Table Of Content’
Wilcox s Surgical Anatomy
of the Heart
Fourth edition
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’
Wilcox s Surgical Anatomy
of the Heart
Fourth edition
Robert H. Anderson, BSc, MD, FRCPath
VisitingProfessor,InstituteofGeneticMedicine,NewcastleUniversity,Newcastle-upon-Tyne,UK;
VisitingProfessorofPediatrics,MedicalUniversityofSouthCarolina,Charleston,SC,USA
Diane E. Spicer, BS, PA(ASCP)
Pathologists’Assistant,UniversityofFlorida–PediatricCardiology,Gainesville,Florida,and
CongenitalHeartInstituteofFlorida,St.Petersburg,FL,USA
Anthony M. Hlavacek, MD
AssociateProfessor,DepartmentofPediatrics,MedicalUniversityofSouthCarolina,Charleston,SC,USA
Andrew C. Cook, BSc, PhD
SeniorLecturer,CardiacUnit,InstituteofChildHealth,UniversityCollegeLondon,London,UK
Carl L. Backer, MD
A.C.BuehlerProfessorofSurgery,NorthwesternUniversityFeinbergSchoolofMedicine,Ann&RobertH.Lurie
Children’sHospitalofChicago,Chicago,IL,USA
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Fourthedition©RobertH.Anderson,DianeE.Spicer,AnthonyM.Hlavacek,AndrewC.Cook,andCarlL.Backer2013
Thispublicationisincopyright.Subjecttostatutoryexception
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noreproductionofanypartmaytakeplacewithoutthewritten
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Fourtheditionfirstpublished2013
Thirdeditionfirstpublished2004
PrintedandboundbyGrafosSA,Artesobrepapel,Barcelona,Spain
AcataloguerecordforthispublicationisavailablefromtheBritishLibrary
LibraryofCongressCataloguinginPublicationdata
Anderson,RobertH.(RobertHenry),1942–
Wilcox’ssurgicalanatomyoftheheart.–Fourthedition/RobertH.Anderson,BSc,MD,FRCPath,DianeE.Spicer,
BS,AnthonyM.Hlavacek,MD,AndrewC.Cook,BSc,PhD,CarlL.Backer,MD.
pages cm
ISBN978-1-107-01448-0(hardback)
1. Heart–Anatomy. 2. Heart–Surgery. I. Title. II. Title:Wilcox’sSurgicalAnatomyoftheHeart.
QM181.W55 2013
6110.12–dc23
2012051614
ISBN978-1-107-01448-0Hardback
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everyefforthasbeenmadetodisguisetheidentitiesoftheindividualsinvolved.
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Contents
Preface pagevii
Acknowledgements viii
Surgicalapproachestotheheart 1
Anatomyofthecardiacchambers 13
Surgicalanatomyofthevalvesoftheheart 51
Surgicalanatomyofthecoronarycirculation 90
Surgicalanatomyoftheconductionsystem 111
Analyticaldescriptionofcongenitallymalformedhearts 128
Lesionswithnormalsegmentalconnections 150
Lesionsinheartswithabnormalsegmentalconnections 244
Abnormalitiesofthegreatvessels 321
Positionalanomaliesoftheheart 363
Index 377
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Preface
Thebooksandarticlesdevotedto feedbackfromthosewhohadusedthefirst DianeSpicertoouranatomicalteam.She
techniqueincardiacsurgeryarelegion. editionwasverypositive.Inthethird hascontributedenormouslybyproviding
Thisismostappropriate,asthesuccessof edition,wesoughttoexpandandimprove manynewandbetterillustrationsofthe
cardiacsurgeryisgreatlydependentupon stillfurtheronthechangesmadeinthe anatomyasseenintheautopsiedheart.
excellentoperativetechnique.But secondedition.Inthesecondedition,we Theseadvancesarecomplimentedbythe
excellenceoftechniquecanbedissipated hadaddedanentirelynewchapteron contributionsofourotherneweditor,
withoutafirmknowledgeoftheunderlying cardiacvalvaranatomy,andgreatly TonyHlavacek.Tonyhasprovidedquite
cardiacmorphology.Thisisjustastruefor expandedourtreatmentofcoronary remarkableimagesobtainedusing
thenormalheartasforthoseheartswith vascularanatomy.Weretainedthisformat computedtomographyandmagnetic
complexcongenitallesions.Itisthe inthethirdedition,asweweregratified resonanceimaging,whichshowthatthe
feasibilityofoperatinguponsuchcomplex that,ashoped,readerswereabletofinda heartcanbeimagedwithjustasmuch
malformationsthathashighlightedthe particularsubjectmoreeasily.Thethird accuracyduringlifeaswhenweholdthe
needforamoredetailedunderstandingof editionalsocontainedstillmorenew specimensinourhandsontheautopsy
thebasicanatomyinitself.Thus,inrecent illustrations,retainingtheapproachof bench.Recognisingthehugecontributions
yearssurgeonshavecometoappreciatethe orientatingtheseillustrations,where ofBenWilcox,wearealsopleasedto
necessityofavoidingdamagetothe appropriate,asseenbythesurgeon renamethisfourthedition‘Wilcox’s
coronaryvessels,ofteninvisiblewhen workingintheoperatingroom,but SurgicalAnatomyoftheHeart’.Aswith
workingwithinthecardiacchambers,and revertingtoanatomicalorientationformost thepreviouseditions,itisourhopethatthe
particularlytoavoidthevitalconduction ofthepicturesofspecimens.Soastoclarify neweditionwillcontinuetobeofinterest
tissues,invisibleatalltimes.Although thevariousorientationsofeachindividual notonlytothesurgeon,butalsotothe
detailedandaccuratedescriptionsofthe illustration,wecontinuedtoincludeasetof cardiologist,anaesthesiologist,andsurgical
conductionsystemhavebeenavailable axesshowing,whenappropriate,the pathologist.Allofthesepractitioners
sincethetimeoftheirdiscovery,only directionsofsuperior,inferior,anterior, ideallyshouldhavesomeknowledgeof
rarelyhasitspositionbeendescribedwith posterior,left,right,apex,andbase.All cardiacstructuresandtheirexquisite
thecardiacsurgeoninmind.Atthetime accountswerebasedontheanatomyasitis intricacies,particularlythosecardiologists
thefirsteditionofthisvolumewas observedand,exceptinthecaseof whoincreasinglytreatlesionsthat
published,tothebestofourknowledge malformationsinvolvingtheaorticarchand previouslyweretheprovinceofthesurgeon.
