Forensic Medical Service of Athens, Athens, Greece.
Department of Clinical Therapeutics, "Alexandra" General Hospital of Athens, School of Medicine, National and Kapodistrian University of Athens, 64 Knossou Str. Gerakas, 15344, Athens, Greece.
Surg Radiol Anat. 2021 Mar;43(3):311-316. doi: 10.1007/s00276-020-02621-5. Epub 2020 Nov 22.
We describe angiographic findings of sinus node arteries (SNAs), focusing in the large sinus node artery (LSNA) variants, regarding the blood supply of the SN and atrial myocardium.
We examined the SN arteries via postmortem angiographic visualization in six hundred hearts derived from victims of various accidents.
The main stem or a branch of the SNA supplied the right atrium (RA) and part of the interatrial septum (IS) in 32% of cases (Group A), one atrium, the IS and a small part of the other atrium (Group B) in 39% and the entire atrial myocardium (LSNAs) (Group C) in 29%. Forty-two percent (42%) of LSNAs were arising from the anterior part of the right coronary artery (RCA) (type 1), 9% from its intermediate part (type 2) and 49% from the posterolateral portion of the left circumflex artery (LCx) (type 3). Type 2 can be injured by surgical procedures, type 3 by interventional ones, while type 1 is not affected by any. The SN area was supplied in Groups A and B by the main stem of SN arteries in 370 cases (62%) and by branches (Br) in 55 (9%). The 175 cases of group C (29%) were supplied only by branches. The clockwise (40% of cases) and counterclockwise rotations (60%) of the SNA around the superior vena cava, concern surgical procedures.
The above findings are essential for every day surgical and interventional procedures.
我们描述了窦房结动脉（SNAs）的血管造影表现，重点关注大窦房结动脉（LSNA）的变异，以了解窦房结和心房心肌的血液供应。
我们通过对来自各种事故受害者的 600 个心脏进行死后血管造影可视化检查，来研究 SN 动脉。
主支或 SN 分支供应右心房（RA）和部分房间隔（IS）的情况占 32%（A 组），供应一个心房、IS 和一小部分另一个心房（B 组）的占 39%，供应整个心房心肌（LSNAs）（C 组）的占 29%。42%的 LSNAs 起源于右冠状动脉（RCA）的前部分（1 型），9%起源于中间部分（2 型），49%起源于左回旋支（LCx）的后外侧部分（3 型）。2 型可能会被手术过程损伤，3 型可能会被介入过程损伤，而 1 型则不会。A 组和 B 组中，SN 动脉的主支供应了 SN 区的 370 个病例（62%），而分支供应了 55 个病例（9%）。C 组的 175 个病例（29%）仅由分支供应。SN 围绕上腔静脉顺时针（40%的病例）和逆时针（60%的病例）旋转，这与手术过程有关。
上述发现对于日常手术和介入过程至关重要。
