Summary
The origin, course and mode of termination of the artery of the sinuatrial node was studied in 45 anatomic specimens by injection-dissection. It was solitary in 88.89% of the cases and double in 11.11%. It arose from the right coronary a. in 64.45% of cases, from the left coronary a. in 24.44%, and from both in 11.11%. The side of origin was not significantly influenced by the coronary dominance. When it arose from the right coronary a., the course of the sinuatrial a. varied greatly with its site of origin from the coronary vessel, either from an atrial a. or from one of its collateral branches, and also depended on its relations with the interatrial septum. When it arose from the left coronary a., its course was relatively uniform, except for arteries arising from the inferior atrial aa., which characteristically involve the posterior wall of the left atrium. Three modes of termination were found: precaval, retrocaval, and in a pericaval arterial circle. These observations made it possible to understand the possible origin of disorders of rhythm observed following disturbance of the arterial supply to the sinuatrial node during certain stages of cardiac surgery, particularly during atriotomies and the surgical correction of certain valvular disorders and congenital malformations, which expose the a. of the sinuatrial node.
Résumé
Sur 45 pièces anatomiques, les auteurs ont étudié, par la méthode d'injection-dissection, l'origine, le trajet et le mode de terminaison de l'a. du nœud sinu-atrial. Unique dans 88,89 % des cas, double dans 11,11 % des cas, elle naissait de l'a. coronaire droite dans 64,45 % des cas, de l'a. coronaire gauche dans 24,44 % des cas et des deux dans 11,11 % des cas. Ce mode d'origine n'a pas été influencé de manière significative par la dominance coronarienne. En cas d'origine droite, le trajet de l'artère a été très variable selon le niveau de naissance sur l'a. coronaire, selon qu'il s'agissait d'une a. atriale ou d'une de ses branches collatérales et selon ses rapports avec le septum interatrial. En cas d'origine gauche, le trajet est relativement stéréotypé à l'exception des artères naissant des aa. atriales inférieures qui ont la particularité d'intéresser la paroi postérieure de l'atrium gauche. Les trois modes de terminaison en précave, en rétrocave et en cercle artériel ont été rencontré. Ces observations anatomiques ont permis aux auteurs de comprendre l'origine possible des troubles du rythme observés à la suite d'une perturbation de l'apport artériel au nœud sinu-atrial au cours de certains temps de la chirurgie cardiaque, en particulier au cours des atriotomies et de la correction chirurgicale de certaines valvulopathies et malformations congénitales qui exposent l'a. du nœud sinu-atrial.
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References
Anderson KR, Hill RW (1982) Occlusive lesions of cardiac conducting tissue arteries in sudden infant death syndrome. Pediatrics 69: 50–52
Anderson KR, Ho SY (1979) Location and vascular supply of sinus node in human heart. Br Heart J 41: 28–32
Anderson RH, Ho SY, Becker AE (1983) The surgical anatomy of the conduction tissues. Thorax 38: 408–420
Biao-Ming He, Yun-Xi Tan, Mi-Cheng, Yi-Qun Cui (1991) The surgical anatomy of the sinoatrial node. Surg Radiol Anat 3: 123–128
Bokeriya LA, Mikhailin SI, Revishvili AS (1984) Anatomical variants of sinoatrial and atrioventricular node arteries. Cor Vasa 26: 220–228
Busquet J, Fontan F, Anderson RH, Ho SY, Davies MJ (1984) The surgical significance of the atrial branches of the coronary arteries. Int J Cardiol 6: 223–234
Christides C, Cabrol C (1975) Vascularisation des nœuds sinuatrial et atrioventriculaire. Arch Mal Cœur Vaiss 68: 1237–1242
Hadziselimovic H (1978) Vascularization of the conducting system in the human heart. Acta Anat Basel 102: 105–110
Halpern MH (1954) Arterial supply to the nodal tissue in the dog heart. Circulation 9: 547–554
James TN (1961) Anatomy of the coronary arteries. Huber, New York
James TN, Burch GE (1958) The atrial coronary arteries in man. Circulation 17: 90–98
Kozakewich HP, Mac Manus BM, Vawter GF (1982) The sinus node in sudden infant death syndrome. Circulation 65: 1242–1246
Kyriakidis M, Vyssoulis G, Barbetseas J, Toutouzas P (1988) A clinical angiographic study of the arterial blood supply to the sinus node. Chest 94: 1054–1057
Lekieffre J, Medvedowsky JL, Thery C (1979) Le noeud sinusal normal et pathologique. Sandoz, Saint Ouen
Mandarim de Lacerda CA, Hureau J (1986) Vascularisation artérielle des nœuds sinuatrial et atrioventriculaire et fréquence des branches des artères coronaires chez Papio Erxleben, 1777. Folia Primatol 46: 65–69
Nerantzis CE, Avgoustakis DG (1980) An S-shaped atrial artery supplying the sinus node area. An anatomical study. Chest 78: 274–278
Niemann JL, Etnevenot G, Cuilliere M, Cherrier F (1976) Variations de distribution des artères coronaires. A propos de 3000 coronarographies. Bull Ass Anat 60: 769–778
Romhilt DW, Hackel DB, Estes EH Jr (1968) Origin of blood supply to sinoauricular and atrioventricular node. Am Heart J 75: 279–281
Vieweg WV, Alpert JS, Hagan AD (1975) Origin of the sinoatrial and atrioventricular node arteries in right, mixed and left inferior emphasis systems. Cathet Cardiovasc Diagn 1: 361–373
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Sow, M.L., Ndoye, J.M. & Lô, E.A. The artery of the sinuatrial node: anatomic considerations based on 45 injection-dissections of the heart. Surg Radiol Anat 18, 103–109 (1996). https://doi.org/10.1007/BF01795227
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DOI: https://doi.org/10.1007/BF01795227