[Pathologic morphology and clinical significance of the anomalous origin of the left circumflex coronary artery from the right coronary artery. General review and autopsy analysis of 30 cases]. / Patoloska morfologija i klinicki znacaj anomalnog izlaska leve cirkumfleksne koronarne arterije is decne koronarne arterije. Opsti pregled i obdukcijska analiza 30 slucajeva.

After an extensive analysis of the world literature (121 references), beginning from the first reported case by Antopol and Kugel, 1933, the general review of the problem stressed especially the following morphologic characteristics and clinical significance of the anomalous origin of the left circumflex coronary artery (LCxA) from the right coronary artery (RCA): The place of the anomalous origin of LCxA from RCA among all other variations and anomalies of LCxA. The anatomical and topographical characteristics of LCxA originating from RCA in normal heart as well as in congenital heart diseases--CHD (especially complete transposition of great arteries--TGA). The formal genesis of LCxA from RCA according to original new Ogden's theory, taking into account the dual origin of the coronary arteries and the peritruncal angioblastic ring that surrounds the developing aorta and pulmonary artery. The frequencies of the origin of LCxA from RCA in autopsy and coronarography series. The importance of LCxA (by its origin and/or caliber) in determination of the right, left or codominance of the coronary arteries including the peculiarities in cases of isolated aortic stenosis and bicuspid aortic valve. The importance of recognizing LCxA from the RCA during implantation of artificial aortic, mitral and tricuspid heart valves, during mitral valve anuloplasty, closure of ostium primum defect as well as during aorto-coronary venous bypass. The LCxA from RCA, especially its proximal segment, shows more frequent and an earlier, faster and heavier obstructive atherosclerosis, causing different manifestations of coronary heart disease and sudden death. Also, mitral insufficiency can be caused by ischemia of the papillary muscles of the left ventricle. The awareness of the possibility that LCxA may arise from the RCA can prevent many complications during cannulations of the coronary arteries for diagnostic coronarography and myocardial perfusion during heart operations. The authors presented their 30 autopsied cases of LCxA from RCA, analysing morphological and topographic data as well as their clinical significance and association with other CHD. There were 6 isolated cases and 24 cases associated with other CHD (20 with TGA and 4 with other CHD). Our first autopsied case of LCxA from RCA was diagnosed as associated with tetralogy of Fallot in 1964. During the period 1964-1985 we had 1015 cases of CHD (including 132 cases of TGA).(ABSTRACT TRUNCATED AT 400 WORDS)

[Morphological study of 2 cases of congenital toxoplasmosis]. / Morfoloska studija dva slucaja kongenitalne toksoplazmoze

A morphological study of two cases of acute generalized congenital toxoplasmosis has shown that in one case the most heavily involved organ was the heart (focal necrotic myocarditis), in addition to some changes in the central nervous system (leptomeningitis), and in the other case, the most affected organ was the cerebrum (focal necrotic encephalitis). In both cases, in almost all organs, there were degenerative and reactive changes. Toxoplasma was found in necrotic foci of the myocardium and the brain. Some basic views concerning a special vulnerability of the central nervous system in toxoplasmosis are put forward. The basic fact is that the explanation for the infection of exposed fetuses lies in the condition of the immune system (in the degree of its development and activity), especially regarding certain localizations of changes in the organs with a less developed activity of the local immune system.