TY - JOUR
T1 - Visualization and quantification of the atrioventricular conduction axis in hearts with ventricular septal defect using phase contrast computed tomography
AU - Yoshitake, Shuichi
AU - Kaneko, Yukihiro
AU - Morita, Kiyozo
AU - Hoshino, Masato
AU - Oshima, Yoshihiro
AU - Takahashi, Masashi
AU - Anderson, Robert H.
AU - oshitake, Shuichi
AU - Morishita, Hiroyuki
AU - Shinohara, Gen
AU - Iwaki, Ryuma
AU - Matsuhisa, Hironori
AU - Nagashima, Mitsugi
AU - Tsukube, Takuro
N1 - Funding Information:
This research is supported by the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development, AMED (17ek0109137h0003) and JSPS KAKENHI grant numbers 16K10639, 16K10629, and 18K08771.
Publisher Copyright:
© 2020 The American Association for Thoracic Surgery
PY - 2020/8
Y1 - 2020/8
N2 - Objective: To visualize and quantify the atrioventricular conduction axis in the setting of ventricular septal defect using phase contrast computed tomography. Methods: We used the SPring-8 synchrotron radiation facility in Hyogo prefecture in Japan, processing and reconstructing the data with 3-dimensional software. Results: We studied 8 hearts obtained from patients known to have had ventricular septal defects, aged from 6 to 150 days, with a median of 24.5 days. None of the individuals, however, had undergone corrective surgery. The penetrating bundle was found at a median of 1.43 mm from the septal crest, with a range of 0.99 to 1.54 mm. The distance to the nonbranching bundle to the right ventricular endocardium was 1.10 mm, with a range from 0.49 to 2.49 mm, to the origin of the left bundle branch was 2.46 mm, with a range from 1.7 to 3.18 mm, and to the origin of the right bundle branch was 2.34 mm, with a range from 0.50 to 2.59 mm. The median distance from the edge of the caudal limb of the septomarginal trabeculation to the right bundle branch was 1.04 mm, with a range from 0.81 to 1.16 mm. Conclusions: We were able to show the precise location of the axis, with our findings suggesting that longitudinal sutures placed along the posteroinferior rim should be effective in avoiding iatrogenic injury, but sutures should not be placed in the valley between the limbs of the septomarginal trabeculation.
AB - Objective: To visualize and quantify the atrioventricular conduction axis in the setting of ventricular septal defect using phase contrast computed tomography. Methods: We used the SPring-8 synchrotron radiation facility in Hyogo prefecture in Japan, processing and reconstructing the data with 3-dimensional software. Results: We studied 8 hearts obtained from patients known to have had ventricular septal defects, aged from 6 to 150 days, with a median of 24.5 days. None of the individuals, however, had undergone corrective surgery. The penetrating bundle was found at a median of 1.43 mm from the septal crest, with a range of 0.99 to 1.54 mm. The distance to the nonbranching bundle to the right ventricular endocardium was 1.10 mm, with a range from 0.49 to 2.49 mm, to the origin of the left bundle branch was 2.46 mm, with a range from 1.7 to 3.18 mm, and to the origin of the right bundle branch was 2.34 mm, with a range from 0.50 to 2.59 mm. The median distance from the edge of the caudal limb of the septomarginal trabeculation to the right bundle branch was 1.04 mm, with a range from 0.81 to 1.16 mm. Conclusions: We were able to show the precise location of the axis, with our findings suggesting that longitudinal sutures placed along the posteroinferior rim should be effective in avoiding iatrogenic injury, but sutures should not be placed in the valley between the limbs of the septomarginal trabeculation.
UR - http://www.scopus.com/inward/record.url?scp=85081885370&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85081885370&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2020.02.036
DO - 10.1016/j.jtcvs.2020.02.036
M3 - Article
C2 - 32192723
AN - SCOPUS:85081885370
VL - 160
SP - 490
EP - 496
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 2
ER -