scholarly journals Location of sinoatrial artery and atria

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Jantraprapavech ◽  
W Boonyapisit

Abstract Background Clinically manifested injury to the coronary arteries during catheter ablation procedures for atrial arrhythmias is rare. Injury to sinoatrial artery can cause sinus arrest and lead to permanent pacemaker implantation. Previous studies only described the anatomy of the artery but not the relation with atrium. Objective Our study aims to illustrate the course of the sinoatrial artery in relation to the atrium. Methods The images of coronary computed tomography angiography (CCTA) of 110 patients performed from June to September 2019 were reviewed. Results The sinus node was supplied by either single artery (98.18%) or dual blood supply (1.82%). Sinoatrial artery mostly originates from right coronary artery (56.25%), followed by left circumflex artery (42.85) and the aorta (0.90%). When sinoatrial artery originated from right coronary artery or the aorta, it ran medially to the right atrium which its course vertically lied within 0.35±0.51 cm above and 1.45±0.63 cm below the superior vena cava-right atrium junction. The artery then passed between left atrium and right atrium, which 21.88% of the course ran within 0.5 cm from the right upper pulmonary vein ostium. When sinoatrial artery arises from left circumflex artery, 95.83% of this pathing were anterior to left atrial appendage. Only 4.17% went along anteriorly to the left upper pulmonary vein. Most of sinoatrial artery that arises from left circumflex artery (97.92%) ran pass the upper one-third of left atrium, then ran toward posteroseptum of right atrium. This course vertically lied within 0.51±0.73 cm above and 0.67±0.83 cm below the superior vena cava-right atrium junction. Additionally, we found that 39.58% of sinoatrial artery arises from left circumflex artery course lied within 0.5 cm from right upper pulmonary vein ostium. Conclusion Exceeding precaution while performing radiofrequency ablation at anterior upper one-third left atrium, base of left atrium appendage, upper part septal wall of right atrium and right upper pulmonary vein ostium should be established to prevent sinoatrial artery injury. FUNDunding Acknowledgement Type of funding sources: None.

Author(s):  
Murali Chiravuri ◽  
Thomas M. Tadros ◽  
Usha B. Tedrow

In the normal heart the sinoatrial (SA) node serves as the principal pacemaker and determines the heart rate. The SA node consists of groups of pacemaker cells marked by their ability to spontaneously depolarize and are located at the junction of the right atrium and the superior vena cava. The blood supply to the SA node is variable with the sinus nodal artery arising from the right coronary artery in 60% percent of cases and from the left circumflex artery in 40% of cases. Following depolarization of the SA nodal cells, the signal traverses the atrium before arriving at the atrioventricular (AV) node. The AV node is marked by its ability to delay impulse propagation, which allows for coordinated contraction of the atria and ventricles. The AV nodal artery arises from the right coronary artery in 90% of cases and from the left circumflex artery in 10% of cases. After exiting the AV node, the impulse is transmitted through the bundle of His, the right and left bundle branches, and ultimately exits the terminal Purkinje fibers of the conduction system into the myocardium near the apex of the heart.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Marco Clement ◽  
R Eiros ◽  
R Dalmau ◽  
T Lopez ◽  
G Guzman ◽  
...  

