ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Anatomy and variations of the arterial supply to the sinoatrial node: Imaging with dual-source cardiac multidetector CT angiography
Düzgün Yıldırım1, Muhteşem Ağıldere2, Sergin Akpek2, Terman Gümüş2
1Department of Radiology, Kasımpaşa Military Hospital, Istanbul
2Department of Radiology, VKV Amerikan Hospital, İstanbul
Background: In this study, our aim is to describe the sinoatrial node (SAN) artery and to define the typical course and variations of it in a Turkish population.

Methods: We retrospectively examined cardiac computed tomography (CT) images of 107 cases acquired with a dual-source multidetector system. Using special software; three-dimensional, maximum intensity projection and curved multiplanar images were generated and evaluated. After depiction of the SAN arterial supply: firstly, the trace of the artery was defined; secondly, calibration at the origin measured and then percentages of different types were calculated.

Results: A single SAN artery which originated from the proximal 35 mm of the right coronary artery (RCA) was detected in 97 (91%), from the proximal left circumflex artery in four (4%), directly from the RCA sinus in three (3%) and from the conal branch of the RCA in two (2%) cases. Only one (1.02%) encircling SAN artery was detected.

Conclusion: The arterial blood supply to the SAN artery can be imaged easily with dual-source multidetector CT examination by processing the routine cardiac CT sections. Awareness of these features (supply to the SAN) is important before invasive procedures like surgery or catheter angiography to prevent potential damages. Compared with the literature, our findings suggest variability between different races, concerning the percentages of the different types of arterial supply to the SAN.

Keywords : Angiography; coronary artery; dual-source computed tomography; sinoatrial node arterial supply
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