Collection of facts illustrative of the morbid conditions of the pulmonary artery / by Norman Chevers.

  • Norman Chevers
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: Collection of facts illustrative of the morbid conditions of the pulmonary artery / by Norman Chevers. Source: Wellcome Collection.

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    exclusively of the three which I have recently seen. The pulmonary artery has been found obliterated in several ways. There may be discovered merely an indistinct band of con¬ densed cellular tissue, or a thin impervious cord extending upwards in the usual course of the vessel, and attached to a small trans¬ verse arterial canal which sends branches to either lung; or a strong firm membrane may be observed stretched completely across the lower part of a narrow channel (the rudiment of a pulmonary artery) extending from the base of the right ventricle, and communicating with a branch from the aorta. The upper surface of this membrane may present some slight traces of a valvular structure (Fig. a), and it is sometimes dilated into a little shallow pouch which projects downwards into the ventricle. Occasionally the orifice appears suddenly constricted, as if a thread had been drawn tightly around it (as represented in the dia¬ gram, fig. b). Perforation of the ventricular a septum is a usual, but not invariable, accom¬ paniment of congenital obliteration of the pulmonary orifice. Wherever life has been prolonged beyond a few weeks the ventricles have communicated. The ductus arteriosus is generally, but not always, pervious. The ovalian canal may or may not remain patent. In most of the cases where life has been considerably prolonged, this opening has been found either completely obliterated or greatly contracted. In the whole of these cases the lungs re¬ ceive blood either directly or indirectly from the aorta, or from arteries distributed by its primary branches. This supply is furnished in several modes, of which the following are the principal. The orifice of the'pulmonary artery oblite¬ rated, the arterial duct remaining pervious. Permanency of the canalis arteriosus is the most frequent as well as the most natural means by which the lungs are supplied with blood in cases where the orifice or ascending trunk of the pulmonary artery is congenitally imperforate. The most remarkable instances of this kind on record are those observed by Dr. W. Hunter, Mr. Hodgson, Mr. How- ship, Dr. Mauran, and Dr. Spittal. In Dr. Hunter’s case,* the infant, which was born at the eighth month, had cyanosis, dyspnoea, and violent palpitation of the heart, and died on the 13th day ; the com¬ mencement of the pulmonary artery was converted into a solid substance or cord ; but, except at its beginning, it wras everywhere pervious, though small, and the canalis arteriosus had supplied it with a scanty share of blood. The right ventricle had scarcely any cavity left. The foramen ovale was very large. There are two preparations, in the col¬ lection at Guy’s Hospital, which bear a strong physiological resemblance to the heart described by Dr. Hunter. In that marked 1383 (which is the heart of a foetus or very young infant), the right ventricle is furnished with a diminutive tricuspid valve, but has become almost obliterated by an extraordinary concentric thickening of its walls. The pulmonary orifice is obliterated, the ductus arteriosus open. The ventricular septum is entire. The aorta, which is large, originates from the left ventricle. The preparation 138264, is also the heart of a foetus : its pulmonary orifice is closed. The auricles are small, commu¬ nicating freely with each other. A very small chink, about a line in length, repre¬ sents the right auriculo-ventricular orifice— below this, and rather to the left, is a little * Med. Obs. and Inquiries, vol. vi., p. 291.
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