Thiene G, Nava A, Rossi L
Eur J Cardiol. 1977 Sep-Oct;6(1):57-70.
The location and course of the conduction system were investigated by serial section in two hearts with corrected transposition of the great arteries in situs inversus. In the first case, characterized by dextrocardia, the interventricular septum was intact, while in the second case with levocardia, a high ventricular septal defect was associated with pulmonary atresia. In both hearts, a regular posterior connecting AV node was present, left-sided in one case and right-sided in the other. The bundle branches were distributed in the morphologically appropriate ventricles. Extensive hemorrhage and coagulation necrosis of the common bundle and bundle branches were observed in the first case, being consequent upon surgical replacement of the right-sided tricuspid valve. The common bundle ran below the membranous septum in this case. In the heart with ventricular septal defect it was related to the postero-inferior rim of the defect. In both cases, an accessory AV node was located anteriorly in the interatrial septum but did not connect with the ventricular musculature. The different position of the atrioventricular conducting tissue in corrected transposition, between cases in situs solitus and situs inversus, is emphasized.
通过对两例镜面右位心合并矫正型大动脉转位心脏的连续切片，研究了传导系统的位置和走行。第一例以右位心为特征，室间隔完整；而第二例为左位心，伴有高位室间隔缺损及肺动脉闭锁。两例心脏均存在正常的后向连接房室结，一例位于左侧，另一例位于右侧。束支分布于形态学上相应的心室。在第一例中，观察到总束支和束支广泛出血及凝固性坏死，这是由于右侧三尖瓣手术置换所致。在此例中，总束支走行于膜周部下方。在伴有室间隔缺损的心脏中，它与缺损的后下缘相关。两例中，均有一个附加房室结位于房间隔前方，但未与心室肌相连。强调了在矫正型大动脉转位中，房室传导组织在正位和镜面右位心病例之间的不同位置。
