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Anomalies of venae cavae superiores in an orang.

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ANOMALIES OF VENAE CAVAE SUPERIORES IN
AN ORANG
RALPH E. CHASE AND CHARLES F. DEOARIS
Department of Anatomy, University of Oklahoma School of Medicine
ONE FIOURL
Anomalies of the venae cavae superiores are fairly frequent
in man, but, as far as we have been able to ascertain, have
not been reported in other primates. The specimen described
here comprises the heart and great vessels from orang-utan
(Pongo pygmaeus), this being one of seven such specimens
added to our stock of primate material through the kindness of Dr. A. H. Schultz, Baltimore, who writes that the
orang-utans were collected by him in British North Borneo on
the Asiatic Primate Expedition of 1937. Three other hearts
from orang-utan had been made available to us from various
sources by Doctor Schultz.
VENAE CAVAE SUPERIORES
The peculiar arrangement of the venae cavae superiores
dorsal
in this specimen from orang-utan a re shown as
diagram in figure 1. Both venae cavae appear reduced in
size, as compared with the other great vessels and with the
heart. The vena cava sinistra, a s usual in cases where it persists, is found emptying into the left extremity of the sinus
coronarius. As it approaches the heart it receives a vein from
the atrium sinistrum. However, this vein at its entrance
into the vena cava has a lumen far wider than can be RCcredited to the small area drained by it and the few tributaries
which i t receives; also a laceration renders part of its wall
incomplete. Fr o m these circumstances and in view of the
61
AYERlCAX J O U B N A L OF I’HYSICAIr ANTHROPOLOOY, VOL. aSXIV, NO. 1
JULY-SLLPRMBCR, 1938
62
R. X. CIIBSE AND
C. F. DE GARIS
relatively small size of veins traceable from the remnant of
the left lung directly into the atrium sinistrum, the possibility
is suggested that a vein from the upper part of the left lung
entering the vena cava sinistra has been torn away at the
point marked G in figure 1. While the presence of such a vein
in this case is suppositional, it is a matter of report that the
vena cava superior sinistra usually does receive a n aberrant
tributary from the left lung before emptying into the sinus
coronarius.
F
G
B
Fig. 1 A, vena cava superior dextra: B, eonfluenee of upper vv. pulmonales
dextrae et azygos; C, atrium dextrum; D, vena eava inferior; E, sinus coronarius;
P, vena cava superior sinistra; G , vein from atrium sinistrum, possibly receiving
a vena pulrnonalis sinistra; H, vv. pulmonales sinistrae; I, v. pulmonalis dextra.
Though there is no evidence of a vena anonyma sinistra,
the exact mode of formation of the venae cavae superiores
cannot be stated, since all the vessels (except the aorta) had
been cut across at levels indicated in figure 1. Having blocks
of pulmonary tissue at the roots of the lungs still attached to
the specimen, we are able to identify an unsual arrangement
of veins on the right side. Tributaries from upper portions
of the right lung form by confluence a large vein, which joins
VENAE CAVAE SUPERIORS I N A N ORANQ
63
the vena cava superior dextra a short distance above the
entrance of this latter into the atrium dextrum. Among the
veins forming this confluence is a large one entirely free of
lung tissue ;this by reason of its size, relations and caval connection is regarded as the vena azygos. A single large vena
pulmonalis from lower portions of the right lung empties directly into the atrium sinistrum.
Examination of the atrium dextrum shows a completed
fossa ovalis, there being no valve-like remnant of the foramen,
as often seen in man. The septum ventriculorum is likewise
complete. Within the atrium dextrnm is found a male nematode approximately 150 mm. long, identified as Acanthocheilonema (Dipetclonema) perstans. This species of the Filaridae
is said to abound in tropical regions of the world as a parasite
in man and other primates, with tendency to infest the peritoneal and pleural membranes. I t s intermediate host is reported to be one of the Culicoides. For information regarding
this parasite of the orang-utan we are indebted to Dr. A. J.
Sheldon of the Department of Bacteriology.
DISCUSSION
Since no literature exists on anomalies of the vena cavae
superiores in primates other than man, it must suflice here to
cite but a few reports of general interest from human
anatomy. The papers by McCotter ('15), Poynter ('23) and
Chase ('38) and the atlas by Abbott ('36) cover classification,
developmental interpretations, associated cardiac and other
malformations and a list of reported cases.
