scholarly journals Vascularization fo the cardiac conduction system in humans by the right coronary artery

2008 ◽  
Vol 22 (S1) ◽  
Author(s):  
Patricia M Herrera ◽  
Adelina Rojas ◽  
Carlos F. Cichero ◽  
Adrián J. Barceló ◽  
Manuel Arteaga ◽  
...  
Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1323
Author(s):  
Giulia Ottaviani ◽  
Graziella Alfonsi ◽  
Simone G. Ramos ◽  
L. Maximilian Buja

A retrospective study was conducted on pathologically diagnosed arrhythmogenic cardiomyopathy (ACM) from consecutive cases over the past 34 years (n = 1109). The anatomo-pathological analyses were performed on 23 hearts diagnosed as ACM (2.07%) from a series of 1109 suspected cases, while histopathological data of cardiac conduction system (CCS) were available for 15 out of 23 cases. The CCS was removed in two blocks, containing the following structures: Sino-atrial node (SAN), atrio-ventricular junction (AVJ) including the atrio-ventricular node (AVN), the His bundle (HB), the bifurcation (BIF), the left bundle branch (LBB) and the right bundle branch (RBB). The ACM cases consisted of 20 (86.96%) sudden unexpected cardiac death (SUCD) and 3 (13.04%) native explanted hearts; 16 (69.56%) were males and 7 (30.44%) were females, ranging in age from 5 to 65 (mean age ± SD, 36.13 ± 16.06) years. The following anomalies of the CCS, displayed as percentages of the 15 ACM SUCD cases in which the CCS has been fully analyzed, have been detected: Hypoplasia of SAN (80%) and/or AVJ (86.67%) due to fatty-fibrous involvement, AVJ dispersion and/or septation (46.67%), central fibrous body (CFB) hypoplasia (33.33%), fibromuscular dysplasia of SAN (20%) and/or AVN (26.67%) arteries, hemorrhage and infarct-like lesions of CCS (13.33%), islands of conduction tissue in CFB (13.33%), Mahaim fibers (13.33%), LBB block by fibrosis (13.33%), AVN tongue (13.33%), HB duplicity (6.67%%), CFB cartilaginous meta-hyperplasia (6.67%), and right sided HB (6.67%). Arrhythmias are the hallmark of ACM, not only from the fatty-fibrous disruption of the ventricular myocardium that accounts for reentrant ventricular tachycardia, but also from the fatty-fibrous involvement of CCS itself. Future research should focus on application of these knowledge on CCS anomalies to be added to diagnostic criteria or at least to be useful to detect the patients with higher sudden death risks.


2010 ◽  
Vol 13 (1) ◽  
pp. 45 ◽  
Author(s):  
Otoni M. Gomes ◽  
Ant�nio Alves Coelho ◽  
Evandro C�sar Vidal Osterne ◽  
Rafael Diniz Abrantes

Background: Percutaneous transluminal septal myocardial alcohol ablation (PTSMAA) is not a procedure without complications. It may produce heart arrhythmias, especially those due to disturbances of atrioventricular (AV) and interventricular (IV) electrical conduction.Objective: The goal of this study was to evaluate the relationship between the anatomical patterns of the right coronary artery and the left anterior descending artery (LAD) and to relate them to the AV and IV bundle branch blocks provoked by PTSMAA.Method: Twenty patients with obstructive hypertrophic cardiomyopathy resistant to treatment with drugs successfully underwent PTSMAA. Electrocardiographic analyses were done before and after PTSMAA, and the results were compared with the abnormal septal anatomy.Results: The effectiveness of PTSMAA was obtained in 18 (90%) of the 20 patients by ethanolization of the first great septal branch. In the other 2 patients (10%), 2 septal branches underwent alcoholization. First-grade temporary AV block (AVB) was observed in 6 patients (30%). Ten patients experienced severe bradycardia due to total AVB that required a temporary pacemaker, but 3 of the patients (15%) required a permanent pacemaker. Fourteen patients (70%) experienced permanent complete right branch block, and 2 developed incomplete left anterior block and incomplete left posterior block. Six patients presented with no electrical conduction disturbance at all.Conclusion: According to the results of the present investigation with the AV node artery derived from the right coronary artery in all cases, complete and permanent AV conduction system blockade occurred after PTSMAA in all types of anatomy regarding the observed LAD.


