THE LYMPHATIC SYSTEM OF THE HEART
- RA Johnson
In recent years lymphatics of the heart have been studied with renewed interest. There have been investigations of the drainage and composition of cardiac lymph (1, 2, 3, 4, 5) as well as studies on the effects of impeding the flow of lymph from the heart through major drainage channels (6, 7). However, many facets of the anatomical details of the intrinsic lymphatic vasculature of the heart itself are still lacking. The more recent anatomical studies (8, 9, 10, 11) have been with injection techniques to acquire information concerning lymphatics in the mammalian heart. In addition, investigations have added further to the knowledge of the relationship of lymphatics to the valves of the heart (9, 12) and have implied also a pathogenic relationship of impaired myocardial lymph drainage to endocardial fibroelastosis (13). We have observed in our laboratory that masses injected into either the coronary artery or vein in pig and dog hearts appear readily in the lymphatic system suggesting presence of lymphatic-blood vascular communications (11).
In general, the major factors interfering with obtaining adequate information about the anatomical features of cardiac lymphatics are the limitations of the available methods of study. The small size and delicate structure of peripheral lymphatics and the presence of valves practically preclude their demonstration by direct injection. Often lymphatics are visualized with vital dyes which are injected into living specimens. In 1922 Magnus and Stubel (14) described a method of demonstrating lymphatics on serous surfaces in nonviable tissue by the direct application of hydrogen peroxide. This method in conjunction with injection techniques was applied in our laboratory to delineate some of the anatomical relationships of subepicardial and subendocardial lymphatics of the heart (15).
How to Cite:
Johnson, R., (1969) “THE LYMPHATIC SYSTEM OF THE HEART”, Lymphology 2(3), 95-108.