*4s has often been pointed out, the failure or suppression of
the embryonic thymicothyroid veins connecting right and left
precardinal channels gives rise to right and left caval trunks.
The vena cava superior sinistra and the sinus coronarius together thus represent the left duct of Cuvier and the adjacent
part of the left precardinal vein.
Regarding connections of the superior caval trunks with
pulmonary veins-in
the present case of the orang-utan
merely suggestive on the left side but fully demonstrated on
64
R. E. CHASE AND C. F. Da GARIS
the right-it may be said that various anomalies of this kind
are attributed t o early plexiform connections between precardinal and pulmonary veins, or between these latter and the
postcardinal portion of the vena azygos. Anastomosis between upper pulmonary veins and the terminal or azygos part
of the postcardinal vein fully account for the confluence'of
the venae pulmonales et azygos entering the vena cava
superior dextra.
It is a matter of interest that of our ten orang-utan hearts
two exhibit anomalous conditions considered worthy of record
in man. The specimen described here is one; the other is a
case of pericardial patency and partial ectocardia in a newborn orang-utan (De Garis, '34). Also branches of the aortic
arch and especially patterns of the coronary circulation, which
we are now studying, vary so widely as to confirm the impression that the orang-utan is a primate having even a stronger
predilection for vascular anomalies than has man.
Further, as compared with rhesus monkey, which we have
examined in large series for coronary patterns (Chase, '38)
and for aortic branches (De Garis, '35, '38), the orang-utan
appears much more variable. Nor did we find in any specimen of rhesus, among the 266 examined, such gross anomalies
as those of the venae cavae superiores or that of the patent
pericardium, both of which occur in our series of ten orangutan specimens.
We must say, with a degree of disappointment, that one
rather frequent anomaly of the human aortic arch, viz., the
arteria subclavia dextra as the fourth branch, has not thus
f a r appeared in any of our primate material.
VEZTAE CAVAE SUPERIORS
I S A S ORANG
65
BUMMABY
In a specimen of the heart and great vessels of orang-utan
(Pongo pygmaeus) are found the following venous anomalies :
the vena cava superior sinistra persists as a tributary of the
left extremity of the sinus coronarius. Conditions of a vein
from the atrium sinistrum to the vena cava superior sinistra
suggest, but do not satisfactorily demonstrate, a vena pulmonalis sinistra emptying at this site.
The vena cava superior dextra, a short distance above its
entrance into the atrium dextrum, receives a large tributary
made up of veins from the upper part of the right lung in confluence with the vena azygos. Veins from the lower part
of the right lung unite to form a single trunk emptying into
the atrium sinistrum. Examination of the interior of the
heart shows no patent foramen ovale; the septum ventriculorum is complete.
From this case and from other considerations the orangutan appears to be highly variable as to its vascular system.
N o previous reports on anomalous venae cavae superiores in
orang-utan are found.
LITERATURE CITED
ABBWT,M. E. 1936 Atlas of Congenital Cardiac Disease. 62 pp. Am. Heart
ABBOC.,N. Y.
CEASE, R. E. 1938 The coronary arteries in 266 hearts of rhesus monkey. Am.
J. Phys. Anthrop., XXIII, 299-320.
1938 A case of persistent vena cava superior sinistra, associated
with patent foramen ovale and saphenous varicosity. Proc. Internat.
Ass. Med. Museums. (In press.)
DE GABIS, C. F. 1934 Pericardial patency and partial ectocardia in a newborn
orangutan. Anat. Rec., LIX, 69-82.
1935 Patterns of the aortic arch in a series of 133 macaques. J.
Anat., LXX, 149-158.
1938 Branches of the aortic arch in 153 rhesus monkeys (second
series). Anat. Rec., LXX, 251-262.
McConz~,
R. E. 1915 Three cases of persistence of the left superior veiia cava.
X,
,371-383.
Anat. k.
POYNTCB,
C. W. M. 1923 Congenital anomalies of the arteries and veins of the
human body with bibliography. University studies, XXII, 1-106.
Lincoln, Nebraska.
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