Anatomy & Physiology: Current Research
Open Access

Diagnosis of Lymphodynamics in Congenital Heart Diseases

Ahila Sunen^{* *}Correspondence: Ahila Sunen, Department of Anatomy, University of Vaasa, Vaasa, Finland, Email:

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Description

The lymphatic system performs a variety of critical physiological functions, including fluid balance between the plasma and interstitial compartments of the extracellular space by returning protein and fluid filtered out of capillaries to the vascular system and fat absorption from the small intestine.

It also maintains important immune functions; various antigens and activated antigen-presenting cells are transported into lymph nodes and export immune effector cells and humoral response factors into the blood circulation. The lymphatic vascular system is divided into two types of vessels: noncontractile initial lymphatic networks and collecting vessels. The anchoring filaments of lymphatic endothelial cells are strongly attached to the surrounding collagen and elastin fibres.

These cells have interdigitated junctions and, single-contact junctions. These junctions can be opened during expansion of the initial lymphatic vessels, allowing fluid to flow from the interstitium into the lymphatic vessels, whereas overlapping junctions can be closed during compression, attenuating the return of lymph flow into the interstitium. If the lymphatic pressure rises, the safety function is activated, and the system responds by increasing the amount of lymph stored and transported by the system.

Lymphatic capillaries drain into precollecting vessels, which are then connected to larger collecting lymphatic vessels. The lymphatic drainage system demonstrates an extremely efficient centripetal flow of lymph, which is supplemented by rhythmic contractions.

The duct is usually double or plexiform below the fifth thoracic vertebra and singular above the fifth thoracic vertebra. The Thyroid Disorder ascends behind the aortic arch and the thoracic part of the left subclavian artery, between the left side of the oesophagus and the left pleura, to the thoracic inlet at the fifth thoracic vertebra. It concludes by opening into the angle formed by the junction of the left subclavian vein and the left internal jugular vein. Due to the proximity of lymphatic vessels to cardiac structures manipulated during surgical repair of congenital heart defects, TD trauma can occur.

Furthermore, abnormally high venous pressure is common following congenital heart surgery. The effects of abnormal physiological states found in congenital heart disease on lymphatic circulation. The lymphatic circulation's long oblivion in paediatric cardiology.

Several contributions have demonstrated its relevance and effect on devastating complications after surgery, such as effusions, chylothorax, plastic bronchitis, and protein-losing enteropathy. Lymphodynamics and the identification of three types of lymphatic failure: traumatic leak from a TD branch; pulmonary lymphatic perfusion syndrome, which occurs when retrograde flow from the TD to the lung or mediastinum; and central lymphatic flow disorder, a newly identified condition with abnormally low or absent central lymphatic flow, effusions in more than one compartment, and dermal backflow through abdominal lymphatic collaterals.

It is not surprising that the vast majority of patients in this most recent contribution had conditions associated with increased central venous pressure and secondary impaired lymphatic drainage. In pure right heart failure, as seen in circulations, the lung is subjected to a paradox in which lymph from the lung is required to drain at a higher pressure than it is created. Both the pulmonary arteriolar pressure and the pulmonary capillary wedge pressure are greater than the central venous pressure in the normal lung, resulting in normal fluid reabsorption. Because more than 80% of total lung arterial flow returns to the heart via pulmonary veins after the superior cavopulmonary anastomosis, the lung interstitium is subjected to normal hydrostatic pressure.

However, because the lymphatic circulation drains at a higher pressure than normal, there is a constant proclivity for fluid accumulation in the lung. As lymphatic drainage resistance increases, lymphatic endothelial cells adhere and lymph cannot be effectively removed from the interstitium.