Inoue S, Becker A E
Department of Cardiovascular Pathology, Academic Medical Center, University of Amsterdam, The Netherlands.
Pacing Clin Electrophysiol. 1998 Aug;21(8):1553-8. doi: 10.1111/j.1540-8159.1998.tb00242.x.
Koch's triangle contains the compact part of the atrioventricular node and is anatomically delineated by the Eustachian ridge, the membranous septum, and the insertion of the tricuspid valve. Inferiorly, Koch's triangle ends at the site of the os of the coronary sinus and, in part, is continuous with the sub-Eustachian pouch. Catheter ablation procedures for several types of reentrant tachycardias are based on identifying these anatomical landmarks. Variability in the dimensions of Koch's triangle thus may be clinically relevant. We examined 50 hearts. Anatomical landmarks measured were the Eustachian ridge, the tricuspid valve, the overall length between the membranous septum and the coronary sinus, the width of the coronary sinus, the Eustachian ridge in its roof and the distance to the tricuspid valve, and that of the sub-Eustachian pouch. Individual variations were marked. The mean values (+/- SD) were: Eustachian ridge 29.4 +/- 5.3 mm, tricuspid valve 28.9 +/- 4.5 mm, coronary sinus 10.8 +/- 2.2 mm, Eustachian ridge 3.7 +/- 2.3 mm, space underneath coronary sinus 8.6 +/- 3.4 mm, and sub-Eustachian pouch 26.8 +/- 3.3 mm. The overall length varied between 15 and 38 mm, with a mean of 26.3 +/- 4.5. In conclusion, Koch's triangle shows considerable individual variations in size. Given the fact that the absolute figures for the range in size of the compact atrioventricular node is much less than that of Koch's triangle, these variations have implications for catheter ablation procedures.
科赫三角包含房室结的致密部分，在解剖学上由欧氏嵴、膜性间隔和三尖瓣的附着缘界定。在下方，科赫三角终止于冠状窦口处，部分与欧氏嵴下隐窝相连。几种折返性心动过速的导管消融手术都是基于识别这些解剖标志。因此，科赫三角尺寸的变异性可能具有临床意义。我们检查了50颗心脏。测量的解剖标志有欧氏嵴、三尖瓣、膜性间隔与冠状窦之间的总长度、冠状窦的宽度、欧氏嵴顶部及其与三尖瓣的距离以及欧氏嵴下隐窝的尺寸。个体差异明显。平均值（±标准差）为：欧氏嵴29.4±5.3毫米，三尖瓣28.9±4.5毫米，冠状窦10.8±2.2毫米，欧氏嵴3.7±2.3毫米，冠状窦下方间隙8.6±3.4毫米，欧氏嵴下隐窝26.8±3.3毫米。总长度在15至38毫米之间变化，平均值为26.3±4.5。总之，科赫三角在大小上显示出相当大的个体差异。鉴于致密房室结大小范围的绝对值远小于科赫三角，这些差异对导管消融手术有影响。
