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The behavior of three types of large sinus node arteries with regard to the blood supply of the atrial myocardium

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Abstract

Purpose

We describe angiographic findings of sinus node arteries (SNAs), focusing in the large sinus node artery (LSNA) variants, regarding the blood supply of the SN and atrial myocardium.

Methods

We examined the SN arteries via postmortem angiographic visualization in six hundred hearts derived from victims of various accidents.

Results

The main stem or a branch of the SNA supplied the right atrium (RA) and part of the interatrial septum (IS) in 32% of cases (Group A), one atrium, the IS and a small part of the other atrium (Group B) in 39% and the entire atrial myocardium (LSNAs) (Group C) in 29%. Forty-two percent (42%) of LSNAs were arising from the anterior part of the right coronary artery (RCA) (type 1), 9% from its intermediate part (type 2) and 49% from the posterolateral portion of the left circumflex artery (LCx) (type 3). Type 2 can be injured by surgical procedures, type 3 by interventional ones, while type 1 is not affected by any. The SN area was supplied in Groups A and B by the main stem of SN arteries in 370 cases (62%) and by branches (Br) in 55 (9%). The 175 cases of group C (29%) were supplied only by branches. The clockwise (40% of cases) and counterclockwise rotations (60%) of the SNA around the superior vena cava, concern surgical procedures.

Conclusion

The above findings are essential for every day surgical and interventional procedures.

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Acknowledgement

The authors thank the Hellenic Heart Foundation for its technical support.

Funding

The authors received no funding related to the conduction of this study.

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Authors and Affiliations

  1. Forensic Medical Service of Athens, Athens, Greece

    Christos E. Nerantzis & Soultana K. Marianou

  2. Department of Clinical Therapeutics, “Alexandra” General Hospital of Athens, School of Medicine, National and Kapodistrian University of Athens, 64 Knossou Str. Gerakas, 15344, Athens, Greece

    Hector Anninos

  3. Henry Dunant Hospital Center, Athens, Greece

    Sokratis Pastromas

Authors
  1. Christos E. Nerantzis
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  2. Hector Anninos
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  3. Soultana K. Marianou
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  4. Sokratis Pastromas
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Contributions

CEN: protocol/project development, manuscript writing/editing, data analysis. HA: manuscript writing/editing, data analysis. SKM: data collection or management. SP: data collection or management.

Corresponding author

Correspondence to Hector Anninos.

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The authors have no conflicts of interest/competing interests to disclose.

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Angiographic images are available. No tissue samples exist

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Nerantzis, C.E., Anninos, H., Marianou, S.K. et al. The behavior of three types of large sinus node arteries with regard to the blood supply of the atrial myocardium. Surg Radiol Anat 43, 311–316 (2021). https://doi.org/10.1007/s00276-020-02621-5

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  • DOI: https://doi.org/10.1007/s00276-020-02621-5

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