Muñoz-Castellanos Luis, Kuri-Nivon Magdalena
Departamento de Embriología, Instituto Nacional de Cardiología Ignacio Chávez, México, D. F., México.
Departamento de Ciencias Morfológicas, Escuela Superior de Medicina, Instituto Politécnico Nacional (IPN), México, D. F., México.
Arch Cardiol Mex. 2016 Apr-Jun;86(2):103-9. doi: 10.1016/j.acmx.2015.08.002. Epub 2015 Sep 11.
To describe morphologically a toracoabdominal visceral block of a scimitar's syndrome case. We propose a pathogenetic theory wich explains the development of the pulmonary venous connection in this syndrome.
The anatomic specimen was described with the segmental sequential system. The situs was solitus, the connections between the cardiac segments and the associated anomalies were determined. The anatomy of both lungs, including the venous pulmonary connection, was described. A pathogenetic hypothesis was made, which explains the pulmonary venous connection throw a correlation between the pathology of this syndrome and the normal development of the pulmonary veins.
The situs was solitus, the connections of the cardiac chambers were normal; there were hypoplasia and dysplasia of the right lung with sequestration of the inferior lobe; the right pulmonary veins were connected with a curved collector which drainaged into the suprahepatic segment of the inferior vena cava; the left pulmonary veins were open into the left atrium. The sequestered inferior lobe of the right lung received irrigation throw a collateral aortopulmonary vessel. There was an atrial septal defect.
The pathogenetic hypothesis propose that the pulmonary venous connection in this syndrome represent the persistent of the Streeter's horizon xiv (28-30 days of development), period in which the sinus of the pulmonary veins has double connection, with the left atrium and with a primitive collector into the right viteline vein which forms the suprahepatic segment of the inferior vena cava.
从形态学上描述一例弯刀综合征的胸腹内脏阻滞情况。我们提出一种发病机制理论,用以解释该综合征中肺静脉连接的发育过程。
使用节段顺序系统描述解剖标本。确定心脏位置正常,明确心脏各节段之间的连接及相关异常情况。描述双肺的解剖结构,包括肺静脉连接情况。提出一种发病机制假说,通过该综合征的病理与肺静脉正常发育之间的相关性来解释肺静脉连接情况。
心脏位置正常,心腔连接正常;右肺发育不全且发育异常,下叶存在肺隔离症;右肺静脉与一条弯曲的集合静脉相连,该集合静脉引流至下腔静脉肝上段;左肺静脉开口于左心房。右肺隔离的下叶通过一条主动脉 - 肺侧支血管获得血液供应。存在房间隔缺损。
发病机制假说提出,该综合征中的肺静脉连接代表了斯特里特发育水平十四期(发育28 - 30天)的持续存在,在此期间肺静脉窦有双重连接,分别与左心房以及与一条原始集合静脉相连,该原始集合静脉汇入形成下腔静脉肝上段的右脐静脉。