The Hunterian lectures on malformations of the heart : delivered before the Royal College of Surgeons of England on March 8th, 10th, and 12th, 1909 / by Arthur Keith.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1909
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Licence: In copyright

Credit: The Hunterian lectures on malformations of the heart : delivered before the Royal College of Surgeons of England on March 8th, 10th, and 12th, 1909 / by Arthur Keith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Hea/rts with one ventricle.—Amongst the malformed hearts which are said to have a common ventricle there are really three kinds : (1) those in which the interventricular septum is so little developed, or, to put it differently, the interventricular foramen is so large that the two ventricles are rightly said to form one chamber ; (2) those cases where the right ventricle is suppressed by the septum being applied to the right side of the heart; and (3) those in which the left ventricle is suppressed by the septum being applied to the left wall of the ventricle. The first form is the commonest (nine cases) and is often associated with transposition of the arterial trunks ; of the second form I have examined seven cases and Fig. 26. Bfuie of a heart iii which there are (1) eteiiosia of the right auriculo-ventricular opening; (2) suppression of the body of the right ventricle; and (3) development of the infundibulum of the right ventricle. The common ventricle is really the left; the auriculo-ventricular bundle in seen on the right lateral wall of the ventricle. of the third five cases. In the second and third groups the absence of a ventricle is associated with a complete oblitera- tion, or almost complete, of the corresponding auriculo- ventricular orifice (Fig. 26). The obliteration is probably due to the fusion of the endocardial tissue out of which the auriculo-ventricular valves and cushions are formed. Develo'pment of the interventriouia/r septum.—A bifid con- dition of the apex of the heart is not uncommon as an abnormality in man and is the normal form in some mammals such as the dugong. I refer to the condition here because it was difficult to give a satisfactory explanation when the interventricular septum was regarded as an upgrowth from