Right posterior sinoatrial node artery showing a pericaval course: a previously undescribed mode of termination

Surg Radiol Anat. 2010 Jul;32(6):609-12. doi: 10.1007/s00276-009-0593-9. Epub 2009 Nov 14.

Abstract

The left posterior sinus node artery (PSNA) originates from the posterolateral left circumflex artery, is quite common and shows more frequently a retrocaval mode of termination. In contrast, the right PSNA that arises from the terminal right coronary artery has been rarely described while information on its mode of termination is generally lacking. The PSNA courses close to the ostia of the superior pulmonary veins; hence, it may get injured during surgical or catheter ablation procedures performed for the treatment of atrial fibrillation. The left PSNA terminates retrocavally more frequently than the usual SNAs; hence, it may be at a greater risk of transection during the popular superior septal approach to the mitral valve. We present a case of right PSNA which terminated in a previously unreported course, i.e., the pericaval. Discussion pertains to the anatomic features of the PSNA that render it susceptible to the aforementioned complications.

Publication types

  • Case Reports

MeSH terms

  • Coronary Angiography / methods*
  • Coronary Artery Bypass / methods
  • Coronary Vessel Anomalies / diagnostic imaging*
  • Coronary Vessel Anomalies / surgery
  • Coronary Vessels / surgery
  • Electrocardiography
  • Emergency Treatment
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / diagnostic imaging*
  • Myocardial Infarction / surgery
  • Risk Assessment
  • Treatment Outcome