scholarly journals Cadaveric Study of Lung Anatomy: A Surgical Overview

2018 ◽  
pp. e000149
Author(s):  
Arthi Ganapathy ◽  
Rati Tandon ◽  
Monica Baxla ◽  
Saroj Kaler
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Intraoperative Complications ◽  
Pulmonary Veins ◽  
Left Lung ◽  
New Delhi ◽  
Normal Pattern ◽  
Lung Anatomy ◽  
Oblique Fissure ◽  
Formalin Fixed

Background: Thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures of lungs. Arrangement of structures in lung hilum act as a guide in performing such procedures. Normal pattern of arrangement of hilar structures in right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In left lung it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. Arrangement of hilar structures from anterior to posterior in both lungs is pulmonary vein, pulmonary artery and principal bronchus. Aim: To report variations in hilar anatomy (arrangement and number) of lungs. Methods and Material: 75 adult formalin fixed cadaveric lungs from department of Anatomy AIIMS New Delhi were observed for variations in lobar anatomy. Arrangement of pulmonary hilar structures observed and variations recorded. Results: Among 75 adult lung specimens observed, 36 were right and rest left lung. Normal pattern of arrangement of hilar structures was seen in 22 right and 23 left lungs. Rest of the lung specimens (14 Right and 16 Left) showed variations in hilar anatomy. Some of them showed alterations in sequence of arrangement of pulmonary artery, pulmonary veins, bronchus and others in number of these structures. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. Conclusion: Alterations in pattern of arrangement of structures in lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent intraoperative complications.

scholarly journals Asymptomatic Pulmonary Vein Stenosis: Hemodynamic Adaptation and Successful Ablation

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
John J. Lee ◽  
Denis Weinberg ◽  
Rishi Anand
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Lung Perfusion ◽  
Atrial Fibrillation Ablation ◽  
Clinical Severity ◽  
Pulmonary Vein Stenosis ◽  
Multiple Imaging ◽  
Vein Stenosis

Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires intervention. We present a patient with severe postatrial fibrillation (AF) ablation pulmonary vein (PV) stenosis, which was seen on multiple imaging modalities including cardiac computed tomography (CT) angiogram, lung perfusion scan, and pulmonary angiogram. This patient did not have any pulmonary symptoms. Hemodynamic changes within a stenosed pulmonary vein might not reflect the clinical severity of the obstruction if redistribution of pulmonary artery flow occurs. Our patient had an abnormal lung perfusion and ventilation (V/Q) scan, suggesting pulmonary artery blood flow redistribution. The patient ultimately underwent safe repeat atrial fibrillation ablation with successful elimination of arrhythmia.

Totally anomalous pulmonary venous connection through the right lung and via a “Scimitar” vein to the inferior caval vein

1993 ◽  
Vol 3 (1) ◽  
pp. 85-87
Author(s):  
Rakesh Dua ◽  
Christine McTigue ◽  
James.L Wilkinson
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Left Lung ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Caval Vein ◽  
Inferior Caval Vein ◽  
The Right ◽  
Left Heart Syndrome ◽  
Anomalous Pulmonary Venous Connection

AbstractWe report a case of totally anomalous pulmonary venous connection in which the two pulmonary veins from the left lung joined to form a common vein which then passed across the midline into a hypoplastic right lung and, after receiving small veins from the right lung, passed inferiorly, exiting the lung below the hilum as a “scimitar” vein and terminating in the inferior caval vein. A separate pulmonary vein from the right lung passed inferiorly independently and joined the “scimitar” vein before it entered the inferior caval vein. There was an associated hypoplastic left heart syndrome.

Variations in the Morphology of Human Lungs and its Clinical Implications

2019 ◽  
Vol 36 (04) ◽  
pp. 231-236
Author(s):  
Suja Mary Jacob ◽  
Vaibhav Venniyoor ◽  
Minnie Pillay
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Veins ◽  
Clinical Implications ◽  
Proper Understanding ◽  
Endoscopic Techniques ◽  
Morphological Variations ◽  
Pulmonary Surgery ◽  
Human Lungs ◽  
The Right ◽  
Oblique Fissure

