Valencia, Venezuela

The investigators : the hypothesis is that the ductus venosus is a special anatomic structure with a special regulating function of the blood flow that need its own innervation and muscular composition to acts contracting or relaxing and therefore changing the qualities of the blood flow through it .

This is a study of the anatomy and function of the ductus venosus. We studied the tissular characterization of the ductus venosus muscular valve for muscle fibers and nervous tissue. As can be seen in the trichromic coloration there is a lot of red fibers that represent the smooth muscle and with the imunohistochemistry S100 , the brown structures are nervous tissue. There are also vasa vasorum, so the ductus venosus has a specific function with its own vasa vasorum and innervation ....like and organ!!!!

Figure1: Anatomic sagittal dissection in the liver showing the umbilical vein entrance, the portal sinus and the ductus venosus as a terminal vessel forming the sub-diaphragmatic venous vestibulum with the inferior cava vein and hepatic vein in the base of the right atrium.

Figure 2: The complete dissection of the umbilical-portal vasculature, the hepatic parenchyma was taken away to leave only the vascular tree.

Figure3: Power Doppler ultrasound showing the echographic / anatomic correlation of the subdiaphragmatic venous vestibulum (HV = hepatic vein, UV = umbilical vein, DV = ductus venosus, ICV = Inferior vena cava)

Figure 4: Two different ways (axial and sagittal view) to explore the ductus venosus Doppler and the normal pulsed Doppler wave with its 3 components S-D-A (ventricular Systole/ventricular Diastole/ Atrial systole) and no reverse flow.

Figure 5: Left figure: Frontal picture of the cardiohepatic block with umbilical cord. Middle figure: Posterior view: the black line is the plane of coronal dissection  to find at last the right figure with the whole vascular portal sinus

Figure 6: Microscopic view of different segment of the portal sinus and its roots to see that the ductus venosus inlet has a special prominent structure in the anterior wall of the vase with a thick muscular wall that projects into the lumen and  that is not present in the portal sinus or in the hepatic vein

Figure 7: Three different microscopic studies with hematoxilin/eosin coloration showing the muscular prominence into the vessel from the anterior wall of the ductus venosus inlet that may contribute to make it wide or  narrow according with necessities of blood flow.

Figure 8:  The special coloration. Trichromic shows in red the smooth muscle composition  of the wall prominence that we call "muscular valve†( that acts like a water dam door)

Figure 9: Special inmunohistochemistry  coloration with antibodies for neural tissue S100 shows in brown the presence of neural tissue, fibers  and cells.