The coronary sinus and its tributaries were studied by anatomical dissection in 37 adult human cadaveric hearts, which had been fixed in formalin solution. An anastomosis of approximately 1.0 mm in calibre was observed between the anterior and posterior interventricular veins in 19% of specimens. Myocardial bridges were detected above the anterior interventricular vein or its tributaries in 8% of specimens. The great cardiac vein formed the base of the arteriovenous trigone of Brocq and Mouchet with the bifurcating branches of the left coronary artery in 89% of specimens and formed an angle accompanying these arterial branches in 11%. In the trigone the anterior interventricular and great cardiac veins were superficial to the arteries in 73% of specimens. The left marginal vein was present in 97% of specimens, emptying into the great cardiac vein in 81% of cases and into the coronary sinus in the remaining 19%. The small cardiac vein was present in 54% of specimens. In the coronary sulcus the great cardiac vein was adjacent to the circumflex branch of the left coronary artery in 76% of specimens and to the right coronary artery in 5%: in 19% there was no relationship with either artery. The coronary sinus maintained a relationship with the right coronary artery in 46% of specimens and with the left coronary artery in 32%: in 22% it had no relationship with these vessels.

Ortale JR, Paganoti C de F, Marchiori GF. Anatomical variations in the human sinuatrial nodal artery. Clinics. 2006;61(6): 551-8. OBJECTIVE:To analyze the anatomical variations of sinuatrial nodal branch(es) of the coronary artery mainly regarding their number; a recent report from Japan claims the presence of 2 branches in up to 50% of cases, an occurrence that would permit adequate flow compensation in case of occlusion or section of 1 of these branches. METHODS:The sinuatrial nodal branch(es) of 50 human hearts fixed in formol solution were dissected with the aid of a Normo Health 3.0 degree visor magnifying lens, measured, and classified as to the origin, route, and number of branches. RESULTS: In 94% (n = 47) of cases, a single sinuatrial nodal branch was found. classified: (A) two right side types, R1 (in 46% of cases, n = 23), situated medial to the right auricle and R2 (in 4% of cases, n = 2), situated on the posterior surface of the right atrium; (B) three left side types, L1 (in 24% of cases, n = 12), situated medial to the left auricle, L2 (in 16% of cases, n = 8), situated posterior to the left auricle, and L3 (in 4% of cases, n = 2), situated on the posterior surface of the left atrium. Except for R2, each type was subdivided into 'a' or 'b' types, according to whether the sinuatrial nodal branch(es) occurred in a clockwise or counterclockwise orientation around the base of the superior cava vena. In 4% of cases (n = 2), 2 sinuatrial nodal branch(es) were observed with 1 branch originating from each of the coronary arteries. In 1 case (2%), 3 sinuatrial nodal branch(es) were found, 2 from the right coronary artery and the third probably from the bronchial branch of the thoracic aorta. In 30% of the cases, the sinuatrial nodal branch(es) formed a ring around the base of the superior cava vena. In all cases, the sinuatrial nodal branch(es) supplied collateral branches to the atrium and/or the auricle of the same side as its origin and/or to the opposite side. CONCLUSION: The low frequency of 2 sinuatrial nodal branch(es) in Brazilian individuals, compared to the higher frequency found among the Japanese, is probably due to a variation associated with ethnic group origin.

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Objective: The objective of the present report was to describe the lateral, diagonal and anterosuperior arterial branches in the epicardial adipose tissue of the left ventricle and to analyze their frequency and diameters according to the type of coronary circulation. The precious knowledge of these branches has surgical application in their revascularization or during the injection of the cardioplegic substances into these branches. Method: Fifty hearts obtained at autopsy from adult cadavers were dissected and fixed in formalin and the left ventricle was divided into three thirds: superior, middle and inferior. The lateral branch originated from the circumflex branch, the diagonal branch from the division of the left coronary artery and the anterosuperior branch from the anterior interventricular branch in the superior third of the left ventricle. The length in the epicardium and the diameter of each branch were measured and the blood flow was related to the type of coronary circulation. Results: The diameter of the lateral branch, present in 88% of the cases, ranged from 0.6 to 4.5 mm (mean: 2.1 ± ± ± ± ± 0.7 mm). The diameter of the diagonal branch, present in 50% of cases, ranged from 1.0 to 3.8 mm (mean: 2.2 ± ± ± ± ± 0.7 mm). The diameter of the anterosuperior branch, present in 84% of cases, ranged from 1.0 to 4.1 mm (mean: 2.5 ± ± ± ± ± 0.8 mm). We detected 30/50 (60%) cases of dominance of the right coronary artery, 14/50 (28%) cases of the balanced type, and 6/12 (12%) cases of dominance of the left coronary artery. Mean blood flow in the anterosuperior branch presented a decreasing value in the following types: dominance of the right coronary artery, balanced and dominance of the left coronary artery. Conversely, the lateral branch showed respectively increasing values, while the diagonal branch presented a greater flow in the balanced type. Conclusion: The results demonstrated the complementarity of the lateral, diagonal and anterosuperior arterial branches, as well as the correlation among these branches with the following types of coronary circulation: right dominance, balanced and left dominance.

