Ho S Y, Anderson R H
Department of Paediatrics, National Heart and Lung Institute, Imperial College School of Medicine, London, United Kingdom.
J Cardiovasc Electrophysiol. 2000 Jan;11(1):83-9. doi: 10.1111/j.1540-8167.2000.tb00741.x.
Although well recognized by anatomists as a border of the triangle of Koch demarcating the location of the AV node, the tendon of Todaro is not visible in the operating room or in the catheterization laboratory. Instead, clinicians use as surrogate a projected line between the eustachian valve and the central fibrous body. The constancy of the tendon of Todaro within this border remains to be determined.
We reexamined serial histologic sections from 25 adults and 50 infants and gross dissections in four normal hearts. The tendon of Todaro was identified in all cases and traced to the central fibrous body in all but one case. It tended to be thicker in the hearts of infants cases (0.2 to 0.8 mm vs 0.1 to 0.6 mm). The tendon and the hinge-line of the septal leaflet of the tricuspid valve were consistent as landmarks for location of the compact AV node in all the cases studied by histology. Gross dissections traced the tendon to the free edge of the eustachian valve.
The tendon of Todaro is present in hearts obtained from both adults and infants. It, or its surrogate, is a reliable border for the triangle of Koch and serves as a landmark to location of the atrial components of the AV conduction axis.
尽管解剖学家已充分认识到托达罗腱是界定房室结位置的科赫三角的边界，但在手术室或心导管室中却看不到托达罗腱。相反，临床医生使用位于欧氏瓣和中心纤维体之间的一条投影线作为替代物。托达罗腱在该边界内的恒定情况仍有待确定。
我们重新检查了来自25名成年人和50名婴儿的连续组织学切片以及4颗正常心脏的大体解剖标本。在所有病例中均识别出了托达罗腱，除1例病例外，在所有病例中均追踪到其与中心纤维体相连。在婴儿心脏中它往往更厚（0.2至0.8毫米，而成年人心脏中为0.1至0.6毫米）。在所有组织学研究的病例中，托达罗腱和三尖瓣隔叶的铰链线作为致密房室结位置的标志是一致的。大体解剖将该腱追踪至欧氏瓣的游离缘。
托达罗腱存在于取自成年人和婴儿的心脏中。它或其替代物是科赫三角的可靠边界，并作为房室传导轴心房部分位置的标志。
