O'Connor W N, Stahr B J, Cottrill C M, Todd E P, Noonan J A
Department of Pathology, University of Kentucky College of Medicine, Lexington 40536.
J Am Coll Cardiol. 1988 May;11(5):1061-72. doi: 10.1016/s0735-1097(98)90066-3.
Myocardial sinusoids communicating with the coronary systems occur in pulmonary atresia with intact ventricular septum. To test the hypothesis that the extent of ventriculocoronary connections correlates with the degree of right ventricular outflow obstruction as evidenced by clinical, angiographic and gross anatomic findings, a serial section study of six human autopsy hearts representing a spectrum of hypoplastic right heart was undertaken. Slides were evaluated for the presence and extent of ventriculocoronary connections, associated developmental abnormalities and secondary changes in the ventricular walls. Whereas extensive blind-ended deep sinusoids were a feature of all five cases with unrelieved obstruction, ventriculocoronary connections were identified in three. Changes that suggested ongoing remodeling provide new evidence for the postnatal temporal evolution of these anomalous communications. The regional distribution of myofiber disarray in hypoplastic right heart supports the concept that vascularization parallels myocardial organization in the developing human heart.
与冠状动脉系统相通的心肌窦状隙见于室间隔完整的肺动脉闭锁。为了验证心室 - 冠状动脉连接程度与右心室流出道梗阻程度相关的假说（临床、血管造影和大体解剖结果均证实了这一点），我们对6例代表不同程度右心发育不全的人类尸检心脏进行了连续切片研究。对切片进行评估，以确定心室 - 冠状动脉连接的存在和范围、相关的发育异常以及心室壁的继发性改变。尽管广泛的盲端深窦状隙是所有5例梗阻未缓解病例的特征，但在3例中发现了心室 - 冠状动脉连接。提示正在进行重塑的变化为这些异常交通的出生后时间演变提供了新证据。发育不全的右心中肌纤维紊乱的区域分布支持了这样的概念，即血管化与发育中的人类心脏中的心肌组织平行。
