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The arterial blood supply of the conducting system in normal human hearts

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Abstract

The distributing artery of the conducting system of the heart is occasionally injured in cardiac surgery. The aim of this study was to define the anatomic characteristics of the principal arterial source of the sinu-atrial node and atrioventricular node. Furthermore, the morphology of the tendon of Todaro was clarified. Thirty hearts were studied by gross anatomic methods, and the exact area of the conducting system was supported by histologic observations of four hearts. The sinu-atrial node was supplied by the right coronary artery more frequently (73% of cases) than by the left (3%), and in 23% of cases this node was supplied by both coronary arteries. The atrioventricular node was supplied by the right coronary artery (80% of cases) more than by the left (10%), and in 10% of the cases this node was supplied by both coronary arteries. The atrioventricular bundle branch arose from the right coronary artery in 10% of cases, the left coronary artery in 73%, and both coronary arteries in 17%. Most of the blood to the right bundle (the moderator band) was supplied by the interventricular septal branches of the anterior interventricular branch from the left coronary artery. Finally, all the arteries of the right bundle and left bundle were defined to be derived from left coronary arteries. The French version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at http://dx.doi.org/10.1007/s00276-0020085-7.

Résumé

Il arrive parfois que la vascularisation artérielle du système cardionecteur soit blessée au cours de la chirurgie cardiaque. Le but de ce travail était de définir les caractéristiques anatomiques des principales sources artérielles pour les nœuds sinu-atrial et atrio-ventriculaire. De plus, nous avons clarifié la morphologie du tendon de Todaro. Trente cœurs ont été étudiés par les techniques d'anatomie macroscopique et la localisation exacte du système cardionecteur a été vérifiée par une étude cytologique sur quatre coeurs. Le nœud sinu-atrial était vascularisé par l'artère coronaire droite plus souvent (73% des cas) que par la gauche (3%) et, dans 23% des cas, il était vascularisé par les deux artères coronaires. Le nœud atrio-ventriculaire était vascularisé plus souvent par l'artère coronaire droite (80% des cas) que par la gauche (10%) et, dans 10% des cas, il était vascularisé par les deux artères coronaires. Le rameau destiné au faisceau atrio-ventriculaire naissait de l'artère coronaire droite dans 10% des cas, de l'artère coronaire gauche dans 73% des cas et des deux artères coronaires dans 17% des cas. L'essentiel de la vascularisation de la branche droite (″moderator band″) était fourni par les rameaux septaux interventriculaires du rameau interventriculaire antérieur de l'artère coronaire gauche. Enfin, toutes les artères destinées au branches droite et gauche dérivaient de l'artère coronaire gauche.

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Acknowledgement

The authors greatly appreciate the very kind instruction by Dr. Tatuo Shimada on how to expose the conducting system of the heart. His knowledge in this field was invaluable and contributed immensely to this study.

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Authors and Affiliations

  1. Department of Anatomy, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8602, Tokyo, Japan

    C. Futami, K. Tanuma & T. Saito

  2. Department of Anatomy, Teikyo University School of Medicine, Tokyo, Japan

    Y. Tanuma

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  1. C. Futami
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  2. K. Tanuma
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  3. Y. Tanuma
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  4. T. Saito
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Correspondence to C. Futami.

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The French version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at http://dx.doi.org/10.1007/s00276-0020085-7

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Futami, C., Tanuma, K., Tanuma, Y. et al. The arterial blood supply of the conducting system in normal human hearts. Surg Radiol Anat 25, 42–49 (2003). https://doi.org/10.1007/s00276-002-0085-7

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  • DOI: https://doi.org/10.1007/s00276-002-0085-7

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