Premium
Surgical Significance of Morphological Variations in the Atrial Septum in Atrioventricular Septal Defect for Determination of the Site of Penetration of the Atrioventricular Conduction Axis
Author(s) -
SEO JEONGWOOK,
ZUBERBUHLER JAMES R.,
HO S. YEN,
ANDERSON ROBERT H.
Publication year - 1992
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1992.tb01022.x
Subject(s) - atrioventricular septal defect , medicine , anatomy , coronary sinus , atrioventricular valve , atrial septum , atrioventricular node , cardiology , heart disease , ventricle , tachycardia
The morphological variation in the recognized landmarks for the atrioventricular conduction system was studied grossly in 94 hearts with atrioventricular septal defect, assessing 20 hearts with normal atrioventricular septation as a control. In all the hearts with intact atrioventricular septal structures, the tendon of Todaro demarcated the superior boundary of the triangle of Koch. In hearts with atrioventricular septal defect, however, the landmarks for the conduction axis made up a separate nodal triangle. The tendon of Todaro, along with a bridging tendon not found in the normal heart, were variably developed in hearts with atrioventricular septal defect and formed a further triangle unrelated to the axis for atrioventricular conduction. The opening of the coronary sinus was also variable in its location and size. It was the location of the inferior bridging leaflet as it crossed the ventricular septum that was the best surgical landmark to the site of penetration of the atrioventricular conduction axis.