Right Ventricle
Takahiro Shiota in 3D Echocardiography, 2020
The shape of the right ventricle (RV) is complicated and thus any 2D imaging cannot represent the entire RV as seen in Figure 4.1 (). In the apical 2D echocardiographic view, the RV looks triangular, while in the cross-sectional view, it appears crescent in the normal condition.1 The RV is composed of the following three components: The inlet, which consists of the tricuspid valve (TV), chordae tendineae, and papillary muscleThe trabecular apical myocardiumThe infundibulum or conus, which refers to the smooth myocardial outflow region
Complications of Mechanical Ventricular Assistance
Wayne E. Richenbacher in Mechanical Circulatory Support, 2020
The first problem that can be encountered in the patient receiving LVAD support is inadequate LVAD flow. This problem is identified as CPB is discontinued and LVAD flow initiated. Regardless of the indication for use or device inserted, the LVAD flow index should always exceed 2.0 L/min/m2. If the LVAD flow index is less than 2.0 L/min/m2 the patient will probably succumb from multisystem organ failure secondary to end organ hypoperfusion. The best way to determine the etiology of inadequate LVAD flow is to monitor both the left atrial and right atrial pressures as CPB is discontinued (Table 5.5). Low left and right atrial pressures are indicative of hypovolemia. Volume administration readily corrects the problem. Upon termination of CPB and initiation of left ventricular assistance, a bulging, poorly contractile right ventricular free wall and infundibulum, associated with inadequate LVAD filling, a low left atrial pressure and high central venous or right atrial pressure are indicative of right ventricular dysfunction. Treatment or more appropriately stated prevention, begins prior to LVAD insertion. The right heart must be adequately protected. If cardioplegic arrest is used the surgeon should ensure that an adequate dose enters the right coronary artery. If there is a right coronary artery stenosis, consideration should be given to concomitant right coronary artery bypass grafting. The free wall of the right ventricle is protected from the ambient room temperature with topical ice or cold pack application. If right ventricular dysfunction is present inotrope and pulmonary vasodilator administration often corrects the problem. If LVAD filling is suboptimal despite inotrope and pulmonary vasodilator therapy the patient requires mechanical right ventricular assistance.
Thorax
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden in Human Sectional Anatomy, 2017
The presence of a pericardial effusion in this subject has produced an artefactual gap in the superior reflection of the pericardial space (42). The aorta at its origin (43) shows the orifice of the left coronary artery. The descending aorta (28) is normally more circular in outline than in this subject. Note that this section passes through the infundibulum of the right ventricle and demonstrates the pulmonary valves (46).
Right Ventricular-Pulmonary Arterial Coupling and Outcomes in Heart Failure and Valvular Heart Disease
Published in Structural Heart, 2021
Bahira Shahim, Rebecca T. Hahn
The RV is a crescent-shaped chamber that wraps around the left ventricle (LV).6 Most anatomic studies divide the RV into three components:1 the inlet, which consists of the tricuspid valve, chordae tendineae, and papillary muscles;2 the trabeculated apex; and3 the infundibulum, or conus, which corresponds to a tubular smooth myocardial outflow region.6 The RV contracts by three separate mechanisms:1 inward movement of the free wall toward the relatively fixed interventricular septum, which produces a bellows effect;2 contraction of the longitudinal fibers, which shortens the long axis and draws the tricuspid annulus toward the apex; and3 traction on the free wall at the points of attachment secondary to LV contraction and LV-RV continuity of the superficial fibers.6
The ‘worm’ in our brain. An anatomical, historical, and philological study on the vermis cerebelli
Published in Journal of the History of the Neurosciences, 2023
Klaus F. Steinsiepe
This stagnancy is demonstrated in another anatomical manuscript, Hieronymo Manfredi’s Anothomia from 1490 (see Singer 1955). Manfredi (1430–1493) had been professor of medicine at the University of Bologna since 1463. His treatise, one of the first written in the vernacular, “is in the main a rearranged and on the whole improved Mondino” (Singer 1955, 105), but if we look at the section on the brain, especially the lines on ventricular anatomy, it is almost verbatim Mondino more than 170 years before. Again, coming from the anterior ventricles to the middle one, there are three things to be seen (tu vederai tre cose), but it is much clearer now that two of them are the bilateral anche or buttocks (the nucleus caudatus), and the third is the lacuna (the infundibulum). There is nothing new about the worm: facta a modo di uno verme subterraneo rosa se sanguinea, a thing like a subterranean worm, red as blood; when it lengthens itself, it closes those anche and so blocks the path between the anterior ventricles and the middle one (for the Italian text, see Singer 1955, 135).
Propulsion of blood through the right heart circulatory system
Published in Scandinavian Cardiovascular Journal, 2018
Torvind Næsheim, Ole-Jakob How, Truls Myrmel
While the left ventricle lends itself to physiological studies given its regular geometric shape, the right ventricle is harder to decipher due to heterogeneous properties throughout the myocardium, difficult volumetry and important interactions with the left ventricle through the interventricular septum (Figure 3). It is apparent from the figure that the septum is functionally integrated in both the left and right ventricle, but morphologically it is part of the left ventricle. A rational approach to assess the function of the right ventricle might be to analyze the septum, sinus and infundibulum (or conus) of the right ventricle independently with regard to stress and strain [44,45]. Furthermore, the function of the right ventricle must always be evaluated in context with the systemic venous return and right sided ventriculoarterial coupling [46].
Related Knowledge Centers
- Aorta
- Bulbus Cordis
- Cardiac Skeleton
- Pulmonary Artery
- Tetralogy of Fallot
- Ventricle
- Heart
- Tetralogy of Fallot