therehadbeennootherbooksthat itsbranches,theyowenothingto Oursenioranatomistremainsactive,and
specificallydisplayedtheanatomyof speculativeembryology. hasbeenfortunatetobegrantedaccessto
normalandabnormalheartsasperceivedat Amajorchangewasforceduponusas severalarchivesofautopsiedheartsheldin
thetimeofoperation.Wetriedtosatisfy wepreparedthisfourthedition,asour theUnitedStatesofAmericasubsequentto
thisneedinthefirstvolumebycombining originalsurgicalauthor,BensonWilcox, hisretirementfromtheInstituteofChild
theexperienceofapractisingcardiac diedinMayof2010.Itisverydifficultto HealthinLondon.Weremainconfident
surgeonwiththatofaprofessionalcardiac replacesuchapioneerandchampionof that,inthehandsofthisnewteam,andif
anatomist.Weaddedsignificantlytothe surgicaleducation,butwearegratifiedthat supplydemands,thebookwillpassthrough
illustrationsinthesecondedition,while CarlBackerhasassumedtheroleof stillfurthereditions,hopefullycontinuing
seekingtoretaintheoverallconcept,as surgicaleditor.Wearealsopleasedtoadd toimprovewitheachversion.
RobertH.Anderson,DianeE.Spicer,
AnthonyM.Hlavacek,
AndrewC.Cook,
andCarlL.Backer,
London,Tampa,CharlestonandChicago
November,2012
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Acknowledgements
Agooddealofthematerialdisplayedin obtainedusingcomputedtomographyand IllustrationsandPhotography,University
thesepages,andtheconceptsespoused,are magneticresonanceimaging.We ofNorthCarolina.Aswiththethird
dueinnosmallparttothehelpofour continue,nonetheless,tooweaparticular edition,weoweanequaldebtofgratitude
friendsandcollaborators.Asindicatedin debttoAntonBeckeroftheUniversityof toGemmaPrice,whohascontinuedto
ourpreface,themajorchangesincewe Amsterdam,BobZuberbuhlerof improveourseriesofcartoons.Forboth
producedthethirdeditionhasbeenthesad Children’sHospitalofPittsburgh, thethirdeditionandthisedition,shehas
passingofourfoundingsurgicaleditor, Pennsylvania,UnitedStatesofAmerica, workedoverandabovethecallofduty.We
BensonR.Wilcox.Wehaverenamedthis andF.JayFrickerofUniversityofFlorida, alsothankViHueTran,whohelped
fourthedition‘Wilcox’sSurgicalAnatomy Gainesville,Florida,UnitedStatesof photographtheheartsfromGreat
oftheHeart’.Wededicatethiseditionto America,allofwhompermittedustouse OrmondStreet.Weareagainindebtedto
hiseternalmemory.Afurtherchangehas materialfromtheextensivecollectionsof ChristineAndersonforherhelpduring
beentheretirementofRobertH.Anderson normalandpathologicalspecimensheldin thepreparationofthemanuscript,and
fromtheInstituteofChildHealthat theircentres.Wealsocontinueto thanktheteamsupportingCarlBackerat
GreatOrmondStreetChildren’sHospital, acknowledgethedebtowedtoSiewYen LurieChildren’sofChicago,in
London.Retirement,however,has Ho,oftheNationalHeartandLung particularPatHeratyandAnneE.Sarwark.
permittedhimtoestablishnew Institute,partofImperialCollegein Finally,itisapleasuretoacknowledgethe
connections,notleastwiththenewest London.Yenproducedmanyofthe supportprovidedbyCambridge
additionstoourteamofauthors.Thishas originaldrawingsfromwhichwe UniversityPress,whohaveensuredthat
permittedmanynewheartstobe preparedourartwork,andphotographed allthegoodpartsoftheprevious
specificallyphotographedforthisnew manyoftheheartsintheBrompton editionswereretained.Inparticular,we
edition,notonlyofautopsyspecimens,but archive.Theinitialphotographsand thankNicholasDuntonandJoanna
alsointheoperatingroom.Inaddition,it surgicalartworkcouldnothavebeen Chamberlinforalltheirhelp
hascreatedthecollaborationthatpermits producedwithouttheconsiderablehelp duringthepreparationofthebookfor
theinclusionofwonderfulimages givenbytheDepartmentofMedical publication.
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11
Surgical approaches
to the heart
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Description:Anderson R. Wilcox`s surgical anatomy of the heart, Cambridge university press, 391 p. Classical cardac anatomy textbook and atlas. For cardiology an heart surgery specialists.
