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Open Heart Surgery: The Prevention of Injury to the Specialized Conducting System

Open Heart Surgery: The Prevention of Injury to the Specialized Conducting System Abstract Normal atrioventricular conduction is dependent upon proper functioning of the specialized conducting system within the heart. This system may be subjected to injury during the repair of congenital cardiac defects from: (1) sutures used in repairing the defect; (2) direct trauma from retractors and other instruments; (3) stretch and/or injury to the moderator band, and (4) interruption of the blood supply. One of the methods which may be used to demonstrate the anatomical relationship of the specialized conducting system to a cardiac defect at the time of surgery is to outline the course of this system at the time of operation. This is one of the problems which this laboratory has been studying during the past 3 years.1-4 By utilizing the heart-lung machine any chamber of the heart may be opened, and surface electrodes may be positioned at specific points under direct vision. It is possible to localize and References 1. Stuckey, J. H.; Hoffman, B. F.; Saksena, C. P.; Kottmeier, P. K., and Fishbone, H.: Electrode Identification of the Conduction System During Open Heart Surgery , Surg. Forum 9:202, 1959. 2. Amer, N. S.; Stuckey, J. H.; Hoffman, B. F.; Cappelletti, R. R., and Domingo, R. T.: Activation of the Interventricular Septal Myocardium Studied During Cardiopulmonary Bypass , Amer. Heart J. 59:224, 1960.Crossref 3. Stuckey, J. H.; Hoffman, B. F.; Bagdonas, A. A., and Venerose, R. S.: Direct Recordings from Chronically Implanted Electrodes on the Specialized Conducting System of the Heart , Proc. Soc. Exp. Biol. Med. 106:90, 1961.Crossref 4. Venerose, R. S.; Stuckey, J. H.; Hoffman, B. F., and Seidenstein, M.: Activation of Subendocardial Purkinje Fibers and Muscle Fibers of the Left Septal Surface Before and After Left Bundle Branch Block , Amer. Heart J. 63:346, 1962.Crossref 5. Hoffman, B. F.; Cranefield, P. F.; Stuckey, J. H., and Bagdonas, A. A.: Electrical Activity During the P-R Interval , Circulat. Res. 8:1200, 1960.Crossref 6. Hoffman, B. F.; Cranefield, P. F., and Stuckey,. J. H.: Concealed Conduction , Circulat. Res. 9:194, 1961.Crossref 7. Bagdonas, A. A.; Stuckey, J. H.; Piera, J.; Amer. N. S., and Hoffman, B. F.: Effects of Ischemia and Hypoxia on the Specialized Conducting System of the Canine Heart , Amer. Heart J. 61:206, 1961.Crossref 8. Stuckey, J. H.; Hoffman, B. F.; Amer, N. S.; Cranefield, P. F.; Cappelletti, R. R., and Domingo, T.: Localization of the Bundle of His with a Surface Electrode During Cardiotomy , Surg. Forum 10:551, 1960. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Open Heart Surgery: The Prevention of Injury to the Specialized Conducting System

Archives of Surgery , Volume 85 (2) – Aug 1, 1962

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Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1962.01310020054012
Publisher site
See Article on Publisher Site

Abstract

Abstract Normal atrioventricular conduction is dependent upon proper functioning of the specialized conducting system within the heart. This system may be subjected to injury during the repair of congenital cardiac defects from: (1) sutures used in repairing the defect; (2) direct trauma from retractors and other instruments; (3) stretch and/or injury to the moderator band, and (4) interruption of the blood supply. One of the methods which may be used to demonstrate the anatomical relationship of the specialized conducting system to a cardiac defect at the time of surgery is to outline the course of this system at the time of operation. This is one of the problems which this laboratory has been studying during the past 3 years.1-4 By utilizing the heart-lung machine any chamber of the heart may be opened, and surface electrodes may be positioned at specific points under direct vision. It is possible to localize and References 1. Stuckey, J. H.; Hoffman, B. F.; Saksena, C. P.; Kottmeier, P. K., and Fishbone, H.: Electrode Identification of the Conduction System During Open Heart Surgery , Surg. Forum 9:202, 1959. 2. Amer, N. S.; Stuckey, J. H.; Hoffman, B. F.; Cappelletti, R. R., and Domingo, R. T.: Activation of the Interventricular Septal Myocardium Studied During Cardiopulmonary Bypass , Amer. Heart J. 59:224, 1960.Crossref 3. Stuckey, J. H.; Hoffman, B. F.; Bagdonas, A. A., and Venerose, R. S.: Direct Recordings from Chronically Implanted Electrodes on the Specialized Conducting System of the Heart , Proc. Soc. Exp. Biol. Med. 106:90, 1961.Crossref 4. Venerose, R. S.; Stuckey, J. H.; Hoffman, B. F., and Seidenstein, M.: Activation of Subendocardial Purkinje Fibers and Muscle Fibers of the Left Septal Surface Before and After Left Bundle Branch Block , Amer. Heart J. 63:346, 1962.Crossref 5. Hoffman, B. F.; Cranefield, P. F.; Stuckey, J. H., and Bagdonas, A. A.: Electrical Activity During the P-R Interval , Circulat. Res. 8:1200, 1960.Crossref 6. Hoffman, B. F.; Cranefield, P. F., and Stuckey,. J. H.: Concealed Conduction , Circulat. Res. 9:194, 1961.Crossref 7. Bagdonas, A. A.; Stuckey, J. H.; Piera, J.; Amer. N. S., and Hoffman, B. F.: Effects of Ischemia and Hypoxia on the Specialized Conducting System of the Canine Heart , Amer. Heart J. 61:206, 1961.Crossref 8. Stuckey, J. H.; Hoffman, B. F.; Amer, N. S.; Cranefield, P. F.; Cappelletti, R. R., and Domingo, T.: Localization of the Bundle of His with a Surface Electrode During Cardiotomy , Surg. Forum 10:551, 1960.

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1962

References