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  • Title: The behavior of three types of large sinus node arteries with regard to the blood supply of the atrial myocardium.
    Author: Nerantzis CE, Anninos H, Marianou SK, Pastromas S.
    Journal: Surg Radiol Anat; 2021 Mar; 43(3):311-316. PubMed ID: 33221970.
    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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