窦房结动脉的应用解剖

Applied anatomy of the S-A node artery

通过血管注射，对成人离体心脏１５０例（３０例新鲜标本，１２０例已固定标本）窦房结动脉的起点、管径、行程和分布进行了观察和测量。窦房结动脉（４８．７％）７４例起于右冠状动脉近侧２ｃｍ处，管径１．５±０．３（０．９～２．２）ｍｍ；（３４．９％）５３例起于左冠状动脉旋支近侧１ｃｍ处，管径１．０±０．４（１．０～２．４）ｍｍ；（１５．８％）２４例起于旋支外后段，管径１．７±０．４（１．０～２．２）ｍｍ。窦房结动脉的行程均与房间前沟和房间肌束有关，多以“逆时针”型终于上腔静脉口。其中约１／４在房间后沟上部有一样下降。后窦房结动脉常见在左心耳和左肺上静脉之间，行经左房外侧壁内。冠状动脉与支气管动脉和前纵隔动脉的吻合，在３０例中出现２０％。对窦房结动脉的临床意义进行了讨论。

he origin,diameter,course and distribution of the S-A node artery were studied in 150adult heart preparations by artery perfusion(30 cases)and dissection (120 cases).48.7%of theS-A node arteries originate fromthe proximal 2 cm of the right coronary artery with a diameter of1.5±0.4(0. 9～2.2)mm;34.9%of them arise from the proximal 1 cm of the circumflex branchof the left coronary artery with a diameter of 1.5± 0.4(1.0～2.4)mm;the rest of the arteries(15. 8%)were from the posterolateral left coronary artery with a diameter of 1.7±0.4(1.0～7. 2)mm. The course of S-A node artery has a close relationship with the anterior interatrial sul-cus and the interatrial muscular bundle,most of them end at the orifice of the superior vena cavawith a counter clockwise course, but one-forth of the cases have a descending loop up the posteri-or interatrial sulcus. The posterior sinus node artery usually proceeds intramurally through thelateral wall of the left atrium between the atrial appendage and the left superior pulmonary vein tothe sinus node.Anastomoses between the coronary arteries and tbe broncbial or anterior medi-astinal arteries were observed in 20%of the 30 artery perfusion specimens.The clinical signifi-cance relating to the S-A node artery was afforded.