Boppana V Subbarao, Castaño Adam, Avula Uma Mahesh R, Yamazaki Masatoshi, Kalifa Jérôme
Internal Medicine, SUNY Upstate Medical Center, Syracuse.
Internal Medicine, Columbia University Medical Center, New York.
J Atr Fibrillation. 2011 Sep 30;4(3):375. doi: 10.4022/jafib.375. eCollection 2011 Sep-Nov.
Coronary anatomy has traditionally focused on ventricular circulation. This is largely due to the extent to which coronary artery disease contributes to ischemic heart disease through ventricular myocardial damage. Atrial fibrillation and other tachyarrhythmias that involve the atria, however, remain a major cause of morbidity and mortality. In order to increase mechanistic research and therapeutic interventional procedures for diseases of the atria, an optimal knowledge of atrial anatomy is necessary. While substantial clarity exists regarding the distribution of nerve terminals and the organization of muscle bundles, the anatomy of coronary atrial circulation remains understudied. Historically, the high anatomical variability of atrial coronary branches led to unstandardized nomenclature in the literature. In this review, we delineate the anatomic courses of key atrial coronary branches and their perfusion territories, clarify their nomenclature, and propose unifying anatomical concepts of atrial circulation that we believe to be critical to the success of modern electrophysiologic and surgical procedures.
传统上，冠状动脉解剖学主要关注心室循环。这在很大程度上是由于冠状动脉疾病通过心室心肌损伤导致缺血性心脏病的程度。然而，心房颤动和其他涉及心房的快速性心律失常仍然是发病和死亡的主要原因。为了增加对心房疾病的机制研究和治疗干预程序，有必要对心房解剖学有最佳的了解。虽然关于神经末梢的分布和肌束的组织已经有了相当清晰的认识，但冠状窦心房循环的解剖学仍未得到充分研究。从历史上看，心房冠状动脉分支的高度解剖变异性导致文献中命名不规范。在这篇综述中，我们描绘了关键心房冠状动脉分支的解剖路径及其灌注区域，阐明了它们的命名，并提出了我们认为对现代电生理和外科手术成功至关重要的统一心房循环解剖学概念。
