The conduction bundle at the atrioventricular junction. An anatomical study.
The conduction bundle at the atrioventricular junction. An anatomical study.
复制标题
房室交界处的传导束。
DOI：
10.1016/1010-7940(89)90023-7
复制
发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Becker Ae
中科院分区：
文献类型：
--
作者：
Hiromi Kurosawa;Becker Ae
本文对四例正常人心脏房室交界处传导束的解剖变异性进行了研究。连接区已被整块切除并连续切片。根据组织切片的计算，重建了传导束及其邻近结构，如隔小梁的后肢和膜性隔。该研究揭示了明显的变异性，特别是在延伸的后肢的小梁septomerialis。在一个例子中，肌肉几乎完全缺席，使分支束位于中线位置和内膜下的右，左室间隔表面。两个心脏的隔梁后肢分叉，只有一小段传导束被肌肉覆盖。在剩下的病例中，隔缘梁发育良好的后肢完全覆盖了传导轴，从而解释了束的左侧位置。所遇到的可变性可能使传导纤维易受三尖瓣装置的拉伸应变的影响，从而增强自然磨损过程，这可能导致传导纤维的破坏和心脏传导阻滞，特别是在老年人中。由于房室交界区传导束的详细解剖结构因人而异，一旦手术操作该区域，必须进行细致的检查。
The variability in the topographical anatomy of the conduction bundle atthe site of the atrioventricular junction has been studied in four normalhuman hearts. The junctional area has been removed en bloc and seriallysectioned. The conduction bundle and adjacent structures such as theposterior limb of the trabecula septomarginalis and the membranous septumhave been reconstructed based on calculations from the histologicalsections. The study reveals marked variability particularly in the extentof the posterior limb of the trabecula septomarginalis. In one instance,the muscle was almost totally absent so that the branching bundle waslocated in a midline position and subendocardial both to the right and theleft ventricular septal surface. In two hearts, the posterior limb of thetrabecula septomarginalis had ramified so that only a small segment of theconduction bundle was covered by muscle. In the remaining case, a well-developed posterior limb of the trabecula septomarginalis completelycovered the conduction axis thus accounting for the left-sided position ofthe bundle. The variability encountered may render the conduction bundlevulnerable to the tensile strain of the tricuspid valve apparatus,enhancing the natural process of wear and tear which may lead to disruptionof conduction fibres and heart block, particularly in the elderly. Sincethe detailed topographical anatomy of the conduction bundle in theatrioventricular junctional area appears to be highly variable from oneindividual to another, meticulous inspection is mandatory once the area ismanipulated at surgery.