1 From the Department of Anatomy, Hebrew University-Hadassah Medical School, and the Department of Internal Medicine B, Hadassah University Hospital, Jerusalem, Israel.
Some anatomic features of the posterior wall of the left atrium, the atrial-pulmonary venous junctions, and the myocardial sleeves extending over the pulmonary veins, as observed in 16 human hearts, are described. Different patterns of direction of the myocardial fibers of the atrial wall were found in the different specimens. The atrial wall between the upper pulmonary veins was consistently thicker than that between the lower ones. Similarly, the sphincter-like structures of the atrial-pulmonary venous junctions were generally more conspicuous, and the myocardial venous sleeves better developed in the superior than in the inferior pulmonary veins. The physiological and pathological implications of these findings are discussed.
© 1966 American Heart Association, Inc.
The Junction Between the Left Atrium and the Pulmonary Veins
An Anatomic Study of Human Hearts
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
 S. Zhou, C.-M. Chang, T.-J. Wu, Y. Miyauchi, Y. Okuyama, A. M. Park, A. Hamabe, C. Omichi, H. Hayashi, L. A. Brodsky, et al. Nonreentrant focal activations in pulmonary veins in canine model of sustained atrial fibrillation Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1244 - H1252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
P.-S. Chen, T.-J. Wu, C. Hwang, S. Zhou, Y. Okuyama, A. Hamabe, Y. Miyauchi, C.-M. Chang, L. S. Chen, M. C. Fishbein, et al. Thoracic veins and the mechanisms of non-paroxysmal atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 295 - 301. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Y. Ho, R. H. Anderson, and D. Sanchez-Quintana Atrial structure and fibres: morphologic bases of atrial conduction Cardiovasc Res, May 1, 2002; 54(2): 325 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
H. Calkins Progress continues in the quest to cure atrial fibrillation with catheter ablation techniques Eur. Heart J., November 2, 2001; 22(22): 2038 - 2040. [PDF]
|
|
|
|
|
|
Guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology Eur. Heart J., October 2, 2001; 22(20): 1852 - 1923. [PDF]
|
|
|
|
 |
|
 O. Rena, E. Papalia, A. Oliaro, C. Casadio, E. Ruffini, P. Filosso, C. Sacerdote, and G. Maggi Supraventricular arrhythmias after resection surgery of the lung Eur. J. Cardiothorac. Surg., October 1, 2001; 20(4): 688 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
 |
|
 S Y Ho, J A Cabrera, V H Tran, J Farre, R H Anderson, and D Sanchez-Quintana Architecture of the pulmonary veins: relevance to radiofrequency ablation Heart, September 1, 2001; 86(3): 265 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Scheinman and F. Morady Nonpharmacological Approaches to Atrial Fibrillation Circulation, April 24, 2001; 103(16): 2120 - 2125. [Abstract] [Full Text] [PDF]
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|
|
|
|
|
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|
|
|
|
|
H. J. J. Wellens Pulmonary Vein Ablation in Atrial Fibrillation : Hype or Hope? Circulation, November 21, 2000; 102(21): 2562 - 2564. [Full Text] [PDF]
|
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|
|
|
|
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|
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|
|
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|
|
|
|
|
|
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 |
|
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