Abstract Introduction The diagnosis of sinus venosus atrial septal defect (SVASD) is complex and requires special imaging. Surgery is the conventional treatment; however, transcatheter repair may become an attractive option. Case report A 60 year-old woman was admitted to the cardiology department with several episodes of paroxysmal atrial flutter, atrial fibrillation and atrioventricular nodal reentrant tachycardia. She reported a 10-year history of occasional palpitations which had not been studied. A transthoracic echocardiography revealed severe right ventricle dilatation and moderate dysfunction. Right volume overload appeared to be secondary to a superior SVASD with partial anomalous pulmonary venous drainage. A transesophageal echocardiography confirmed the diagnosis revealing a large SVASD of 16x12 mm (Figure A) with left-right shunt (Qp/Qs 2,2) and two right pulmonary veins draining into the right superior vena cava. Additionally, it demonstrated coronary sinus dilatation secondary to persistent left superior vena cava. CMR and cardiac CT showed right superior and middle pulmonary veins draining into the right superior vena cava 18 mm above the septal defect (Figures B and C). After discussion in clinical session, a percutaneous approach was planned to correct the septal defect and anomalous pulmonary drainage. For this purpose, anatomical data obtained from CMR and CT was needed to plan the procedure. During the intervention two stents graft were deployed in the right superior vena cava. The distal stent was flared at the septal defect level so as to occlude it while redirecting the anomalous pulmonary venous flow to the left atrium (Figure D). Control CT confirmed the complete occlusion of the SVASD without residual communication from pulmonary veins to the right superior vena cava or the right atrium (Figure E). Anomalous right superior and middle pulmonary veins drained into the left atrium below the stents. Transthoracic echocardiographies showed progressive reduction of right atrium and ventricle dilatation. The patient also underwent successful ablation of atrial flutter and intranodal tachycardia. She is currently asymptomatic, without dyspnea or arrhythmic recurrences. Conclusions In this case, multimodality imaging played a key role in every stage of the clinical process. First, it provided the diagnosis and enabled an accurate understanding of the patient’s anatomy, particularly of the anomalous pulmonary venous connections. Secondly, it allowed a transcatheter approach by supplying essential information to guide the procedure. Finally, it assessed the effectiveness of the intervention and the improvement in cardiac hemodynamics during follow-up. Abstract P649 Figure.


2021 ◽  
pp. 28-31
Author(s):  
Inkar Sagatov ◽  
Nurzhan Dosmailov

The article describes the types of correction of the supracardial form of abnormal drainage of the pulmonary veins. One of the methods of correcting this defect is the Warden operation, which includes: after sternotomy, connection of artificial circulation, cardioplegia, the superior vena cava is cut off, the proximal end is sutured. Next, a right atriotomy is performed, an anastomosis is formed using an autopericardial patch between the abnormal drainage and the left atrium through the ASD. Then an anastomosis is formed between the auricle of the right atrium and the distal end of the superior vena cava. As a result, blood from the abnormal pulmonary veins begins to drain into the left atrium through the ASD.


2018 ◽  
Vol 33 (12) ◽  
pp. 864-866
Author(s):  
Xiangyu He ◽  
Weiqiang Ruan ◽  
Junyang Han ◽  
Ke Lin

BMJ ◽  
1986 ◽  
Vol 293 (6551) ◽  
pp. 855-855 ◽  
Author(s):  
D Leys ◽  
J Manouvrier ◽  
T Dupard ◽  
P Kassiotis ◽  
C Rey ◽  
...  

2019 ◽  
Vol 27 (9) ◽  
pp. 776-778
Author(s):  
Mustafa Yılmaz ◽  
Edem Ziadinov ◽  
Hayrettin Hakan Aykan

We report the successful surgical treatment of a case of double drainage of the right upper pulmonary vein into the superior vena cava and left atrium in a 9-year-old girl.


Author(s):  
Reina Tonegawa-Kuji ◽  
Kenichiro Yamagata ◽  
Kengo Kusano

Abstract Background  Cough-induced atrial tachycardia (AT) is extremely rare and its electrical origin remains largely unknown. Atrial tachycardias triggered by pharyngeal stimulation, such as swallowing or speech, appears to be more common and the majority of them originate from the superior vena cava or right superior pulmonary vein (PV). Only one case of swallow-triggered AT with right inferior pulmonary vein (RIPV) origin has been reported to date. Case summary  We present a case of a 41-year-old man with recurring episodes of AT in the daytime. He underwent electrophysiology study without sedation. Atrial tachycardia was not observed when the patient entered the examination room and could not be induced with conventional induction procedures. By having the patient cough periodically on purpose, transient AT with P-wave morphology similar to the clinical AT was consistently induced. Activation mapping of the AT revealed a centrifugal pattern with the earliest activity localized inside the RIPV. After successful radiofrequency isolation of the right PV, AT was no longer inducible. Discussion  In the rare case of cough-induced AT originating from the RIPV, the proximity of the inferior right ganglionated plexi (GP) suggests the role of GP in triggering tachycardia. This is the first report that demonstrates voluntary cough was used to induce AT. In such cases that induction of AT is difficult using conventional methods, having the patient cough may be an effective induction method that is easy to attempt.


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