Dean J W, Ho S Y, Rowland E, Mann J, Anderson R H
St. George's Hospital Medical School, London, England.
J Am Coll Cardiol. 1994 Dec;24(7):1725-31. doi: 10.1016/0735-1097(94)90179-1.
This study reevaluated the anatomy of the areas anterior and posterior to the atrioventricular (AV) septal structures, previously said to represent anterior and posterior septal areas.
In descriptions of the locations of accessory AV pathways within the AV junctions, four regions have been recognized: the left and right free walls and the anterior and posterior septums. On the basis of known facts concerning cardiac structure, it is questionable whether these so-called septums are truly septal.
Ten human hearts were dissected to elucidate the clinical anatomy of these purportedly septal regions, together with the overall arrangement of the AV junctions.
The true septal components of the AV junctions are the muscular and membranous AV septal areas. These separate the cavity of the right atrium from that of the left ventricle. The region previously designated as the anterior septum is part of the right parietal junction. It is contiguous with the membranous part of the septum but extends anteriorly and laterally from the septum as part of the supraventricular crest of the right ventricle ("crista supraventricularis"). In the region posterior to and beneath the mouth of the coronary sinus, only the most anterior extent, in continuity with the central fibrous body, is part of the muscular AV septum. The posterior extent of this area roofs over the diverging right and left ventricular walls and is filled in with fibroareolar tissue of the AV groove.
The larger part of the regions anterior and posterior to the true AV septal areas are not septal but are parts of the parietal AV junctions. An understanding of these anatomic relations is essential for those wishing to modify conduction across the AV junctions.
本研究重新评估了房室（AV）间隔结构前后区域的解剖结构，此前这些区域被认为代表前后间隔区域。
在描述房室交界区内附加房室通路的位置时，已识别出四个区域：左右游离壁以及前后间隔。基于有关心脏结构的已知事实，这些所谓的间隔是否真的是间隔值得怀疑。
解剖了10颗人类心脏，以阐明这些所谓间隔区域的临床解剖结构以及房室交界区的整体布局。
房室交界区真正的间隔成分是肌肉性和膜性房室间隔区域。这些区域将右心房腔与左心室腔分隔开。先前被指定为前间隔的区域是右壁交界区的一部分。它与间隔的膜性部分相邻，但从间隔向前和向外侧延伸，作为右心室室上嵴（“室上嵴”）的一部分。在冠状窦口后方和下方的区域，只有与中心纤维体连续的最前部是肌肉性房室间隔的一部分。该区域的后部覆盖在左右心室壁分叉处上方，并填充有房室沟的纤维乳晕组织。
真正的房室间隔区域前后的大部分区域并非间隔，而是壁侧房室交界区的一部分。对于那些希望改变房室交界区传导的人来说，了解这些解剖关系至关重要。
