The role of atrial vessels in aortic root and mitral valve operations.
BACKGROUND
For the last 90 years, several authors have focused on studying the blood supply to the conduction system in the human heart. However, an important gap has been maintained between this topic and cardiac surgical procedures when they should have been closely matched. This paper is aimed at clarifying the morphology of the conduction system and its blood supply and assessing its role in cardiac surgical procedures.


METHODS
Twenty human hearts were dissected after antegrade and retrograde injection. After dissection, different surgical procedures were simulated. Finally, we assessed the damage that these procedures might have caused either to the conduction system or to the vessels supplying it.


RESULTS
Kügel's artery, the right superior descending artery, and the sinoatrial node artery were found to be harmed by the surgical procedures performed. In all these cases, these vessels were supplying part of the conduction system.


CONCLUSIONS
All the vascular structures described in the paper play a very important role in the blood supply to the conduction system, and they become vulnerable during aortic root and mitral valve surgical procedures.
Abuin
G
G
Division of Anatomy, Instituto de Neurobiología, School of Medicine, Fundación H.A. Barceló, Buenos Aires, Argentina. gabuin@intramed.net.ar
Nieponice
A
A
Martinez
S
S
Fernando
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000601:surgery*; D006329:Heart Conduction System / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D012016:Reference Values