Анатомия венечного синуса сердца взрослого человека

Abstract

Background. Anatomy of the coronary sinus (CS) is important for radiofrequency ablation and implantation of intracardiac electrodes. The objective was to explore structure and topography of the CS in the adult heart. Material and methods We studied 50 specimens of the heart by dissection, corrosion, and histotopographic method. Morphometry was performed with a caliper; histotopograms were studied by means Olympus stereomicroscope. Results The CS length was 34.3 mm, varied from 13.7 to 50 mm in dissected specimens, and 31.8 mm (23.8–44.8 mm) in corrosion casts. The circumference of the CS in its middle (Rs=.85) and at the confluence (Rs=.7; p<.005) increased with the thickening of the left ventricular myocardium but didn’t depend on the heart weight. On histotopograms, the thickness of the CS wall was 1.27 mm (.15 to 3.73 mm). Despite the differences in the thickness of certain walls in the distal, middle, and proximal parts of the CS, the average values of the CS wall thickness increased in the direction of blood flow, which was primarily due to the presence of the myocardial “sheath” around the CS. We analyzed the correspondence of coronary dominance and variants of the adjacent anatomy of CS and neighboring arteries. Conclusion CS is revealed to be anatomical variability, which is exhibited by certain shape variants, size ratios, thickness parameters and histotopographic features of the walls, and various relationships of CS with the atrial myocardium and arteries in the coronary sulcus.