de Leval M R, Bastos P, Stark J, Taylor J F, Macartney F J, Anderson R H
J Thorac Cardiovasc Surg. 1979 Oct;78(4):515-26.
Traumatic heart block remains a major concern after ventricular septal defect (VSD) closure in patients with atrioventricular discordance. A technique of closing the VSD, placing the suture line on the morphologically right side of the septum without opening the systemic ventricle, is described. This was used in 13 consecutive patients. The VSD was closed through the right atrium in eight patients, the left ventricle in three patients, the right atrium and the left ventricle in one patient, and through the right ventricle in one patient with atrioventricular disordance and ventriculo-arterial concordance. All patients were in sinus rhythm preoperatively, two exhibited atrioventricular dissociation before intracardiac manipulation began, and 11 patients were in sinus rhythm postoperatively. No major arrhythmia could be attributed to the closure of the VSD.
对于房室不一致的患者，室间隔缺损（VSD）封堵术后创伤性心脏传导阻滞仍然是一个主要问题。本文描述了一种关闭VSD的技术，即将缝线置于室间隔形态学右侧而不打开体循环心室。该技术应用于13例连续患者。8例患者经右心房关闭VSD，3例经左心室，1例经右心房和左心室，1例房室不一致但心室-动脉一致的患者经右心室关闭VSD。所有患者术前均为窦性心律，2例在心脏内操作开始前出现房室分离，11例患者术后为窦性心律。没有严重心律失常可归因于VSD的封堵。
