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Figure 2-4: (Plate 1) The three primary planes of the body (left) and heart (tight). Note that the planes of the body are aligned with vertical midline structures, such as the esophagus. In contrast, the major axis of the heart is oriented obliquely. Thus the heart's long and short axes do not lie in the same plane as the body's long and short axes. The body planes cut the heart obliquely and not in its primary planes. Conversely, the heart's primary planes cut the body obliquely.

Figure 2-4: (Plate 1) The three primary planes of the body (left) and heart (tight). Note that the planes of the body are aligned with vertical midline structures, such as the esophagus. In contrast, the major axis of the heart is oriented obliquely. Thus the heart's long and short axes do not lie in the same plane as the body's long and short axes. The body planes cut the heart obliquely and not in its primary planes. Conversely, the heart's primary planes cut the body obliquely.

Thus, first, when describing the orientation of a specific organ such as the heart, one must take into account both the position of the heart and the position of adjacent structures such as the thoracic aorta and esophagus. When interpreting two-dimensional images, clinicians must avoid making correlations that yield impossible anatomy6 (&H0; Fig. 2-6). Accurate anatomic diagnoses require close interdisciplinary interactions between cardiovascular pathologists, clinicians, radiologists, anesthesiologists, and surgeons and emphasize a critical need for teamwork and a "common language" when describing cardiac anatomy and pathology.

Methods Used to Study Cardiac Anatomy

The two conventional approaches to the study of cardiac anatomy that have stood the test of time are (1) the inflow-outflow method (B+-0- Fig. 2-7) and (2) the tomographic ventricular slice methodM Fig. 2-8, Plate 3). Although the inflow-outflow method readily demonstrates disease processes in a given cardiac chamber or valve, it does not allow simultaneous visualization of the effects of that process on contiguous structures.6 Furthermore, the inflow-outflow method does not correspond well to clinical tomographic imaging modalities except possibly cavitary angiography.6 With the ventricular slice technique (see Fig. 2-8), the ventricles are "bread sliced" perpendicular to the plane of the ventricular septum. This technique is ideal for the evaluation of ischemic heart disease but may need to be carried basally, well beyond the papillary muscle tips.6

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