Modification of the radial procedure in a patient with partial atrioventricular septal defect.
We successfully cured atrial fibrillation while preserving internodal conduction in a patient with a partial atrioventricular septal defect. Because the anterior and middle internodal tracts are interrupted by the defect, the lower right atrial incision of either the maze or the radial procedure may interrupt the remaining posterior tract, resulting in internodal conduction block. We deleted the posterior septal incision from the radial procedure and replaced it with a right-side left atriotomy. The patient resumed normal sinus rhythm with significant contraction of the right and left atria. The preserved internodal pathway through the posterior interatrial septum was confirmed by electrophysiologic study.
Nitta
Takashi
T
Department of Cardiothoracic Surgery, Nippon Medical School, Tokyo, Japan. nitta_takashi/surg2@nms.ac.jp
Yamauchi
Hitoshi
H
Ohkubo
Naoko
N
Ishii
Yosuke
Y
Tanaka
Shigeo
S
Hayashi
Meiso
M
Kobayashi
Yoshinori
Y
Takano
Teruo
T
D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery; D004562:Electrocardiography; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology / Q000601:surgery*; D006346:Heart Septum / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000601:surgery