Wilkinson J L, Smith A, Lincoln C, Anderson R H
Br Heart J. 1978 Jan;40(1):41-8. doi: 10.1136/hrt.40.1.41.
Three cases of congenitally corrected transposition in situs inversus individuals were characterised by visceroatrial situs inversus, atrioventricular discordance, and ventiruloarterial discordance: one case was studied clinically, and the other 2 were necropsy specimens. The disposition of the atrioventricular conducting tissues was established in each case, in the living patient by intraoperative mapping, and in the necropsy specimens by histopathological investigation. In all, the connecting atrioventricular bundle arose from a normally situated posterior atrioventricular node, normally related to the landmarks of the atrial septum. Though anterior nodes were identified in the necropsy specimens, as reported in congenitally corrected transposition in situs individuals, they differed from those in the latter situation in that they made no atrioventricular connection. These findings have obvious surgical importance. It is suggested that the posterior connection is related to the good septal alignment in these cases which lacked significant septal defects. Posterior connections are not necessarily present in all situs inversus individuals with corrected transposition, particularly when there are malalignment ventricular septal defects: further studies are required in such cases.
三例镜像右位心个体的先天性矫正型大动脉转位表现为内脏心房反位、房室不一致和心室动脉不一致：1例进行了临床研究，另外2例为尸检标本。通过术中标测确定了活体患者每例的房室传导组织分布，通过组织病理学研究确定了尸检标本的分布。总体而言，连接房室束起源于正常位置的后房室结，通常与房间隔的标志相关。尽管在尸检标本中发现了前结，如镜像右位心个体的先天性矫正型大动脉转位中所报道的那样，但它们与后者情况不同，因为它们没有房室连接。这些发现具有明显的手术重要性。提示在这些无明显室间隔缺损的病例中，后连接与良好的间隔对齐有关。后连接不一定存在于所有镜像右位心且矫正型大动脉转位的个体中，特别是当存在对位不良的室间隔缺损时：此类病例需要进一步研究。
