Multidetector CT imaging of arterial supply to sinuatrial and atrioventricular nodes

Abstract

The arteries that supply the sinuatrial node and atrioventricular node can be imaged with multidetector CT. These arteries have variations in number, origin and course.

The atherosclerosis of the sinus node artery is associated with an increased history of supra-ventricular arrhythmias: a retrospective study on 541 standard coronary angiograms

“…In this regard, we think that the real life data provided by this study may have a more immediate impact on the clinical practice suggesting to check when feasible the patency of the SNA during a standard coronary angiography, especially in the presence of a history of SVA. Furthermore, we provide some additional anatomic information regarding the left rather than right-sided origin of the SNA with the latter found to be slightly more frequent (57.7% vs. 45.1%), confirming the previous findings of older studies in European, North American and Brazilian subjects ( Cezlan et al, 2012 ; Saremi et al, 2008 ; Ortale, Paganoti & Marchiori, 2009 ). In our experience, the angiographic projection to visualize the SNA vary depending on the inconstant position and course of this vessel; however, we have observed that a right-sided SNA can be better visualized with a Right Anterior Oblique (RAO) straight (−30°; 0°) or a Left Anterior Oblique (LAO) cranial (+45°; +20°) view, whereas a LAO caudal “spider” view (+45°; −30°) or a RAO caudal view (−20°; −20°) are the most suitable to show a left-sided SNA branching from the proximal LCX.…”

Transient sinus arrest due to sinus node artery thrombus after revascularisation of the left circumflex artery

“…The SN is supplied by the SNA, one of the first branches of RCA in 61%, Cx in 37%, and both RCA and Cx in 2% of patients 6. After revascularisation of RCA and proximal Cx in our patient, the SNA was noted to have flush distal occlusion causing ischaemic SN dysfunction.…”

RE: An Unusual Course of Right Coronary Artery Originating from Sinoatrial Node Artery

“…We retrospectively analyzed the coronary CT angiography results of 875 consecutive patients and found that only two cases (0.2%) showed this type of origin and course of the sinoatrial node artery. The frequency of RCA originating from the S-shaped sinoatrial node artery has been reported as 0.25% and 0.4% ( 3 , 4 ). Since an unusual course of a coronary artery is important, especially in cardiovascular surgery, this rare subtype should be recognized and pointed out by radiologists.…”