The ramification of the portal vein in the right hemiliver was studied by anatomic dissection in 36 formalin-fixed human livers. In 28/36 (77.8%) cases, the portal vein bifurcated into a right branch and a left branch and the right branch bifurcated into anterior and posterior segmental branches. The anterior segmental branch terminated in the anterosuperior subsegment (S₈) in two types: bifurcated when it divided into anterior P₈ and posterior P₈ branches towards the respective regions of S₈ (24/28 cases) and monopodal when it had a single pedicle (4/28 cases). The maximum anteroinferior subsegmental branch (P₅ maximum) originated either from the anterior segmental branch (16/28 cases) or from the anterior P₈ branch (12/28 cases). The posterior segmental branch vascularized the posteroinferior (S₆) and the posterosuperior (S₇) subsegments, and was terminated in three types: fan-shaped (16/28), bifurcated (9/28) and tripodal (3/28). In 4/36 (11.1%) cases the portal vein bifurcated into a right branch and a left branch but the posterior segmental branch was not present. In 4/36 (11.1%) the right branch of the portal vein was not present. These anatomical variations are explained separately and finally all cases are considered as a whole.

The objective of this study was to analyze the caudate portal branches and their relationships with the hepatic caudate veins and propose a new nomenclature for the caudate branches based on their territory of distribution. We realized the fine dissection of the veins of the caudate lobe in 40 human livers fixed and preserved in formalin. In 15/40 (37.5%) cases there was a single branch to the caudate lobe. In 25/40 (62.5%) cases there was more than one branch, with a posterior caudate branch in 20/40 (50%) cases, an anterior caudate branch in 15/40 (37.5%) cases, a left caudate branch in 14/40 (35%) cases, and a right caudate branch in 8/40 (20%) cases. The most frequent combination detected (11/40, 27.5% of cases) was that of the posterior and anterior branches. The venous drainage of the caudate lobe and its papillary process was provided by the superior caudate hepatic vein in 23/40 (57.5%) cases, by the middle caudate vein in 35/40 (87.5%) cases (which was the only vein in 12/35 cases), and by the inferior caudate vein in 16/40 (40%) cases. In 11/40 (12.5%) cases there were accessory caudate veins, which emptied into the left and intermediate hepatic veins. The portal branches and the hepatic veins related to the caudate process were studied. In conclusion, the new nomenclature analyzes more precisely the distribution of the caudate portal branches.

The ramification of the portal vein at the porta hepatis was studied by anatomic dissection performed in 32 formalin fixed human livers. In all the specimens there were branches which ran towards the caudate lobe, arising from the portal vein and either from the left or the right portal branches. Tri- and quadrifurcation of the portal vein was observed. In 5 cases (16%) there were branches arising from left portal branch or portal vein and directed anteriorly to the quadrate lobe or to the region of the gall-bladder sulcus. These branches ranged from 1.0 to 6.0 mm in diameter. The portal caudate branches were divided into 3 groups. Group 1: Branches to the papillary process; 1 or 2 branches in 26 cases (82%), 3 or 5 branches in 3 cases (9%) and no branches in 3 cases (9%); Group 2: Branches to the vena cava region, including the left part of the caudate process; 1 or 2 branches in 30 cases (94%), 3 branches in 1 case (3%) and no branches in 1 case (3%); Group 3: Branches to the right part of the caudate process; 1 or 2 branches in 12 cases (37%), and no branches in 20 cases (63%).

468The clinical application of the anatomical study of the ventricular branches of coronary arteries is the execution and interpretation of examination methods and the planning and performing of cardiovascular disease treatment [1][2][3][4][5][6] . In 1940, Schlesinger 1 developed the anatomical concept of balance or predominance in coronary artery circulation in the diaphragmatic face of the heart, using the crux cordis region as a reference. The crux cordis is defined as the point where the coronary sulcus meets the interatrial and interventricular sulci. According to the author 1 , the right coronary artery was predominant when it provided the posterior interventricular branch and supplied blood for most of the left ventricular posterior wall. However, this criterion did not quantify the limit of this region in the posterior wall. In the balanced type, the right coronary artery irrigated only the right ventricle and the posterior part of the interventricular septum, and did not provide significant branches for the left ventricle, which was irrigated by the left coronary artery. The criterion remained subjective, because it did not define the concept of significant branches, because, for example, in left dominance, the left coronary artery provided, along with the right coronary artery, parallel posterior interventricular branches, or only the left coronary artery provided a posterior interventricular branch, sometimes sending branches to the right ventricle.Blunk and DiDio 7 considered dominance of the right coronary artery to be all cases in which the right coronary artery provided branches for the posterior face of the right ventricle. More recent studies by Falci Junior et al 8 reported that in right dominance, the right coronary artery reached and extended beyond the crux cordis, providing 1 or more branches to the left ventricle; in balanced circulation, the right coronary artery reached that point, but did not extend beyond it; and, in left dominance, the left coronary artery reached the crux cordis, originating, or not, branches to the right ventricle. For this reason, they did not consider the possibility that the branches extending beyond the crux cordis were of little significance.In addition, these classifications did not consider the fact that sometimes the anterior interventricular branch surrounded the apex of the heart and extended upward in the posterior interventricular sulcus, which, according to Cavalcanti et al 9 occurred in 28.18% of the cases, and according to Lima Júnior et al 10 in 50%. Therefore, we found it pertinent to include the analysis of the anterior interventricular branch among our classification criteria.Pino et al 6 reported a division of the ventricles between the coronary sulcus and the apex of the heart into superior, middle, and inferior thirds. However, we believe that the addition of 1 ObjectiveTo describe the trajectory of the posterior ventricular branches of the coronary arteries in the epicardial adipose tissue, and to propose a new criterion for analyzing the di...