Biomedical subjects

M Kuri Nivón

Publications and source records attributed to M Kuri Nivón.

9 recordsLinked to original sources

PubMedDate not supplied

[Persistent common trunk. Anatamopathological study of 25 specimen].

In order to inform the pathologic features and their associated anomalies twenty five hearts with common trunk were studied with the segmental sequential system. An anatomico-embryological correlation was made to understand the pathological complex of this malformation. The results were: type I truncus (96%), infundibular ventricular septal defect (96%), displastic truncal valve (28%), ventriculo infundibular fold (92%), left coronary artery arising from the posterior wall of the truncus (75%), right coronary artery arising from their anterior wall (96%), coronary arteries arising from opposite Valsalva sinuses in the tetracuspid valves; the biventricular conection of the truncus was balanced in 60%, prevailing on the right (16%) or on the left (16%) ventricles. Among the associated anomalies there were right aortic arch, interruption of the aortic arch, anomalous origin of the left subclavian artery, vascular ring, aneurysm of the sinus of Valsalva, and absence of the left branch of the pulmonary artery. Developmentally common trunk is explained as a failure of truncoconal septation in the embryonic heart; a migration arrest of neural crest cells is implicated in the Di George syndrome. Knowledge of the anatomic features of common trunk and their associated anomalies, provides the morphological basis to interpret correctly the clinical diagnostic imagenology.

Aorta, Thoracic↗

PubMedDate not supplied

[Anatomopathologic-embryologic correlation in atrioventricular connection absence].

In order to offer a pathogenetic explanation for the absence of atrioventricular connexion, a correlation was made between the pathologic anatomy of this cardiac malformation and the embryonic processes which take part in the septation of the atrioventricular canal and the development of atrioventricular connections. The correspondence was made between the development of the canal's atrioventricular cushions, the septation of the common atrioventricular canal, the right and left atrioventricular canals and the morphogenesis of the mitral valve, all these processes were correlated with the anatomic elements derived from them. This led to infer that the malposition of the atrioventricular cushions divide the common atrioventricular canal unequally, giving rise to a narrow canal becoming atretic and a big canal where the mitral valve is evolved. The extreme lateralization of the atrioventricular septum to the right side would led to the absence of the right atrioventricular connection and the same process but to the left side, would give rise to the left absence of the atrioventricular connection. This ectopic septation process is supported by similar ones which can occur in other segments of the heart such as in tetralogy of Fallot and the transposition of the great arteries. This hypothesis explains sufficiently the pathologic anatomy of this type of congenital heart disease.

Heart Septal Defects↗

PubMedDate not supplied

[Absence of the tricuspid valve. A case report].

An anatomical embryological and histological study of a malformed heart is presented in which the right concordant atrioventricular connexion is unguarded by the tricuspid valve, due to absence of the three leaflets, chordae tendinae and papillary muscles; only the fibrous ring is present in the atrioventricular junction. This very rare malformation is associated with atresia of the valve connected with the right ventricle generally being the pulmonary valve; the ventricular septum is intact. This congenital lesion always present fibrosis in the free wall of the right ventricle. We believe a primary pathogenetic step occurs in the wall of the right ventricle which prevents the morphogenesis of the tricuspid valve from this ventricle. This malformation must be distinguish from Ebstein's disease and Uhl's disease, although they are pathogenetically related.

Diagnosis, Differential↗

PubMedDate not supplied

[Bilateral infundibula in congenital cardiopathies].

The goal of this paper has been to count and describe congenital heart disease associated with double conus. We studied 196 pathologic specimens from to the Pathologic Collection of the Department of Embryology of the National Institute of Cardiology "Ignacio Chávez" of México. We found 3% of double conus in classic tricuspid atresia with concordant ventriculoarterial connection, 53% with double outlet right ventricle, 16% with discordant ventriculoarterial connection, 91% with double outlet single ventricle, 8% with one outlet right ventricle with pulmonary atresia, 20% with one outlet left ventricle and 25% with one outlet single ventricle. The morphological data of the associated anomalies were gathered in an informatized sheet designed according the segmental and sequential approach to diagnose congenital heart disease. From our results we conclude that double conus cannot be considered pathognomonic of any congenital cardiopathy, although they appear associated more frequently with truncoconal anomalies and single ventricle. It is frequent the association between double conus and stenosis of one of them, specially the subpulmonary one. We found great association between left juxtaposition of the atrial appendages and double conus.

Electronic Data Processing↗

PubMedDate not supplied

[Juxtaposition of the atria].

