心房动脉的应用解剖

Applied anatomy of arterial supply to human atrium

目的：为心房切开术或经心房介入治疗术提供心房动脉的解剖学基础.方法：对27例成人心的心房动脉进行解剖,重点观测营养房间隔及左心耳的动脉的起源并测量其外径、主干长度.结果：右心房动脉有2～4支,平均3.0支,均起于右冠状动脉右侧壁,起始处外径为（1.6±0.4） mm,左心房动脉有2～5支,平均3.0支,92.6%分支起于旋支,7.4%的分支来自右冠状动脉.营养房间隔的动脉行于前房间沟下部,48.1%（13例）由右冠状动脉发出,起始处外径为（1.3±0.4） mm,主干长度为（21.0±9.6） mm,51.9%（14例）由旋支发出,起始处外径为（1.2±0.4） mm,主干长度为（9.0±4.2） mm;左心耳动脉有1～5支,平均2.3支,除1例起于右冠状动脉外,其余均起于旋支,起始处外径（0.7±0.4） mm,主干长度（13.1±6.7） mm.根据其行走特点可分为4型.结论：进行心腔内直视手术时需注意房间隔动脉及左心耳动脉的走行特点,以防伤及,引起血供障碍.

Objective： To provide the anatomical basis for atriotomy and interventional therapy. Methods： 27 Chinese adult heart specimens were dissected to expose the arterial supply of atrium. And arteries supplying the interatrial septum and left atrial auricle were highlighted on their origin and related parameters including the origin diameter and trunk length. Results： 2 to 4 （average 3.0） arterial branches originated entirely from the right wall of right coronary artery pieced into the right a trium. The mean diameter of their origins were （1.6±0.4） mm. The left atrium was supplied by 2 to 5 （average 3.0） branches, which derivated from the circumflex branch （92.6 %） and right coronary artery （7.4 %）. The artery supplying the interatrial septum was coursed underneath the anterior interatrial groove, 13 of 27 these arteries were originated from the right coronary artery with （1.2±0.4） mm in mean origin diameter and （21.0±0.9） mm in length, another 14 arteries were bifurcated from circumflex branch with mean origin diameter （1.3±0.4） mm and （9.0±4.2） mm. The left atrial auricle re- ceived arterial blood from 1 to 5 （average 2.3） branches that dominantly originated from the circumflex branch excluding one, which derivated from the right coronary artery. These arterial branches possessed （0.7±0. 4） mm in mean origin diameter and （13.1±6.7） mm in trunk length. According to their course, the arterial supplying the left atrial auricle can be classified to 4 types. Conclusion： It should be pay more attention to the anatomical characteristics of arteries supplying the interatrial septum and the left atrial auricle in open heart surgery and interventional therapy.