SURGICON 2019 Heart Dissection Workshop Radu-Mihai Grigoriu

Step-by-Step Dissection of the Heart

A. Exterior Inspection
1.
1.1. Identify the LEFT CORONARY ARTERY in the
coronary groove
1.2. Identify and follow the ANTERIOR
INTERVENTRICULAR ARTERY in the namesake groove
to the apex of the heart
1.3. Identify and follow the LEFT CIRCUMFLEX BRANCH
in the coronary groove.
1.4. Identify the LEFT MARGINAL ARTERY
2.
2.1. Identify the origin of the RIGHT CORONARY
ARTERY off the right side of the Ascending Aorta and
follow in in the coronary groove.
2.2. Identify the RIGHT MARGINAL ARTERY.
2.3. Continue following RIGHT CORONARY ARTERY until in
branches the POSTERIOR INTERVENTRICULAR
ARTERY.
2.4. Follow the POSTERIOR INTERVENTRICULAR
ARTERY in the namesake groove
3.
3.1. Identify the GREAT CARDIAC VEIN in the anterior
interventricular groove
3.2. Identify the MIDDLE CARDIAC VEIN in the posterior
interventricular groove
3.3. Identify the RIGHT AND LEFT MARGINAL VEINS
3.4. Identify the LESSER CARDIAC VEIN in the right
extremity of the coronary sinus
3.5. Follow all these veins back to the CORONARY
SINUS.
SURGICON 2019 Heart Dissection Workshop Radu-Mihai Grigoriu

B. Opening the Chambers of the Heart

Chambe Dissection Interior Elements
r
Right 1. Pass the blade of the  Crisa
Atrium scalpel through the terminalis
orifice of the SVC  Pectinate
downwards into the muscles
right atrium and  Interatrial
through the orifice of septum
the IVC  Fossa ovalis
2. Cut laterally to open the and its limbus
atrium  Openings of
3. Using the scissors make IVC and SVC
a second incision on the  Right atrio-
anterior side of the ventricular
atrium. It should be at opening
an angle of 90 degrees.  Opening of
Repeat once. the coronary
sinus

Right 1. Pass the scalpel through  Trabeculae

Ventricl the AV valve, between carnae
e the anterior and septal  Tricuspid
cusps, up to the apex of valve with
the right ventricle. anterior,
2. Cut the ventricular wall posterior and
in an antero-lateral septal cusps
direction.  3 papillary
3. Starting at the inferior muscles
part of the previous  Tendinous
incision, pass the scalpel chords
upwards through the  Opening of
pulmonary valve and the pulmonary
into the pulmonary valve +
trunk. Pulmonary
4. Cut the ventricular wall valve
in an anterior direction.  Conus
SURGICON 2019 Heart Dissection Workshop Radu-Mihai Grigoriu

arteriosus
 Moderator
band

Notes:

Chambe Dissection Interior Elements

r
Right 1. Make a vertical incision  Openings of
Atrium between the two orifices the four
of the right pulmonary pulmonary
veins veins
2. Make a vertical incision  Left
between the two orifices atrioventricula
of the left pulmonary r opening
veins
3. Make a transverse
incision, which will join
the previously made
incisions.
4. Open the left atrium
posteriorly.

Left 1. Pass the scalpel through  Trabeculae

Ventricl the left AV orifice, carnae
e until it reaches the apex  Mitral valve
of the left ventricle. with its
2. Cut the ventricular wall anterior and
laterally and to the left. septal cusps
3. Starting at the inferior  Anterior and
part of the previous posterior
incision, pass the scalpel papillary
superiorly, between muscles
SURGICON 2019 Heart Dissection Workshop Radu-Mihai Grigoriu

the anterior cusp of  Tendinous

the mitral valve and chords
the interventricular  Aortic
septum. Reach the vestibule
aortic valve.  Aortic opening
4. Cut the ventricular wall and aortic
posteriorly, to reveal the valve
interior of the left
ventricle and the
ascending aorta.

Notes: