Arterial blood supply of the human sinus node.

Verhaeghe, L; Hauwaert, L Van der

doi:10.1136/hrt.29.5.801

Cited by 25 publications

(10 citation statements)

References 9 publications

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“…What accounted for the reduced incidence of SND when the cavoatrial junction was preserved is mainly the pattern of blood supply to the ASD node [54,56]. Considering this fact, the incidence of SND was highest in surgical options requiring double-patch technique from our review.…”

Section: Discussionmentioning

confidence: 86%

“…While the location of the SA node can be predicted using the summit of the crest of the right atrial appendage and the sulcus terminalis as landmarks, on external examination of the heart; on the other hand the location of the artery supplying the node is less predictable, thus if surgical injury was to be prevented with certainty, then the entire cavoatrial junction should be avoided [54]. The sinus nodal artery which is the largest atrial coronary branch may originate from the right or left coronary artery and encircles the orifice of the SVC in either a clockwise or a counterclockwise direction [56]. Thus double-patch technique which requires the incision of the anterior portion of the SVC and also compromises the posterior applied blood supply because of a posterior suture line was associated with the highest incidence of SND.…”

Section: Discussionmentioning

confidence: 99%

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Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options

Okonta¹,

Sanusi²

2013

OJTS

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Background: Superior sinus venosus atrial septal defect (SV-ASD) is an interatrial defect with partial anomalous pulmonary venous connection (PAPVC) draining into the right atrium. The principle for SV-ASD surgical repair involves redirecting the pulmonary venous blood back to the left atrium and closure of the atrial septal defect without compromising the adjoining structures. Methods: We reviewed English literature relating to this topic via a MEDLINE and Google scholar search using the following terms: surgery for sinus venosus atrial septal defect (SV-ASD), surgery for partial anomalous pulmonary venous connection (PAPVC) and complications of the surgery. Results: A total of 910 consecutive cohort patients with different surgical options between 1984 to 2012 were analyzed. The breakdown showed that 291(32.0%) had single-patch, 275(30.2%) had Warden's procedure, 185(20.3%) had a double-patch and 159(17.5%) had use of autologous right atrial appendage for the anastomosis. The total follow-up was between 0.008-30 years. Sinus node dysfunction (SND) was the commonest complication occurring mostly in patients who had doublepatch technique 16(8.6%) followed by 15(5.5%) patients with single-patch technique, 7(4.4%) patients in whom right atrial appendage was used and 5(1.8%) patients with Warden's procedure. Venous obstruction occurred in 22(7.7%) patients with SP, 13(5.1%) patients with Warden's Procedure and 5(2.7%) patients with double-patch. Conclusion: The two major complications, SND and venous obstruction, assumed a seesaw approach as surgical maneuvers avoiding venous obstruction encouraged SND and vice versa. However, adopting surgical options which avoided incision across the Cavoatrial junction attenuated all the complications.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options

Okonta¹,

Sanusi²

2013

OJTS

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“…The characteristics of included studies are summarized in Table 1 . In the total of 66 studies (n = 21455 hearts) included in the meta-analysis, there were 42 cadaveric studies[ 3 , 5 – 8 , 10 , 11 , 13 , 14 , 16 – 22 , 27 – 31 , 35 – 38 , 40 – 42 , 44 , 45 , 48 , 51 , 52 , 54 , 56 , 59 , 67 – 72 ] and 24 imaging studies[ 9 , 12 , 15 , 23 – 26 , 32 – 34 , 39 , 43 , 46 , 47 , 49 , 50 , 53 , 55 , 57 , 58 , 73 – 76 ]. The modalities used in these imaging studies were either X-ray angiography (6 studies)[ 34 , 39 , 43 , 47 , 74 , 76 ] or Computed Tomography (CT) angiography (18 studies)[ 9 ,…”

