The clinical anatomy of the sinus node artery.
BACKGROUND
Our basic aim was to describe the topographic relation between the sinus node artery and the superior posterior border of the interatrial septum with regard to the sinus node dysfunction that follows the superior transseptal approach to the mitral valve.


METHODS
During our study 50 human hearts without previous pathologic alterations were analyzed. The position of the sinus node and the course of the sinus node artery were investigated. For identification of the origin of the artery, selective coronary angiograms were performed. The course of sinus node artery and its topographic relation to the interatrial septum was identified by the dry dissections of the hearts. Based on histologic and dry dissected specimens the exact position of the sinus node was determined.


RESULTS
We found that the sinus node artery originates from the right coronary artery in 66% of examined cases and from the left coronary artery in 34% of cases. The sinus node artery crosses the superior posterior border of the interatrial septum in 54% of cases.


CONCLUSIONS
Our results were compared with clinical studies focusing the incidence of the sinus rhythm disturbance after the superior transseptal approach. The incidence of rhythm disturbance varies from 52% to 60% of cases. Comparing our morphologic and clinical results we can state that the risk for intraoperative damage to the sinus node artery during the superior transseptal approach to the mitral valve is high.
Berdajs
Denis
D
Institute of Anatomy, Histology, and Embryology, Laboratory for Applied and Clinical Anatomy, Semmelweis University Budapest, Budapest, Hungary. denis_berdajs@hotmail.com
Patonay
Lajos
L
Turina
Marko I
MI
D000328:Adult; D000368:Aged; D001158:Arteries; D001283:Atrioventricular Node / Q000033:anatomy & histology*; D002102:Cadaver; D003331:Coronary Vessels / Q000033:anatomy & histology*; D006801:Humans; D008875:Middle Aged