Left juxtaposition of atrial appendages is an anomaly of their origin and position which is associated with a high incidence of complex congenital heart defects. We studied six cases of juxtaposed right atrial appendages. They emerged from the anterior wall adjacent to the atrial septum and were situated to the left of the origin of the great arteries. Associated congenital heart defects were: single outlet, right ventricular hypoplasia, absent right atrioventricular connection, ventricular and atrial septal defects and pulmonary outflow obstruction. Other abnormal morphological features present were anatomically corrected malposition of the great arteries, bilateral infundibulum and right aortic arch. Although the association of these malformations with juxtaposed atrial appendages does not per se constitute a syndrome, its presence is an ominous sign of severe cyanotic congenital heart disease which should alert both clinicians and surgeons. There are various possible embryological explanations for the genesis of this malformation. We believe that juxtaposition is the consequence of the ectopic origin of the atrial appendage rudiment, which in the presence of truncal alterations grows behind and to the left of the great arteries.

Heart Atria↗

PubMedDate not supplied

[Surgical anatomy of tetralogy of Fallot].

We analyzed 131 hearts with tetralogy of Fallot for their prominent surgical anatomical features. Special attention was paid to the different elements of the right ventricular outflow tract obstruction, the supraventricular bands and types of septal defect and their relations with the conducting tissue and coronary supply. The infundibular region proved to be the core of the malformation in tetralogy, the left and anterior septal deviation being the origin of pulmonary stenosis and the rest of the embryopathological elements that characterize this malformation. Our results support the notion that each case has, besides the general features of the malformation, particular aspects which must be analyzed. This conjunction of general and particular features provides the clinician with a morphological basis for the interpretation of the diverse diagnostic procedures and the surgeon with the general scope of tetralogy and the individual features of each case which must be taken into account in the choice of the best possible surgical procedure.

Humans↗

PubMedDate not supplied

[Spectrum of biventricular aortic connection and double outlet chamber of the right ventricle produced experimentally in the chicken heart by hypothermia (34.5 degrees C)].

In this experimental work, fertilized chicken eggs were subjected to hypothermia (34.5 degrees) as to inhibit the incorporation of the aortic infundibulum into the left ventricle. This produced a spectrum of biventricular connection of the aorta including double outlet right ventricle (DORV), a cardiopathy seen naturally in man and in chicken. It represents the persistence in the postnatal heart of the spectrum of embryonic aortic dextroposition, a fact which allowed us to establish a precise anatomoembryologic correlation. Pathogenetically, the failure in the connection of the aortic infundibulum with the left ventricle is due to inhibition, in different degrees, of the leftward morphogenetic movement of the infundibular segment, an embryologic process which is discussed in relation to different theories on the origin of DORV. The role played by cell death in normal and pathologic morphogenesis, is emphasized and some methodological aspects on experimental teratogeneses are mentioned.

Animals↗

PubMedDate not supplied

[A morphological study of 23 hearts with Ebstein's anomaly].

The literature published of the Ebstein anomaly of the tricuspid valve have been given little attention to the study of the trabecular portion of the right ventricle. This motivate us to study the morphology of twenty-three hearts by the segmentary sequential method determining with special interest the extension and grade of valvular attachment, dysplasia, characteristics of the trabecular portion of the right ventricle and associated anomalies. The three valves had some grade of attachment but this was less frequently in the anterior valve. However in our material this occurred in 43% which is consider high comparing with the rest of the literature; the trabecular portion had several bands at this zone and it was covered by the valve attachment. The downward displacement of the functional ring was directly proportional to the valve attachment. The structural anomalies of the right ventricle related to the valve malformation lead us to consider that the primary damage that causes this cardiopathy occurred at the right ventricle during the embryonic development altering the morphogenesis of the tricuspid valve.

Aortic Valve↗

PubMedDate not supplied

[A morphometric study of the right ventricular infundibulum in complete transposition of the great arteries].

To demonstrate that the right ventricular infundibulum changes its spatial orientation in hearts with complete transposition of the great arteries, sixty five hearts with this malformation, with anterior and right sided aorta were studied morphometrically. The inlet apex and infundibular arises in the right ventricule were interrelated. The angles formed by the intersection of both arises were measured, and the results were compared with those obtained from a similar study in thirty five normal hearts. The angles obtained in the hearts with transposition of the great arteries were of 156.5 degrees, and those measured in the normal hearts were of 126.6 degrees. This difference was interpreted as an indicator of a vertical shift of the right ventricular infundibulum toward the right, to the same side in which the aorta is located and with which it is connected. In this way this outlet looses its leftward direction observed in normal hearts. It is concluded that although complete transpositions of the great arteries developmentally has its origin primarily in the truncus of the embryonic heart, the infundibulum is also involved modifying its position.

Aorta↗