Maloney J D, Ritter D G, McGoon D C, Danielson G K
Mayo Clin Proc. 1975 Jul;50(7):387-94.
The high incidence of surgically induced heart block in patients with levotransposition of the great arteries is now better understood because of recent anatomic demonstration of an unusual anterior location of the atrioventricular specialized conducting tissue. The two cases reported herein proved electrophysiologic confirmation of this previously described anatomy. The specialized conducting bundle was easily and consistently identified and then avoided in successful surgical correction in one patient with common ventricle, type A-3, and in another with corrected transposition, large ventricular septal defect, and valvular pulmonary stenosis. Electrophysiologic identification of the atrioventricular conduction tissue at the time of operation may decrease the incidence of heart block and offers additional optimism for successful correction of levotransposition complexes.
由于最近对房室特殊传导组织异常前位的解剖学证明，大动脉左旋位患者手术诱发心脏传导阻滞的高发生率现在得到了更好的理解。本文报道的两例病例从电生理方面证实了先前描述的这种解剖结构。在一名患有共同心室、A-3型的患者以及另一名患有矫正性大动脉转位、大型室间隔缺损和瓣膜性肺动脉狭窄的患者的成功手术矫正中，很容易且一致地识别出了特殊传导束，进而避开了它。手术时对房室传导组织进行电生理识别可能会降低心脏传导阻滞的发生率，并为成功矫正大动脉左旋位复合体带来更多希望。
