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Biomedical subjects

Brian Curry

Publications and source records attributed to Brian Curry.

7 recordsLinked to original sources
PubMed2006

Superior phrenic artery: an anatomic study.

The majority of anatomical textbooks offer very little information concerning the anatomy and distribution of the superior phrenic artery (SPA). However, in the last decade, a number of reports have appeared with reference to the transcatheter arterial chemoembolization of the collateral arterial supply of hepatic carcinoma (HC). Considering the potential role of the SPA as a source of collateral blood supply to HC, the aim of this study was to identify the origin and distribution of the SPA. One hundred formalin-fixed adult cadavers with no evidence of significant gross diaphragmatic pathology were examined. The right SPA originated from the aorta (R1) in 42%, as a branch of the proximal segment of the 10th intercostal artery (R2) in 33%, and as a branch of the distal segment of the 10th intercostal artery (R3) in 25%, of the specimens. The left SPA originated from the aorta (L1) in 51%, from proximal segment of the left 10th intercostal artery (L2) in 40%, and from the distal segment of the left 10th intercostal artery (L3) in 9%, of the specimens. In types R1, R2, L1 and L2 the SPA terminated, after a short course, within the medial and posterosuperior surfaces of the thoracic diaphragm and diaphragmatic crura. Conversely, in types R3 and L3 the lateral origin of the SPAs confined the ultimate distribution of the vessels to the posterior surface of the diaphragm. These findings could provide a better understanding of the anatomy and distribution of the arterial supply of the diaphragm and the potential involvement of the right SPA as an extrahepatic collateral artery developed in HC.

Aged↗
PubMed2006

Pseudoaneurysm of the membranous septum, case report and review of the literature.

Pseudoaneurysm (dissecting aneurysm) of the membranous septum is a rare occasion. Clinically, aneurysms and pseudoaneurysms not only have the potential to reduce ventricular size, but also can be further complicated by rupture of the aneurysm and by promoting tricuspid insufficiency, aortic valve prolapse, ventricular outflow tract obstruction, and bacterial endocarditis. We describe a case in which a pseudoaneurysm of the membranous septum was identified protruding into the left outflow tract.

Aged↗
PubMed2006

Surgical anatomy of the accessory phrenic nerve.

BACKGROUND: Reports place the frequency of phrenic nerve injury after cardiac operations between 10% and 85%, emphasizing the importance of an accurate anatomic description of the diaphragm's innervating nerves to reduce iatrogenic injury, length of hospitalization, and associated costs. The aim of our study was to explore the anatomic variations of the accessory phrenic nerve and relate these findings to phrenic nerve injury. METHODS: Eighty adult formalin-fixed cadavers were dissected, resulting in 160 nerve specimens. Fifty nerve specimens were also examined laparoscopically with findings later confirmed through gross dissection. All nerves contributing to the phrenic nerve after crossing the anterior scalene were considered to be accessory phrenic nerves. RESULTS: The phrenic nerve was present in all specimens, and 99 (61.8%) also had an accessory phrenic nerve. The accessory phrenic nerve arose from the nerve to subclavius in 60 specimens (60.6%), ansa cervicalis in 12 (12.1%), and nerve to sternohyoid in 7 (7%). The accessory phrenic nerve joined with the phrenic nerve in the thorax anterior to the subclavian vein in 45 (45.5%) specimens and posterior in 17 (22.2%). A phrenic-accessory phrenic nerve loop was found around the subclavian vein in 45 (35 on the right, 10 on the left) specimens and around the internal thoracic artery in 38 (31 on the right, 7 on the left). CONCLUSIONS: To reduce injuries to the diaphragm, the presence of an accessory phrenic nerve should be considered before mobilization and skeletonization of the internal thoracic artery above the second rib.

Adult↗
PubMed2006

The relationship of myocardial bridges to coronary artery dominance in the adult human heart.

Myocardial bridging is recognized as an anatomical variation of the human coronary circulation in which an epicardial artery lies in the myocardium for part of its course. Thus, the vessel is 'bridged' by myocardium. The anterior interventricular branch of the left coronary artery has been reported as the most common site of myocardial bridges but other locations have been reported. The purpose of this study was to provide more definitive information on the vessels with myocardial bridges, the length and depth of the bridged segment, and the relationship between the presence of bridges and coronary dominance. Two hundred formalin-fixed human hearts were examined. Myocardial bridges were found in 69 (34.5%) of the hearts with a total of 81 bridges. One bridge was found in 59 of these hearts and multiple bridges were observed in ten (eight with double bridges and two with triple bridges). Bridges were most often found over the anterior interventricular artery (35 hearts). Bridges were also found over the diagonal branch of the left coronary artery (14), over the left marginal branch (five) and over the inferior interventricular branch of the left coronary artery (six). Bridges were also found over the right coronary artery (15 hearts), over the right marginal branch (four) and over the inferior interventricular branch of the right coronary artery (two). The presence of bridges appeared to be related to coronary dominance, especially in the left coronary circulation. Forty-six (66.6%) of the hearts with bridges were left dominant. Forty-two of these had bridges over the left coronary circulation and four over the right coronary circulation. Seventeen hearts (24.6%) were right dominant. Eleven of these had bridges over the right coronary circulation and six over the left coronary circulation. The remaining six hearts were co-dominant with four having bridges over the left coronary circulation and two over the right coronary circulation. The mean length of the bridges was 31 mm and the mean depth was 12 mm. The possible clinical implications of myocardial bridging may vary from protection against atherosclerosis to systolic vessel compression and resultant myocardial ischaemia.

Adult↗