Trokvržični zalistak

Trokvržični zalistak
Prednji (frontalni) izgled otvorenog srca
Bijele strelice pokazuju normalan tok krvi.
(Trokvržični zalistak je obilježen na dnu lijevo.)
Baza komore nakon otklanjanja pretkomora (Trokvržični zalistak je vidljiv na dnu desno.)
Identifikatori
MeSHD014261
TA98A12.1.02.003
TA23982
FMA7234
Anatomska terminologija

Trokvržični zalistak – poznat i kao trikuspidni zalistak ili desni prekomorno-komorni zalistak i prednji atrioventrikularni zalistak – nalazi se na desnoj leđnoj srtrani sisarskog srca, između desne pretkomore i desne komore. Funkcija ovog zaliska je prevencija povranog toka krvi u desnu pretkomoru.[1]

Struktura

Normalni trikuspidni zalistak obično ima tri listića i tri papilarna mišića. Oni su povezani sa papilarnim mišićima preko chordae tendineae (vrpce srčanog zaliska), koja se nalazi u desnoj komori. Trokvržični zalisci ne sastoje se uvijek od tri listića i mogu se javiti sa dva ili četiri; njihov broj može se promijeniti tokom života.[2]

Funkcija

Trikuspidne zalistak sprečava povratak toka krvi iz desne komore u desnu pretkomoru, tokom komorne sistole, kada se zatvara i omogućava krvi da teče iz desne pretkomore u desnu komoru tokom ventrikularne dijastole kada se otvori. Upotreba droga i lijekova slabi ovaj zalistak. Unazadni protok krvi je također poznat i kao regresijska ili trikuspidna regurgitacija.[3]

Klinički značaj

Trikuspidna povratni tok krvi nije neuobičajen u trokvržičnom zalisku. Uobičajen je za inficirani zalistak što dovodi do endokarditisa, kod intravenskog drogiranja korisnika.[4][5] Pacijenti koji intravenski ubrizgavaju droge ili druge lijekove, mogu unijeti i infekcije, koji će otići na desnu stranu srca, a najčešće su uzrokovane bakterijom S. aureus.[6] Kod ostalih pacijenata, bez historije intravenske izloženosti, često se javlja ljevostrani endokarditis.[6] Trikuspidni ventil može biti pod utjecajem reumatske groznice, što može dovesti do trikuspidne stenoze ili trikuspidne insuficijencije (koja se naziva i trikuspidna regurgitacija).[7]

Neki pacijenti su rođeni sa kongenitalnim abnormalnostima trikuspidnog zaliska. Kongenitalno apikalno izmještanje trokvržičnog zaliska ventila zove se Ebsteinova anomalija i obično uzrokuje značajnu trikuspidnu regurgitaciju. Određeni karcinoidni sindromi mogu uticati na pojavu trikuspidne fibroze zbog proizvodnje serotonina tih tumora.

Prvi endovaskularni trikuspidnni implantat proizveli su hirurzi u Cleveland Clinic.[8]

Dodatna slika

Također pogledajte

Reference

  1. ^ Guyton, A.C. & Hall, J.E. (2006) Textbook of Medical Physiology (11th ed.) Philadelphia: Elsevier Saunder ISBN 0-7216-0240-1
  2. ^ Richard Van Pragh: Cardiac anatomy in A. C. Chang et al.: Pediatric Cardiac Intensive Care, Philadelphia 1998.
  3. ^ Healthline Editorial Team. "Right atrioventricular valve (Tricuspid valve)". Healthline.
  4. ^ Demin AA, Drobysheva VP, ((Vel'ter OIu)) (2000). "[Infectious endocarditis in intravenous drug abusers]". Klinicheskaia meditsina (jezik: Russian). 78 (8): 47–51. PMID 11019526.CS1 održavanje: upotreba parametra authors (link) CS1 održavanje: nepoznati jezik (link)
  5. ^ Butany J, Dev V, Leong SW, Soor GS, Thangaroopan M, Borger MA (2006). "Infective endocarditis of the tricuspid valve". Journal of cardiac surgery. 21 (6): 603–4. doi:10.1111/j.1540-8191.2006.00313.x. PMID 17073968.CS1 održavanje: upotreba parametra authors (link)
  6. ^ a b Mitchell RS, Kumar V, Robbins SL, Abbas AK, Fausto N (2007). Robbins Basic Pathology (8th izd.). Saunders/Elsevier. str. 406–8. ISBN 1-4160-2973-7.CS1 održavanje: upotreba parametra authors (link)
  7. ^ Tricuspid valve disease Mount Sinai Hospital, New York
  8. ^ "University Circle Inc". Arhivirano s originala, 17. 6. 2008. Pristupljeno 5. 12. 2016.

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