Surgeons use a coring tool to cut a hole in the myocardium of the left ventricle so that the cannula of an LVAD (Left Ventricular Assist Device) can be inserted.

Human thorax and pectoral girdle with isolated arteries and veins

The abdominal (or thoracic) aorta and the inferior vena cava are the major artery and vein, respectively, that follow the spine down to the pelvis. 

Traité complet de l’anatomie de l’homme comprenant la medecine operatoire, par le docteur Marc Jean Bourgery. Illustrated by Nicolas Henri Jacob, 1831.


Aortic Coarctation.

These are MRI and MRA images of a 22-year-old man with aortic coarctation, a congenital condition whereby the aorta narrows in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts and it is considered when a section of the aorta is narrowed to an abnormal width.

Coarctation is a congenital anomaly of unknown etiology that results in a focal obstruction at the junction of the distal aortic arch and descending thoracic aorta. It is responsible for 6% of congenital cardiac anomalies. Although there is blood flow across the coarc segment, it is supplemented by collateral blood flow that bypasses the obstruction via intercostal, internal mammary, epigastric, spinal, and periscapular arteries.

It is rare before 10-years of age and is most pronounced along the posterior upper ribs. Prognosis is good with early surgical intervention, poor without surgical intervention; very high mortality rate by 6th decade of life in this subset of patients.

(Images and clinical informations via VCU Medical Center).


Tetralogy of Fallot.

Tetralogy of Fallot (TOF) is a congenital heart defect which is classically understood to involve abnormalities of the heart. It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome.

As such, by definition, it involves four heart malformations which present together:

  • Pulmonary Infundibular Stenosis: A narrowing of the right ventricular outflow tract. It can occur at the pulmonary valve (valvular stenosis) or just below the pulmonary valve (infundibular stenosis).
  • Overriding aorta: Aorta is situated above the ventricular septal defect and connected to both the right and the left ventricle.
  • Ventricular septal defect (VSD): A hole between the two bottom chambers (ventricles) of the heart.
  • Right ventricular hypertrophy: The right ventricle is more muscular than normal, causing a characteristic boot-shaped (coeur-en-sabot) appearance as seen by chest X-ray. 

Signs and symptoms: Tetralogy of Fallot results in low oxygenation of blood due to the mixing of oxygenated and deoxygenated blood in the left ventricle via the ventricular septal defect (VSD) and preferential flow of the mixed blood from both ventricles through the aorta because of the obstruction to flow through the pulmonary valve. This is known as a right-to-left shunt. The primary symptom is low blood oxygen saturation with or without cyanosis from birth or developing in the first year of life. Other symptoms include a heart murmur which may range from almost imperceptible to very loud, difficulty in feeding, failure to gain weight, retarded growth and physical development, dyspnea on exertion, clubbing of the fingers and toes, and polycythemia. Digital clubbing or watch-glass nails with cyanotic nail beds is common in adults with tetralogy of Fallot (2nd picture).

I: muscles, tendons, heart, pump, aorta, valves, ventricle, the coronary blood.
She: neurons, stomach, skin, taste, meninges, liver, diaphragm, bile, arteries.
And we shared everything, and I do not remember if that one was my heart, if that one was his skin,
and It all ended in a big mess.
Simone Ferri

Io: muscoli, tendini, cuore, pompa, aorta, valvole, ventricolo, coronarie, sangue.
Lei: neuroni, stomaco, pelle, papille, meningi, fegato, diaframma, bile, arterie.
E ci siamo scambiati tutto, e non ricordo se quel cuore era mio, se quella pelle era sua,
e finì tutto in un gran casino.
Simone Ferri