Martinez J, Vahdat F, Redonnet J
Arch Mal Coeur Vaiss. 1976 Jun;69(6):581-7.
Based on a study of 43 cases the authors attempt to assess the exact aetiology of the appearance of right bundle branch block, which is seen very frequently after repair of a ventricular septal defect. A comparison of the electrocardiograms with the anatomical type of VSD, the surgical approach, and the size of the septal defect would seem to indicate that a monofascicular block by a lesion of the right branch of the bundle of His is responsible. The correlations are not, however, absolute, and in a certain number of cases a simple peripheral lesion was to blame. The importance of precise knowledge of the case of the branch is that it is possible that first a bi- and then a tri-fasicular block will develop; this means that complete atrioventricular block is one of the long-term sequelae of surgery. In the authors' experience of 43 cases, only one tri-fascicular block developed.
基于对43例病例的研究，作者试图评估室间隔缺损修复术后非常常见的右束支传导阻滞出现的确切病因。将心电图与室间隔缺损的解剖类型、手术方式以及室间隔缺损大小进行比较，似乎表明希氏束右支病变导致的单束支传导阻滞是其原因。然而，这些相关性并非绝对，在一定数量的病例中，单纯的外周病变才是罪魁祸首。精确了解束支情况的重要性在于，可能首先会发展为双束支传导阻滞，然后是三束支传导阻滞；这意味着完全性房室传导阻滞是手术的长期后遗症之一。根据作者对43例病例的经验，仅出现了一例三束支传导阻滞。
