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Right arrow Electrophysiology - arrhythmias

Ann Thorac Surg 2002;73:661-663
© 2002 The Society of Thoracic Surgeons

Case report

Modification of the radial procedure in a patient with partial atrioventricular septal defect

Takashi Nitta, MD*a, Hitoshi Yamauchi, MDa, Naoko Ohkubo, MDa, Yosuke Ishii, MDa, Shigeo Tanaka, MDa, Meiso Hayashi, MDb, Yoshinori Kobayashi, MDb, Teruo Takano, MDb

a Department of Cardiothoracic Surgery, Nippon Medical School, Tokyo, Japan
b Department of Cardiology, Nippon Medical School, Tokyo, Japan

Accepted for publication May 17, 2001.

* Address reprint requests to Dr Nitta, Department of Cardiothoracic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
e-mail: nitta_takashi_surg2{at}nms.ac.jp

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.






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