting, the vital mechanism for RV ejection against increased pulmonary vascular resistance. Therefore, the septum is considered "the lion or motor of RV performance." Distortion of such normal structure/function relationships underlies the pathophysiologic mechanisms of RV failure. Operative methods that restore normal myocardial fiber orientation are described to outline evolving surgical techniques for the surgical treatment of RV failure.
本章描述了右心室（RV）的结构/功能关系，并展示了螺旋形心室心肌带模型的几何形状如何定义构成动态活动基础的游离壁和室间隔的空间几何形状。心肌纤维方向是健康和疾病状态下功能表现的关键。右心室游离壁的横向几何形状允许收缩（风箱式运动），而斜行的室间隔纤维方向和室间隔中线位置对于心室扭转至关重要，心室扭转是右心室克服增加的肺血管阻力进行射血的关键机制。因此，室间隔被认为是“右心室功能的关键或动力”。这种正常结构/功能关系的扭曲是右心室衰竭病理生理机制的基础。文中描述了恢复正常心肌纤维方向的手术方法，以概述用于右心室衰竭外科治疗的不断发展的手术技术。