Objective To observe variations in the fissures, in the lobes, and in the hilar pattern of lungs and correlate these findings with clinical implications. Materials and Methods The present study was performed on random lung specimens available in the Department of Anatomy. A total of 96 lungs (47 right and 49 left) were studied for variations in the fissures and lobes, and 92 lungs (45 right and 47 left) for variations in the hilar pattern. Results Among the right-sided lungs, 70% presented incomplete horizontal fissure, 15% with absence of the horizontal fissure, and 51% with incomplete oblique fissure. Accessory fissures were also seen, but incomplete, and accounted for 17% of the total number of right lungs.Among the left-sided lungs, 62% presented incomplete oblique fissures, and 4% with absence of the oblique fissure. Accessory fissures accounted for 6% of the total number of left lungs.Regarding hilar pattern variations, 11% of the right-sided lungs showed > 2 bronchi, 69% showed > 2 pulmonary veins, and 37% showed > 1 pulmonary artery.Among the left-sided lungs, 57% showed > 1 bronchi, 21% showed > 2 pulmonary veins, and 17% showed > 1 pulmonary artery. Conclusion The field of pulmonary surgery is now highly advanced, with well-developed radiological and endoscopic techniques. Hence, a proper understanding and knowledge of these morphological variations of lung fissures and of the hilar pattern would be advantageous for surgeons, as well as for radiologists.

scholarly journals A left lung with four lobes: a new discovery during the thoracotomy for recurrent primary spontaneous pneumothorax

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Saadat Mehrabi ◽  
Nader Tanideh ◽  
Reza Hosseinpour ◽  
Cambyz Irajie ◽  
Mohammad Javad Yavari Barhaghtalabi
Keyword(s):  
Side Effects ◽  
Spontaneous Pneumothorax ◽  
Left Lung ◽  
Primary Spontaneous Pneumothorax ◽  
Case Presentation ◽  
Lung Anatomy ◽  
The Right ◽  
Oblique Fissure ◽  
New Discovery

Abstract Background The right and left lung anatomy are similar but asymmetrical. The right lung consists of three lobes, and the left lung consists of two lobes. Our study is unique because of discovering a very rare morphological feature of the left lung which has not been reported yet. By the way, we compared two different available chemical agents for pleurodesis (talc and bleomycin) according to side effects, complications, and pneumothorax recurrence. Case presentation We reported a case of bilateral primary spontaneous pneumothorax, who underwent talc slurry and bleomycin pleurodesis at right and left side retrospectively, and then complicate with left-sided recurrent spontaneous pneumothorax, so underwent open thoracotomy and was surprisingly and accidentally found to have 4 lobes and 3 fissures in left lung. Conclusion In our case report, there were one main oblique fissure and two accessory fissures which divided the lung into 4 separated lobes, and this discovery in human’s and other animals’ lung anatomy has not been previously reported. In our case study, the talc slurry was more effective in preventing spontaneous pneumothorax recurrence, but with more side effects than bleomycin. We could hypothesize that the morphological variation of the lung might affect spontaneous pneumothorax development and recurrence.

Mitral and Aortic Atresia Associated with Hypoplastic Right Lung, Crossover Segment of Right Lower Lobe, and Anomalous Scimitar-like Right Pulmonary Venous Connection with Inferior Vena Cava: Clinical, Angiocardiographic, and Autopsy Findings in a Rare Case

1998 ◽  
Vol 1 (5) ◽  
pp. 413-419 ◽  
Author(s):  
Ulrike Bartram ◽  
Stella Van Praagh ◽  
John F. Keane ◽  
Peter Lang ◽  
Mary E. van der Velde ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Pulmonary Vein ◽  
Inferior Vena ◽  
Pulmonary Veins ◽  
Left Lung ◽  
Vena Cava ◽  
Lower Lobe ◽  
Aortic Atresia ◽  
Collateral Vein ◽  
The Right

A newborn female infant was found to have a unique and previously unreported group of anomalies: ( 1) mitral and aortic atresia with a highly obstructive atrial septum; ( 2) hypoplasia of the right lung with a crossover segment involving the right lower lobe; ( 3) normally connected pulmonary veins, two from the left lung and one from the right; and ( 4) a large anomalous branch of the right pulmonary vein of scimitar configuration that anastomosed with the normally connected right pulmonary vein and with the inferior vena cava (IVC). The scimitar vein appeared obstructed at its junction with the right pulmonary vein and at its junction with the inferior vena cava within the hepatic parenchyma. To our knowledge, this is the first report of a scimitar-like vein coexisting with mitral and aortic atresia and connecting both with the right pulmonary vein and with the inferior vena cava. The highly obstructed left atrium was partially decompressed by retrograde blood flow via the normally connected right pulmonary vein to the anomalous scimitar venous pathway and thence to the inferior vena cava via a pulmonary-to-IVC collateral vein.

