The Visceroatrial Arrangement (Situs)


In the sequential segmental approach to diagnosing congenital heart disease, the morphological arrangement of the atria is the starting point [1, 2]. The appendages are the most constant component of the atria. Their shape and the morphology of their junction with the atria always show a morphologically right or left pattern. The morphologically left atrial appendage is tubular and hook-shaped, with a narrow junction with the venous portion of the atrium. The vestibular aspect of the left atrium is smooth, as the pectinate muscles are restricted to the appendage. The morphologically right atrial appendage is essentially triangular, with a broad junction with the venous portion of the atrium. Its internal aspect contains pectinate muscles that extend around the atrioventricular junction and reach thecrux of the heart (Fig. 3.1) [3].
Fig. 3.1

In this specimen of a normal heart, viewed form above, the upper portion of the atria is sectioned to show the “floor” of the atria with their appendages. The different size of the junction of the atrial appendages (white brackes) and different distribution of the pectinated muscles (yellow dotted line) within each atrium is demonstrated. AV aortic valve, LA left atrium, LAA left atrial appendage, PV pulmonary valve, RA right atrium, RAA right atrial appendage


Atrial Appendage Situs Inversus Arran Gement Pectinate Muscle Fetal Cardiology 
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