Arterial vascularisation of the atrioventricular node

Arid, Jean Marc El; Armstrong, O.; Rogez, J.-M.; Robert, R; Lardoux, M. C.; Leborgne, J

doi:10.1007/s00276-000-0093-4

Cited by 20 publications

(5 citation statements)

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“…In 80-87% of patients, atrioventricular nodal artery arises from distal RCA and penetrates to the posterior interatrial septum base at the level of heart crux. In the remaining patients, it arises from terminal part of LCX (8-13%) or rarely from left anterior descending artery (2-10%) [2,3,24]. Pejković et al [21] defined AVNA as the first and the longest inferior septal perforator branch that usually arose from RCA (90%) and infrequently from LCX artery (10%).…”

Section: Discussionmentioning

confidence: 99%

Multidetector CT imaging of arterial supply to sinuatrial and atrioventricular nodes

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Multidetector CT imaging of arterial supply to sinuatrial and atrioventricular nodes

et al. 2011

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“…Left‐sided origin results in traversing in front of cardiac sulci through the inferior atrioventricular sulcus, near the opening of the coronary sinus, towards the Koch's triangle apex, as found in a previous study by Sow et al (1996). As the course of the AVNA is highly variable, another study performed by Adrid et al (2000) found the AVNA's course to be proximal to the tricuspid valve's septal cusp as well as the aortic ring.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 5028 articles were initially evaluated by two independent reviewers. Eventually, 33 articles met the required criteria and were used in this meta‐analysis (James & Burch, 1958; Romhilt et al, 1968; Vieweg et al, 1975, 1982; Hutchinson, 1978; Anderson & Murphy, 1983; Brugada et al, 1990; Wang et al, 1990; Sneddon et al, 1991; Burke et al, 1993; Krupa, 1993; Sow et al, 1996; Arid et al, 2000; Lin, 2000; Sanchez‐Quintana et al, 2001; Futami et al, 2003; Kaplana, 2003; Berdajs et al, 2008; Pejković et al, 2008; Saremi et al, 2008; Nerantzis et al, 2009; Paulsen & Vetner, 2009; Ramanathan et al, 2009; Rusu et al, 2009; Ballesteros et al, 2010; El‐Maasarany et al, 2010; Cezlan et al, 2012; Kazemisaeid et al, 2012; Sabnis & Silotry, 2012; Verma et al, 2014; Divyaprakash et al, 2016; Kawashima & Sato, 2018; Iwanaga et al, 2023). The overall data collection process can be found in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

The anatomy of the atrioventricular nodal artery: A meta‐analysis with implications for cardiothoracic surgery and ablation procedures

et al. 2023

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The objective of the present meta‐analysis was to evaluate recent and applicable data regarding the location and variation of the atrioventricular nodal artery (AVNA) in relation to adjacent structures. In order to minimize postoperative risks and maintain physiological anastomosis for proper cardiac function, understanding such possible variations of vascularization of the AV node is of immense importance prior to cardiothoracic surgery as well as ablations. In order to perform this meta‐analysis, a systematic search was conducted in which all articles regarding, or at least mentioning, the anatomy of the AVNA was searched. In general, the results were based on 3919 patients. AVNA was found to originate only from the RCA in 82.41% (95% CI: 79.46%–85.18%). The pooled prevalence of AVNA originating only from LCA was found to be 15.25% (95% CI: 12.71%–17.97%). The mean length of AVNA was found to be 22.64 mm (SE = 1.60). The mean maximal diameter of AVNA at its origin was found to be 1.40 mm (SE = 0.14). In conclusion, we believe that this is the most accurate and up‐to‐date study regarding the highly variable anatomy of the AVNA. The AVNA was found to originate most commonly from the RCA (82.41%). Furthermore, the AVNA was found to most commonly have no (52.46%) or only one branch (33.74%). It is hoped that the results of the present meta‐analysis will be helpful for physicians performing cardiothoracic or ablation procedures.

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“…Arid et al also found, in 33,33% of the specimens with "right coronary dominance" (there was made no distinction with the hyperdominance), the AVNA leaving "from the terminal part of the right coronary a., as well as the left retroventricular a. and the posterior interventricular a. thus forming a sort of trifurcation" -in our study we defined as trifurcated only the arteries (RCA's, type IV) with adjacent origins of the PIVA, left RVA and AVNA and if the AVNA emerged from the initial part of the RVA or the PIVA we considered that artery as origin (types II and III) and didn't take the RCA branching pattern as trifurcation. Moreover, Arid et al didn't found any specimen with the AVNA leaving the Uturn of the RCA, with left RVA absent [5].…”

Section: Discussionmentioning

confidence: 99%

Morphofunctional considerations on the atrioventricular node arterial vascularization

Rusu¹,

Ferechide²,

Cristian³

et al. 2009

Rom J Leg Med

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The atrioventricular node (AVN) is the relay station for electrical impulses passing from the atria to the ventricles. The arterial resources of the AVN are functionally relevant and may be interfered by various surgical procedures which deal with the cardiac valves. Our study aim to bring detailed evidences on the arterial supply of the AVN. We dissected and microdissected 50 human adult hearts without any known history or evident cardiac pathology, in order to evidence the arterial suppliers of the AVN; subepicardial dissections were continued in the interatrial septum (the triangle of Koch). We were able to define 5 morphological types (each with distinctive subtypes) of the atrioventricular node artery (AVNA) emerged at crux cordis: type I (22%, AVNA from the U-turn of the right coronary artery (RCA), the left retroventricular artery (RVA) absent), type II (18%, AVNA from PIVA, left RVA present), type III (34%, AVNA from the left RVA, PIVA from the RCA), type IV (AVNA from the bifurcation of the RCA into the PIVA and the left RVA-trifurcated RCA) and type V (AVNA from the circumflex artery). In 18% of specimens we found duplicated AVNA. In 22% of specimens, the AVN area was additionally supplied by the descending septal artery (right descending superior artery) originating from the sinoatrial artery, on the right side of the aorta. The origin of the AVNA, which is variable, and the accessory resources, such as the descending septal artery, can explain the possible individual occurrences of the cardiac rhythm alterations determined by coronary ischemia. Our AVNA types are all related to the atrioventricular and aortic valves and thus liable to damage during specific surgical procedures, interfering with the respective valves. Duplicated AVNAs must be kept in mind during the selective atrioventricular nodal artery catheterizations and AVNA must be evaluated angiographically prior to the interventions. Our study demonstrates that classical dissections combined with microdissections can still offer valuable informations for a pathologist assigning not only the mechanisms but also the morphological conditions of the cardiac arrest. A seek and search investigation is launched in every sudden cardiac death: the forensic pathologist make a good team with the anatomist retrieving very useful etiological data.

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Arterial vascularisation of the atrioventricular node

Cited by 20 publications

References 4 publications

Multidetector CT imaging of arterial supply to sinuatrial and atrioventricular nodes

Multidetector CT imaging of arterial supply to sinuatrial and atrioventricular nodes

The anatomy of the atrioventricular nodal artery: A meta‐analysis with implications for cardiothoracic surgery and ablation procedures

Morphofunctional considerations on the atrioventricular node arterial vascularization

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