Clarkson P M, Barratt-Boyles B G, Neutze J M
Circulation. 1976 Mar;53(3):519-24. doi: 10.1161/01.cir.53.3.519.
Between 1964 and 1971, 49 patients were discharged from hospital following atrial baffle repair for transposition of the great arteries. Electrocardiograms of 47 of these patients were available for review seven months to eight and a half years (average 31 months) after operation. Of the 46 patients in sinus rhythm prior to operation, 40 (87%) were in sinus rhythm with normal atrioventricular conduction when last seen. Four patients (8.7%) had benign supraventricular dysrhythmias: three were junctional, one was atrial. None was noted to experience rapid dysrhythmias. Two patients showed evidence of abnormal atrioventricular conduction. There were five late deaths but in only one of these patients was a dysrhythmia a possible factor. The effects of variations in caval cannulation, extent of excision of the atrial septum and placement of the baffle suture line on the rhythm present at last review were examined. To preserve sinus rhythm it appears necessary to avoid surgical trauma in the vicinity of both the sinus node and the A-V node. Preservation of the internodal tracts appears less important. It is uncertain whether the 'sinus' rhythm seen after operation originates in the sinoatrial node but the rhythm is functionally similar.
1964年至1971年间，49例因大动脉转位接受心房内板障修复术的患者出院。其中47例患者的心电图在术后7个月至8年半（平均31个月）可供复查。术前处于窦性心律的46例患者中，最后一次检查时40例（87%）处于窦性心律且房室传导正常。4例患者（8.7%）出现良性室上性心律失常：3例为交界性，1例为房性。未发现有快速性心律失常。2例患者有房室传导异常的证据。有5例晚期死亡，但其中只有1例患者的心律失常可能是一个因素。研究了腔静脉插管方式的变化、房间隔切除范围及板障缝合线位置对最后复查时心律的影响。为维持窦性心律，似乎有必要避免在窦房结和房室结附近造成手术创伤。保留结间束似乎不那么重要。术后所见的“窦性”心律是否起源于窦房结尚不确定，但该心律在功能上相似。