Effects of Histamine, 5 Hydroxytryptamine and Epinephrine on Pulmonary Hemodynamics With Particular Reference to Arterial and Venous Segment Resistances

1958 ◽  
Vol 194 (1) ◽  
pp. 165-170 ◽  
Author(s):  
Robert P. Gilbert ◽  
Lerner B. Hinshaw ◽  
Hiroshi Kuida ◽  
Maurice B. Visscher
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Lung Weight ◽  
Pulmonary Hemodynamics ◽  
Resistance Increase ◽  
Arterial Resistance ◽  
Venous Resistance ◽  
Venous Segment ◽  
Sizeable Increase

Studies were made of the effects of histamine and 5 hydroxytryptamine (5HT) on arterial and venous segmental resistances in the isolated perfused dog lung. The lung was perfused at constant flow while pressures were measured in the pulmonary artery (PA), left atrium (PV) and in either the pulmonary artery wedge position (PAw) or a small pulmonary vein (PVs). Arterial resistance changes were inferred from changes in the PA-PAw pressure drop, and venous resistance from the PAw-PV pressure gradient. Changes in lung weight were recorded continuously. It was found that histamine usually caused a greater increase of the venous resistance than of the arterial resistance, while 5HT usually increased the arterial resistance more than the venous resistance. When the predominant resistance increase was arterial the lung weight fell, but when there was a sizeable increase of the venous resistance the lung weight rose, presumably as a result of increased capillary blood content. The correlation coefficient between the change in lung weight and the change in venous resistance was + .791. Small pulmonary vein pressures rose after administration of epinephrine, norepinephrine, histamine and 5HT. This result gives further proof of constriction of pulmonary veins by these agents.

scholarly journals A study on pulmonary venous ostia pattern in the left atrium and its clinical applications

2018 ◽  
Vol 7 (04) ◽  
pp. 201-204
Author(s):  
Rajesh S. ◽  
Vijaya Kumar S. ◽  
Manikanda Reddy V.
Keyword(s):  
Atrial Fibrillation ◽  
Radio Frequency ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Anatomical Variation ◽  
Pulmonary Veins ◽  
Clinical Applications ◽  
Ectopic Beats ◽  
The Right ◽  
Formalin Fixed

Abstract Background & aims : Normally four pulmonary veins open into the left atrium. Frequently there are variations in the number of pulmonary veins opening in to the left atrium. Ectopic beats in atrial fibrillation commonly originates from the ostia of the pulmonary veins. The treatment of atrial fibrillation is by radio frequency ablation of the focus of origin and hence the knowledge of anatomical variation of pulmonary veins is necessary to find the ectopic focus in the origin of atrial fibrillation. Materials and Method : In this study the variation of pulmonary venous ostia pattern in the left atrium was studied in 80 formalin fixed adult cadaveric hearts. Results and Conclusion : 63 hearts showed no variation in the pulmonary venous ostia pattem which accounts for 78.75%, rest of the 17 hearts showed variation in the pulmonary venous ostia which accounts for 21.25%, the variation in the number of pulmonary veins was slightly higher for the left side [11.25%] when compared to the right sided variation [ 10%], the number of hearts which showed bilateral variation was noted in 2 hearts - both showed a single pulmonary vein opening on either side which accounts for 2.5%

scholarly journals Mechanical stretching of the pulmonary vein mediates pulmonary hypertension due to left heart disease by regulating SAC/MAPK pathway and the expression of IL-6 and TNF-α

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wenhui Huang ◽  
Hongjin Liu ◽  
Yichao Pan ◽  
Hongwei Yang ◽  
Jing Lin ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Lung Tissue ◽  
Sham Group ◽  
Pulmonary Veins ◽  
Left Ventricular ◽  
Left Heart ◽  
Model Group ◽  
Tnf Α ◽  
Mechanical Stretching

Abstract Background This study aimed to explore whether the mechanical stretching-induced expression of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in pulmonary veins occurred through the stretch-activated channel (SAC)/ mitogen-activated protein kinases (MAPKs) pathway. Methods Sixty male Sprague-Dawley rats were divided into three sham groups and seven model groups. A metal clip was placed on the ascending aorta in the model group to establish PH-LHD rat model. The sham group received a similar operation without ascending aorta clamped. On day 25, pulmonary vein was given mechanical stretching with 0 g, 2.0 g tension in two model groups and two sham groups. Another four model groups were given 2.0 g tension after MAPKs pathway inhibitors soaked. The last sham group and model group rats’ pulmonary veins, pulmonary artery and lung tissues were obtained on day 35. Pulmonary vein, pulmonary artery and lung tissue were evaluated by echocardiography, HE staining, immunohistochemistry and western blotting respectively. Results On day 25, left heart weight, right ventricular pressure (35.339 cmH2O) and left atrial pressure (13.657 cmH2O) were increased in model group than those in sham group. Echocardiography showed left heart failure in the PH-LHD group (Interventrieular septum dimension 1.716 mm, left ventricular internal end diastolic dimension 4.888 mm, left ventricular posterior wall thickness in diastole 1.749 mm, ejection fraction 76.917%). But there was no difference in lung tissue between the sham group and PH-LHD group as showed by HE staining. Our results showed that the expression of IL-6 and TNF-α was highly expressed in PH-LHD rats’ serum and pulmonary vein, which were further increased after 2.0 g tension was given and were decreased after SAC/MAPKs inhibitors treatment. Meanwhile, on day 25, immunohistochemistry analysis showed the expression of IL-6 and TNF-α was higher in the PH-LHD rats’ pulmonary vein than that in pulmonary artery and lung tissue, and these expressions in pulmonary vein of PH-LHD group were also higher than that in sham group. However, on day 35, IL-6 and TNF-α were all increased in the pulmonary veins, arteries and lung tissues. Besides, our results uncovered that SAC/MAPKs pathway were upregulating in PH-LHD rats’ pulmonary vein. Conclusion In conclusion, pulmonary vein mechanical stretching exacerbated PH-LHD possibly through the SAC/MAPKs pathway and upregulating expression of IL-6 and TNF-α.

