McKay R, Anderson R H, Smith A
Institute of Child Health, Alder Hey Children's Hospital, Liverpool, England.
J Thorac Cardiovasc Surg. 1996 May;111(5):988-97. doi: 10.1016/s0022-5223(96)70375-6.
Gross morphologic study of 14 hearts with congenitally corrected transposition or discordant atrioventricular connections and double-outlet right ventricle or pulmonary atresia disclosed consistently the origins of the coronary arteries from two aortic sinuses. With usual atrial arrangement, the artery arising in sinus 1 (right-hand facing), as seen from the noncoronary aortic sinus, supplied the morphologically right ventricle. Coronary blood supply to the morphologically left ventricle usually came from sinus 2 (left-hand facing), although in two hearts the circumflex branch was a continuation of the artery from sinus 1. The sinus nodal artery arose from the circumflex coronary artery, and histologic studies of two hearts demonstrated that blood supply to the anterior atrioventricular node also came from this vessel. Early branching and entrapment in fat or right ventricular muscle, as well as malalignment of aortic and pulmonary sinuses, occurred frequently. These findings may have implications for coronary arterial transfer in the double switch operation in hearts with discordant atrioventricular connections.
对14例患有先天性矫正型大动脉转位或房室连接不一致以及右心室双出口或肺动脉闭锁的心脏进行大体形态学研究，结果始终显示冠状动脉起源于两个主动脉窦。在正常心房排列情况下，从无冠状动脉主动脉窦观察，起源于窦1（面向右侧）的动脉供应形态学上的右心室。形态学上左心室的冠状动脉供血通常来自窦2（面向左侧），不过在两颗心脏中，回旋支是来自窦1的动脉的延续。窦房结动脉起源于回旋冠状动脉，对两颗心脏的组织学研究表明，前房室结的血液供应也来自该血管。早期分支以及被脂肪或右心室肌肉包绕，还有主动脉窦和肺动脉窦的排列不齐，这些情况都很常见。这些发现可能对房室连接不一致的心脏在双调转手术中的冠状动脉转移有影响。
