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Ann Thorac Surg 1996;61:1678-1679
© 1996 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1666.

DR JAMES J. MORRIS (Charleston, SC): Doctor Gandhi, along with Dr Cox, Dr Huddleston, and their colleagues, has presented a very well conceived and elegant investigation.

Over the past several decades with improvements in the treatment of congenital heart disease and with the availability of long-term follow-up, the late occurrence of atrial tachydysrhythmias after a variety of corrective operations has been increasingly recognized to be a significant source of subsequent morbidity and mortality. Attempts to more clearly understand the relationship between atrial anatomy and the electrophysiologic basis of these dysrhythmias to modify old operations and to tailor new operations to prevent problematic late atrial flutter and fibrillation seems to represent an important new frontier in cardiac surgery.

In this light, Dr Gandhi and his colleagues have demonstrated several points. First, the combination of a longitudinal atriotomy and an incision in the right atrial appendage, as would be performed with the classic Fontan atriopulmonary connection, results in a reproducible macroreentrant substrate for the induction of sustained reentrant atrial tachycardia. They have shown characteristic propagation of the reentrant wavefront is through the bridge of atrial myocardium between the two atrial incisions.

Second, and importantly, the investigators have shown that . . . [Full Text of this Article]


Related Article

Characterization and Surgical Ablation of Atrial Flutter After the Classic Fontan Repair
Sanjiv K. Gandhi, Burt I. Bromberg, Richard B. Schuessler, Bryan J. Turken, John P. Boineau, James L. Cox, and Charles B. Huddleston
Ann. Thorac. Surg. 1996 61: 1666-1678. [Abstract] [Full Text]





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Copyright © 1996 by The Society of Thoracic Surgeons.