Théry C L, Folliot J P, Gosselin B, Lekiefre J, Warembourg H
Arch Mal Coeur Vaiss. 1977 Jan;70(1):15-23.
The authors report 8 cases of complete atrio-ventricular block (AVB) which came on during bacterial endocarditis. The aortic valve was more frequently affected (6/8). The conduction disorder is necessarily unstable. The prognostic significance of AVB is always very grave--all the patients have died. The valve lesions are often severe. A histological study of the conducting pathways has been carried out. The classically described aneurysm of the membranous septum was not responsable for any cases of AVB in this series. The most frequent cause of the AVB (5/8) was an infiltration of the prenodal area and the A-V nod itself, starting from the posterior aortic cusp and, in one case, from the tricuspid valve. The bundle of His is affected either by extension of the A-V node lesion or by the focus on the right cusp. Strings of inflammatory cells may follow the sheath of the bundle branches. Haematogenous micro-abscesses are sometimes found in the conducting tissues.
作者报告了8例在细菌性心内膜炎期间发生的完全性房室传导阻滞（AVB）病例。主动脉瓣受累更为常见（6/8）。传导障碍必然不稳定。AVB的预后意义总是非常严重——所有患者均死亡。瓣膜病变往往很严重。已对传导通路进行了组织学研究。本系列中经典描述的膜性间隔动脉瘤并非任何AVB病例的病因。AVB最常见的原因（5/8）是结前区和房室结本身的浸润，始于主动脉后瓣叶，1例始于三尖瓣。希氏束要么因房室结病变的扩展而受累，要么因右瓣叶的病灶而受累。炎性细胞条索可能沿着束支的鞘膜走行。有时在传导组织中发现血源性微脓肿。
