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Ann Thorac Surg 2000;70:1234-1237
© 2000 The Society of Thoracic Surgeons

Original articles: cardiovascular

The role of atrial vessels in aortic root and mitral valve operations

Gustavo Abuin, MDa, Alejandro Nieponice, MDa, Silvio Martinez, MDa, Cichero Fernando, MDa

a Section of Cardiac Anatomy, Division of Anatomy, Instituto de Neurobiología, School of Medicine, Fundación H.A. Barceló, Buenos Aires, Argentina

Address reprint requests to Dr Abuin, Cardiac Anatomy Research Laboratory, Serrano 669, 1414 Buenos Aires, Argentina
e-mail: gabuin{at}intramed.net.ar

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.




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