Esophageal Cardiac Anatomy And Ultrasound Applications

Objective: to establish a set of anatomic data for ultrasonic cardiac diagnosis, matching the displaying sections of the main structure of transesophageal echoeardiography, and to provide morphological basis for clinical ultrasonic examinations with best examination sections, orientations and examining path. Methods: By application of self-designed cryomicrotome for frozen gross soft tissue, transesophageal horizontal section and radial section centering the esophagus as an axis of the normal heart sample were performed(three examples, respectively). The information of the section was collected by digital camera and images were numbered and input into computer for observation. Ultrasonic instruments were used to scan the normal heart transesophageally and radially. Tomogram was compared with ultrasonic images to conclude the relationship of the major cardiac structures and spatially moving changes and the best location and the main area of TEE scanning. Results:〤ryomicrotome for soft tissue was designed and prepared. The minimum thickness by horizontal microtome was 0.4mm, while the rotating and radial microtome could perform the cutting job in the field of I ~O 170 ~ The preliminary preparation of these two kinds of microtomes has been finished. Consequently, they would be a new kind of cutting instrument for thin section anatomy. ?One hundred and sixty sections were prepared transesophageally and horizontally. Based on the horizontal plane of the root aorta, we observed the horizontal changes of the major cardiac structures. On this plane, the root aorta, the aorta valves, the left and right cardiac atria, the efferent tract of the left ventricle, the left atrioventricular orifice, the bicuspid valve and the right ventricle could be observed. Hence this was the satisfactory plane to observe the aortic valves and the bicuspid valve. At the spots of different upper and lower distances on this plane, the major cardiac structures, such as the coronary orifice, the pulmonary trunk, the membranous septum of the left and right atrioventricular orifices, the fossa ovalis, the superior and inferior vena cavas could be observed. orty-five sections were prepared transesophageally and radially. Based on the transesophageal and sagittal plane, we observed the changes of the major cardiac structures on the radial plane. On this plane, the aortic sinus, the left cardiac atrium, the left atrioventricular orifice, the left ventricle, the right atrium, the efferent tract of the right ventricle, the pulmonary orifice, the pulmonary valve, and the pulmonary trunk, could be observed. At the spots of different upper and lower distances on this plane, the left and right atrioventricular orifice and its valve, the aortic orifice, the pulmonary orifice and its valve, the pulmonary trunk, ascending aorta, the super and inferior vena cavas could be observed. GThree sets of image data of transesophageal echocardiogram of the normal heart were obtained. These data were composed of the section images of the major cardiac structures, including minor axis section of the root aorta, the four cardiac chambers, the five cardiac chambers, the two atria, the horizontal section of the left heart, the left auricle, the pulmonary vein, major axis section of the root aorta, the efferent tract of the right ventricle, and the superior vena cava. Conclusion:㏕he microtome for frozen gross soft tissue is of easy operation and easy to control the thicknes...