外科的両脚ブロックの実態と成因に関する研究

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  • A study on surgical BBBB and its etiology
  • ゲカテキ リョウキャク ブロック ノ ジッタイ ト セイイン ニカンスルケンキ

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Surgical BBBB was surveyed in our series of intracadiac surgery consisting of 254 with VSD, 48 with TOF and 4 with TGA III, from Jan., 1970 through March, 1981. Of surgical BBBB, LAHB with RBBB was commonest and LPHB(LBBB)with RBBB was next: they were usually transient and benign. Two cases with trifascicular block following surgical CAVB, developed to CAVB later:impairment of the bundle of His was suspected. In our clinical study, LAHB with RBBB often followed trauma to the lower rim of VSD near the muscle of Lancisi or the Lancisi equivalent structure, while LPHB with RBBB followed thar to the more posterior lower rim. Electrophysiological delineation of the conduction system revealed relatively tight correlations of the RB with the Lancisi equivalent strucure, little affected by the type of VSD and TOF. This result was worthwhile for presuming the bifurcated site of the His bundle, and for reducing the incidence of surgical BBBB.

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