The vascularized cardiac thrombus as a possible vicarious source of blood supply in ischemic human hearts

Abstract

A thrombus in the heart undergoes much the same evolutionnary change as elsewhere. It is covered by endothelium, and organized by fibroblasts and capillaries. In time, a more or less vascular connective tissue replaces part or all of the clot. In large vessels, the invasion of the thrombus by capillaries proceeds from the wall of the vessel involved, and from the patent parts of the lumen. New cappillaries which originate from one of these sources may connect with those derived from the other 1,2. Through communications thus established, blood from the lumen of the vessel may enter the vasa vasorum. It appeared possible that new vascular channels formed in the cardiac thrombus may similarly convey blood from the lumen of the heart to the myocardium. Our aim was to test this hypothesis anatomically. The study reported upon here was confined to thrombi associated with infarcts in the left ventricle of human hearts, and deals with the presence or absence of vascular intercommunications between the lumen of the left ventricle, the thrombus, and the myocardium. We have been unable to find reference to similar studies on record. A detailed account of the vascularization of thrombi in various chambers of hearts with and without infarcts will be given in a subsequent report.