1985 ◽  
Vol 25 (1) ◽  
pp. 29-43 ◽  
Author(s):  
Niriellage Chandrasiri

The histopathology of the cardiac conduction system was studied in 75 coroners' autopsies. Existing methods have been simplified and are described in detail. A minimum of three ***5 u sections need to be cut from each vena cavo atrial strip and each atrio ventricular block, for a successful result. Reasons for failure, difficulties in interpretation, and age-related changes in histopathological features are discussed. Fatty infilteration commences at 33 years old and fibrosis at 43 years old. Conduction system studies do not seem to increase the accuracy of routine autopsy diagnosis in deaths due to coronary artery disease. However, its study in unexpected sudden death in the young should be made compulsory. The difficulties in performing choline esterase tests on conduction systems are also highlighted.


Author(s):  
Giulia Ottaviani ◽  
Graziella Alfonsi ◽  
Simone G. Ramos ◽  
Anna M. Lavezzi ◽  
L. Maximilian Buja

A retrospective study was conducted on pathologically diagnosed arrhythmogenic cardiomyopathy (ACM) from consecutive cases over the past 34 years (n = 1,109). The cardiac conduction system (CCS) was removed in two blocks, containing the following structures: Sino-atrial node (SAN), atrio-ventricular junction (AVJ) including the atrio-ventricular node (AVN), the His bundle (HB), the bifurcation (BIF), the left bundle branch (LBB) and the right bundle branch (RBB). The ACM cases (2.07% of the total cases) consisted of 20 (86.96%) sudden unexpected cardiac death (SUCD) and 3 (13.04%) native explanted hearts; 16 (69.56%) were males and 7 (30.44%) were females, ranging in age from 5 to 65 (mean age ± SD, 36.13 ± 16.06) years. The following anomalies of the CCS, displayed as percentages of ACM SUCD cases, have been detected: Hypoplasia of SAN (80%) and/or AVJ (86.67%) due to fatty-fibrous involvement, AVJ dispersion and/or septation (46.67%), central fibrous body (CFB) hypoplasia (33.33%), fibromuscular dysplasia of SAN (20%) and/or AVN (26.67%) arteries, hemorrhage and infarct-like lesions of CCS (13.33%), islands of conduction tissue in CFB (13.33%), Mahaim fibers (13.33%), LBB block by fibrosis (13.33%), AVN tongue (13.33%), HB duplicity (6.67%%), CFB cartilaginous meta-hyperplasia (6.67%), and right sided HB (6.67%). Arrhythmias are the hallmark of ACM, not only from the fatty-fibrous disruption of the ventricular myocardium that accounts for reentrant ventricular tachycardia, but also from the fatty-fibrous involvement of CCS itself. The careful examination of the cardiac conduction system on serial sections was crucial in documenting the fatty-fibrous infiltration of CCS in ACM.


2019 ◽  
Vol 25 (2) ◽  
pp. 137
Author(s):  
E. V. Rosseĭkin ◽  
V. V. Bazylev ◽  
E. E. Kobzev ◽  
A. B. Voevodin ◽  
P. A. Batrakov ◽  
...  

2007 ◽  
Vol 10 (4) ◽  
pp. E325-E328 ◽  
Author(s):  
Ali Gürbüz ◽  
Ufuk Yetkin ◽  
Ömer Tetik ◽  
Mert Kestelli ◽  
Murat Yesil

2015 ◽  
Vol 18 (6) ◽  
pp. 253
Author(s):  
Renyuan Li ◽  
Yiming Ni ◽  
Peng Teng ◽  
Weidong Li

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>


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