Topography of cardiac ganglia in the adult human heart

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Presentation transcript:

Topography of cardiac ganglia in the adult human heart Sanjay Singh, MSca, Patricia I. Johnson, PhDa, Robert E. Lee, MD, PhDb, Emilo Orfei, MDb, Vassyl A. Lonchyna, MDc, Henry J. Sullivan, MDc, Alvaro Montoya, MDc, Hoang Tran, BSa, William H. Wehrmacher, MDa, Robert D. Wurster, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 112, Issue 4, Pages 943-953 (October 1996) DOI: 10.1016/S0022-5223(96)70094-6 Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Photomicrograph of a cardiac ganglion surrounded by epicardial adipose tissue (AT) from the para-SA nodal ganglia of an adult human heart. Note the capsule of connective tissue (CT) around the ganglion and peripherally located postganglionic neurons (arrow). Neuropil (Np) is found throughout the ganglion. Bar represents 100 μm. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 943-953DOI: (10.1016/S0022-5223(96)70094-6) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Photomicrograph of a multipolar postganglionic neuron from the para-SA nodal ganglia of an adult human heart. Eccentrically located nuclei (Nu) and nucleoli are clearly visible. Note the two neuronal processes (arrows) visible at this level. A thin layer of connective tissue (CT) surrounds the neuron, whereas satellite cells (SC) are intermingled within the neuropil. Bar represents 10 μm. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 943-953DOI: (10.1016/S0022-5223(96)70094-6) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Posterior view of an adult human heart showing topography of the cardiac ganglia (•). Para-SA nodal ganglia are concentrated primarily lateral to the right pulmonary veins. The para-AV nodal ganglia are on the epicardial surface superior to the coronary sulcus (CS) and within the interatrial septum(★). Smaller collections of ganglia are dispersed throughout both atria, including the region superior to coronary sinus, the superior left atrial surface, and lateral to the left pulmonary veins. The right atrial free wall (RA) and the adventitia of the aorta (Ao) and pulmonary artery (PA) do not contain cardiac ganglia. Most of the left ventricular (LV) and right ventricular (RV) myocardium is also devoid of ganglia. However, some ganglia exist inferior to coronary sulcus and occasionally in the fat surrounding the coronary vasculature. SVC, Superior vena cava; IVC, inferior vena cava; LAu, left atrial appendage. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 943-953DOI: (10.1016/S0022-5223(96)70094-6) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 Anterior view of an adult human heart showing topography of the cardiac ganglia (•). Ganglia are concentrated primarily at base of aorta (Ao) and pulmonary artery (PA), and not on the ascending aorta or pulmonary trunk. Ganglia from the para-SA nodal collection can be seen extending to the right atrial (RA) and atrial-appendage junction, whereas the lateral portions of the atrial appendages lack ganglia. Most of the left ventricular (LV) and right ventricular (RV) myocardium is devoid of cardiac ganglia, although some can be found near the coronary vasculature. SVC, Superior vena cava; LAu, left atrial appendage; RCA, right coronary artery. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 943-953DOI: (10.1016/S0022-5223(96)70094-6) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Superior view of an adult human heart showing topography of the cardiac ganglia (•). The aorta and pulmonary artery have been removed to reveal the aortic (AV) and pulmonary valves (PV). From this perspective, the para-SA node ganglia can be seen lateral to the right pulmonary veins (RPV), with some ganglia extending toward the right atrial appendage (RAu). Ganglia on the superior and anterior left atrial surfaces (LA) as well as the base of the great vessels are depicted. Ganglia also exist lateral to the left pulmonary veins (LPV) and extend to the left atrial appendage (LAu). RA, Right atrium. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 943-953DOI: (10.1016/S0022-5223(96)70094-6) Copyright © 1996 Mosby, Inc. Terms and Conditions