Section: Resultsmentioning

confidence: 99%

Anatomical Variations in the Sinoatrial Nodal Artery: A Meta-Analysis and Clinical Considerations

et al. 2016

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Background and ObjectiveThe sinoatrial nodal artery (SANa) is a highly variable vessel which supplies blood to the sinoatrial node (SAN). Due to its variability and susceptibility to iatrogenic injury, our study aimed to assess the anatomy of the SANa and determine the prevalence of its anatomical variations.Study DesignAn extensive search of major electronic databases was performed to identify all articles reporting anatomical data on the SANa. No lower date limit or language restrictions were applied. Anatomical data regarding the artery were extracted and pooled into a meta-analysis.ResultsSixty-six studies (n = 21455 hearts) were included in the meta-analysis. The SANa usually arose as a single vessel with a pooled prevalence of 95.5% (95%CI:93.6–96.9). Duplication and triplication of the artery were also observed with pooled prevalence of 4.3% (95%CI:2.8–6.0) and 0.3% (95%CI:0–0.7), respectively. The most common origin of the SANa was from the right coronary artery (RCA), found in 68.0% (95%CI:55.6–68.9) of cases, followed by origin from the left circumflex artery, and origin from the left coronary artery with pooled prevalence of 22.1% (95%CI:15.0–26.2) and 2.7 (95%CI:0.7–5.2), respectively. A retrocaval course of the SANa was the most common course of the artery with a pooled prevalence of 47.1% (95%CI:36.0–55.5). The pooled prevalence of an S-shaped SANa was 7.6% (95%CI:2.9–14.1).ConclusionsThe SANa is most commonly reported as a single vessel, originating from the RCA, and taking a retrocaval course to reach the SAN. Knowledge of high risk anatomical variants of the SANa, such as an S-shaped artery, must be taken into account by surgeons to prevent iatrogenic injuries. Specifically, interventional or cardiosurgical procedures, such as the Cox maze procedure for atrial fibrillation, open heart surgeries through the right atrium or intraoperative cross-clamping or dissection procedures during mitral valve surgery using the septal approach can all potentiate the risk for injury in the setting of high-risk morphological variants of the SANa.

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“…The sinus node artery in many kinds of species has been demonstrated, including human (Verhaeghe and Van Der Hauwaert, 1967; Anderson et al, 1979; DiDio et al, 1995; Kawashima and Sasaki, 2003), camel (Ghazi and Tadjalli, 1996), bovine (James, 1965), horse (Bishop and Cole, 1967), sheep (Yalcin et al, 2004), dog (Izumisawa et al, 1994), and rabbit (James, 1967).…”

Section: Introductionmentioning

confidence: 99%

Morphological Study of the Sinus Node and Its Artery in Yak

Duan

Cui

2012

The Anatomical Record

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The sinus node of yak has been studied by the histological methods and transmission electron microscopy. The sinus node artery of yak was also determined by the injection-corrosion casting technique, the angiography, and histological methods. The results showed that the sinus node of yak contained an extensive framework of collagen and two main type cells: pacemaker cells (P cells) and transitional cells (T cells). The P cells had a perinuclear clear zone, contained less myofibrils, and appeared smaller mitochondria than T cells. The T cells were longer and slender than P cells, and had a variety of shapes. At the periphery of sinus node there were many nerve fibers and ganglions. Gap junction did not reveal reaction with anti-connexin43, but it was detected by electron microscopy in the central part of sinus node of yak. The sinus node artery of yak originated from left coronary artery more frequently (98%) than by right (2%). The artery located at the periphery of sinus node. It had an internal elastic membrane throughout its course, and a large nerve bundle was found running in a longitudinal direction.

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Arterial blood supply of the human sinus node.

Cited by 25 publications

References 9 publications

Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options

Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options

Anatomical Variations in the Sinoatrial Nodal Artery: A Meta-Analysis and Clinical Considerations

Morphological Study of the Sinus Node and Its Artery in Yak

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