[Anatomy of the valve system of the internal jugular vein].
BACKGROUND
Central venous catheters (CVC) in the internal jugular vein have become an important adjunct to the overall management of intensive care patients, but their use is associated with frequent neck complications. In a review of the literature anatomical variation in size, form and function of the valve system of the internal vein was found.


OBJECTIVE
This study macroscopically and microscopically investigates the anatomical variety of the vein valves of the inferior internal jugular vein.


METHODS
100 cadavers from legal autopsies were investigated. We selected 45 patients with an acute myocardial infarction death and a control group (55 patients) formed by different causes of death. The veins were prepared for light microscopic study, the specimens were serially sectioned (ca. 30 sections) and stained with hematoxylin and eosin.


RESULTS
Anatomical variety was observed predominantly unilateral on the right side of the internal jugular vein. The valves were often bicuspid at the right side (92%) and tricuspid on the left side (64%) and mostly located ca. 2 cm above the subclavia-jugularis bifurcation. In the histological study, a variability of the net of collagen and elastin fibres in the tunica intima and media was observed. The structure of the adventitia was constant. 18 patients with a jugular valve vein incompetence (age over 60) appeared to have thickening of the tuberculum in the sinus of the valve. The cups of the valves were found rudimentary in these patients with advanced stages of tricuspid incompetence.


CONCLUSIONS
The present study demonstrates the variety of the valves of the jugular vein. They play an important role to impede the retrograde flow during cardiopulmonary resuscitation as well as in jugular vein cannulation.
HNO-Klinik der Universität Hamburg.
M
M
Sanchez-Hanke
K
K
Püschel
R
R
Leuwer
D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy; D002102:Cadaver; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003094:Collagen; D004396:Coloring Agents; D004549:Elastin; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007601:Jugular Veins / Q000033:anatomy & histology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology; D012151:Resuscitation; D017539:Tunica Intima / Q000033:anatomy & histology / Q000473:pathology; D017540:Tunica Media / Q000033:anatomy & histology / Q000473:pathology
D004396:Coloring Agents; D003094:Collagen; D004549:Elastin