Lesions of the Atrioventricular Conduction System after Repair of Ventricular Septal Defect

Abstract

Lesions related to surgical repair of ventricular septal defects were found in atrioventricular (AV) conduction system in 12 of 13 human hearts from patients who were operated on from 1955 through 1959 and who died in the postoperative period. Complete heart block was demonstrated postoperatively in 6 of 9 patients whose hearts showed major lesions in AV node or main bundle of His, or both. In 2, available evidence suggested that complete heart block had been present. In the other case, records were insufficient to permit evaluation of the functional status of conduction tissue. Three patients had right bundle-branch block. In each of their hearts, lesions were observed in the right branch; in 2, lesions also were observed in the common bundle. It is concluded that, in patients operated on for closure of ventricular septal defects, postoperative interference with AV conduction may be correlated with lesions in the conduction system.