Malformation of the heart : atresia of the orifice of the pulmonary artery : aorta communicating with both ventricles / by Thomas B. Peacock, M.D.

  • Thomas Bevill Peacock
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: Malformation of the heart : atresia of the orifice of the pulmonary artery : aorta communicating with both ventricles / by Thomas B. Peacock, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    ably very hastily performed, and the heart was unfortunately removed with only a short portion of the aorta and pulmonary artery attached. Externally the heart had much the natural shape; it was longer than it was wide, and was about the proper size for a child of the age. The aorta arose further to the right than usual, and was from its origin entirely exposed in the pericardium. On opening the cavities the right auricle was found somewhat large, and the foramen ovale was entirely closed. The right ventricle was formed almost wholly of the sinus, and its walls were thick and firm; the infundibular portion was, on the contrary, reduced to a small canal with thin parietes. There was a very distinct separation between the sinus and infundibular portions of the ventricle, so that they formed distinct though connected cavities. The aorta communicated freely with the sinus, but the infundibular portion, instead of giving origin to the pulmonary artery, terminated with a kind of septum or diaphragm, which was entirely impervious, so that there was no communication between the cavity of the ventricle and that of the artery. This septum was evidently formed by the semilunar valves united toge- ther. It was thick and opaque, and was protruded forwards in the course of the pulmonary artery so as to have a funnel shape, the base being towards the ventricle and the pointed extremity towards the artery. Near the point there was a small blind furrow or punc- tum, which seemed to indicate the seat of a former opening. On one side of the septum there was a process, resembling the raphe or cross-bar met with in cases of fusion of the valves, and probably indicating the former existence of a separation into two or more segments. The trunk of the pulmonary artery was of small size, but quite pervious down to the upper surface of the septum ; its coat& were thin. The left auricle was natural; the left ventricle of small size relatively to the right, and its walls of about the usual width. The aorta communicated with both ventricles through the medium of an opening between them from deficiency of the base of the septum ; it had, however, more direct connection with the right than with the left cavity. The vessel was of unusually large size. Both the aorta and pulmonary artery were unfortunately cut ofi so low down that the state of the ductus arteriosus could not be ascertained. It will thus be seen that this case ofifered a very decided and, considering the age of the patient, a very remarkable instance of entire obliteration of the orifice of the pulmonary artery ; but the pre-
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