Reflex cardiovascular responses caused by stimulation of pulmonary C-fibers with capsaicin in dogs

1986 ◽  
Vol 60 (3) ◽  
pp. 949-958 ◽  
Author(s):  
S. S. Cassidy ◽  
J. H. Ashton ◽  
W. B. Wead ◽  
M. P. Kaufman ◽  
Y. Monsereenusorn ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Veins ◽  
Acid Amide ◽  
Left Lung ◽  
Cardiovascular Responses ◽  
Left Ventricular ◽  
Inhibitory Influence ◽  
Ventricular Contractility ◽  
C Fibers ◽  
Stimulation Of

The purpose of these studies was to determine quantitatively the reflex cardiovascular responses to stimulation of the pulmonary C-fibers in dogs. We used a preparation in which the airway, pulmonary artery, and the pulmonary veins to the left lung were cannulated in situ. Ventilation and perfusion of the right lung maintained the animal in relatively normal homeostasis. Capsaicin, a decylenic acid amide of vanillylamine that selectively stimulates nerve endings of unmyelinated fibers (C-fibers), was injected into the left pulmonary artery in 5-ml boluses. Maximal reflex responses were obtained with concentrations as low as 0.8–1.6 X micrograms-1 X kg-1. Heart rate, hindlimb resistance, and left ventricular contractility were lowered transiently (the maximal responses showing declines of 40, 13, and 15.2%, respectively). As a result of these changes, combined with vasodilation in other resistance vessels, cardiac output fell 28% and blood pressure fell 35%. Interrupting the afferent neural pathway by severing the ipsilateral cervical vagus nerve eliminated these responses, confirming the distribution of their reflex origin. Although the role of these reflexes in homeostasis has not been decided, the results of this study suggest that the lungs of dogs, if appropriately stimulated, potentially can exert a major inhibitory influence on the neural regulation of cardiovascular function.

Pharmacological properties of canine intrapulmonary blood vessels

1984 ◽  
Vol 62 (9) ◽  
pp. 1198-1202 ◽  
Author(s):  
Siow-Kee Kong ◽  
Newman L. Stephens
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Contractile Response ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Pulmonary Vasculature ◽  
Maximal Response ◽  
Response Curves ◽  
Significant Difference ◽  
Differential Responsiveness

The contractile response of ring segments of large, medium, and small pulmonary arteries and veins of the dog to histamine, norepinephrine, and serotonin have been studied. The maximum contractile response to these drugs was normalized with respect to the maximal response obtained in stimulation with 127 mM K+. The small pulmonary artery was more reactive to histamine, norepinephrine, and serotonin when compared with large and medium pulmonary arteries. The medium and large pulmonary artery showed no difference in reactivity to histamine. However, the mean effective dose (ED50) values for these agonists among the different segments of pulmonary arteries showed no significant difference. The small and medium pulmonary veins demonstrated increased reactivity to histamine, but not to norepinephrine and serotonin. The ED50 values also indicated that both small and medium veins were more sensitive to histamine when compared with the large pulmonary vein. The log concentration percent response curves for both small and medium pulmonary veins were displaced leftward (increased sensitivity) with respect to that for the large pulmonary vein. However, the reactivity and sensitivity to histamine between medium and small pulmonary veins were no different. The reactivity and sensitivity of different segments of pulmonary veins to norepinehrine and serotonin showed no significant differences among them. We conclude that histamine and other vasoactive substances, which are directly or indirectly related to mast cell degranulation, exert pharmacological effects on the pulmonary vasculature which possesses differential responsiveness at various levels of the vascular tree.

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