Filaire Marc, Nohra Olivier, Sakka Laurent, Chadeyras Jean Baptiste, Da Costa Valence, Naamee Adel, Bailly Patrick, Escande Georges
Univ Clermont1, UFR Médecine, Laboratoire d'Anatomie, 63001 Clermont-Ferrand, France.
Surg Radiol Anat. 2008 Jun;30(4):369-73. doi: 10.1007/s00276-008-0334-5. Epub 2008 Mar 11.
The interatrial septum (IAS) can be dissected to resect pulmonary tumors invading the left atrium. The aim of this study was to describe the dissected structures, and to expose the benefits, the limits, and the embryologic reasons of such dissection.
We dissected the IAS of 11 fresh, non-embalmed human hearts. The dissected structures were described and the length and depth of the dissection were measured. A histological study was performed in four other fresh hearts to identify and differentiate between dissectible and non-dissectible structures.
The dissection was performed through a fatty tissue located between two muscular walls. The depth limit of the IAS dissection was identified as the limbus of the fossa ovalis and the muscular roof of the atria. The section of the latter doubles the depth of the dissection at the level of the upper pulmonary veins. Mean length of the dissected IAS was 77 mm (55-90). Mean depths of the IAS were 41 mm (35-50) at the level of the left upper pulmonary vein, 27 mm (12-35) between the upper and lower pulmonary veins, and 14 mm (8-20) at the level of the left inferior pulmonary vein
The surgical dissection of the IAS is performed through the septum secundum that appears as an infold of the atrial wall. The length of the resectable left atrial cuff reaches a mean of 40 mm at the level of the upper pulmonary vein.
可解剖房间隔以切除侵犯左心房的肺部肿瘤。本研究的目的是描述解剖结构，并揭示这种解剖的益处、局限性及胚胎学原因。
我们解剖了11颗新鲜、未防腐处理的人类心脏的房间隔。描述了解剖结构，并测量了解剖的长度和深度。对另外4颗新鲜心脏进行了组织学研究，以识别和区分可解剖与不可解剖的结构。
解剖通过位于两个肌壁之间的脂肪组织进行。房间隔解剖的深度极限被确定为卵圆窝边缘和心房肌顶。后者的切开使上肺静脉水平处的解剖深度增加了一倍。解剖的房间隔平均长度为77毫米（55 - 90）。在左上肺静脉水平，房间隔的平均深度为41毫米（35 - 50），在上、下肺静脉之间为27毫米（12 - 35），在左下肺静脉水平为14毫米（8 - 20）。
房间隔的手术解剖是通过作为心房壁褶皱出现的继发隔进行的。在上肺静脉水平，可切除的左心房袖带长度平均达到40毫米。
