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心脏房室结支的解剖学研究

Anatomical Study of the Atrioventricular Nodal Branch of the Heart.

作者信息

Iwanaga Joe, Manoharan Sreeganesh, Cardona Juan J, Anadkat Samir, Saga Tsuyoshi, Loukas Marios, Tubbs R Shane

机构信息

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA.

Department of Neurology, Tulane University School of Medicine, New Orleans, USA.

出版信息

Cureus. 2023 Feb 24;15(2):e35412. doi: 10.7759/cureus.35412. eCollection 2023 Feb.

Abstract

Background The atrioventricular (AV) node is a relay station for electrical signals passing between the atria and ventricles. The artery supplying the AV node is functionally important, and its anatomical topography is relevant during invasive procedures. Therefore, the aim of this study was to identify and understand the variations of the origin of the AV nodal branch (AVNb) and its variations. Materials and methods We dissected 31 adult human hearts to evaluate their AVNb and its variations. A classification scheme was used to detail the morphology found for each of these arteries. Results We identified five distinct origins of the AVNb: AVNb originating from the right coronary artery (RCA) proximal to the inferior interventricular branch (IVb) (type I, 3.2%), AVNb originating from the junction of the RCA and IVb (type II, 19.4%), AVNb originating from the RCA distal to the IVb (type III, 64.5%), AVNb originating from the IVb (type IV, 6.5%), and AVNb originating from the circumflex branch of the left coronary artery (LCA) (type V, 6.5%). Conclusions Our study provides data on the morphology and variations of the AVNb. Such information can assist in better diagnoses based on imaging, better guide invasive procedures, and provide the cardiac surgeon with an improved method of classifying the AVNb and its branches during procedures of the coronary arteries and their branches.

摘要

背景

房室(AV)结是心房和心室之间电信号的中继站。供应房室结的动脉在功能上很重要,其解剖形态在侵入性手术中具有相关性。因此,本研究的目的是识别和了解房室结分支(AVNb)起源的变异情况。

材料与方法

我们解剖了31颗成人心脏,以评估其AVNb及其变异情况。采用一种分类方案来详细描述这些动脉各自的形态。

结果

我们确定了AVNb的五种不同起源:起源于右冠状动脉(RCA)在室间支(IVb)近端的AVNb(I型,3.2%),起源于RCA与IVb交界处的AVNb(II型,19.4%),起源于RCA在IVb远端的AVNb(III型,64.5%),起源于IVb的AVNb(IV型,6.5%),以及起源于左冠状动脉(LCA)回旋支的AVNb(V型,6.5%)。

结论

我们的研究提供了关于AVNb形态和变异的数据。这些信息有助于基于影像学进行更好的诊断,更好地指导侵入性手术,并为心脏外科医生在冠状动脉及其分支手术过程中提供一种改进的AVNb及其分支分类方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45ae/10042528/2a7ddd85b195/cureus-0015-00000035412-i01.jpg

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