Características morfológicas y posibles implicaciones clínicas de las arterias nodales: morphological characteristics and potential clinical implications of nodal arteries

Abstract

The morphological expression of nodal arteries is important in the diagnosis and management of cardiac clinical events and surgical approaches. 88 nodal arteries of hearts obtained from autopsies were studied. Coronary arteries were injected with polyester resin pigmented with red. Morphological and morphometrical characteristics of nodal arteries were registered. The sinoatrial node artery had its origin in the right coronary artery in 52 cases (59,1%), in the circumflex in 33 (37,35%), and in both in 3 (3,4%). Its proximal caliber was 1,31mm (± 0,3), corresponding to the arteries originated in the right coronary artery of 1,25 mm (± 0,3), while those that originated in the circumflex artery had a caliber of 1,42 mm (± 0,3), difference that was significant (p= 0,01). Its origin occurred more frequently in the anteriomedial third of both the right coronary artery and the circumflex artery (54,6% and 61,2% respectively). In its final segment, it crossed in most cases (44%) in front of the cava vein, while in 22 hearts (24,5%) went around the cava vein. In 14 cases the artery had an «S» shape (15,9% of the total sample and 42,4% of those arising from the circumflex artery). The atrioventricular node artery was originated from the segment in inverted «U» of the right coronary artery, at the level of the crux cardia in 81 hearts (92%) and had a proximal caliber of 1,06 mm (± 022). In relation to the caliber and origin, the findings are consistent with previous studies. Prevalence of «S» shape artery and trajectory of the sinoatrial artery around the superior cava vein are highlighted.