Anatomically guided surgery to the AV node. AV nodal skeletonization: experience in 46 patients with AV nodal reentrant tachycardia
We report our combined experience with operative therapy foratrioventricular nodal tachycardia using an anatomically guided procedure.The operative rationale was to dissect the AV node with the intent ofmodifying perinodal tissues (skeletonization). The anterior septal andposterior septal regions we...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 1990-01, Vol.4 (9), p.461-464 |
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| creator | GUIRAUDON, G. M KLEIN, G. J VAN HEMEL, N GUIRAUDON, C. M YEE, R VERMEULEN, F. E. E |
| description | We report our combined experience with operative therapy foratrioventricular nodal tachycardia using an anatomically guided procedure.The operative rationale was to dissect the AV node with the intent ofmodifying perinodal tissues (skeletonization). The anterior septal andposterior septal regions were initially approached epicardially tofacilitate endocardial dissection. Under normothermic cardiopulmonarybypass, the right atrial septum was mobilized and the intermediate AV nodewas exposed anterior to the tendon of Todaro. Ablation of concomitantaccessory pathways was done prior to AV nodal skeletonization. Forty-sixpatients aged 9-71 years (mean 36) were operated upon. Five patients hadaccessory pathways in addition to AV nodal reentry. Atelectro-physiological study prior to discharge, no patient had an AV blockalthough anterograde and retrograde Wenckebach cycle lengths weresignificantly prolonged. Ten patients had a retrograde AV block. The 46patients were free of arrhythmia and not taking antiarrhythmic medicationafter a follow-up of 1-45 months (mean 17). Three patients had a recurrenceof the tachycardia 10 days, 2 months and 7 months post-operatively,respectively. All patients had a subsequently successful reoperation. |
| doi_str_mv | 10.1016/1010-7940(90)90166-W |
| format | Article |
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AV nodal skeletonization: experience in 46 patients with AV nodal reentrant tachycardia</title><source>MEDLINE</source><source>Oxford University Press Journals Digital Archive Legacy</source><creator>GUIRAUDON, G. M ; KLEIN, G. J ; VAN HEMEL, N ; GUIRAUDON, C. M ; YEE, R ; VERMEULEN, F. E. E</creator><creatorcontrib>GUIRAUDON, G. M ; KLEIN, G. J ; VAN HEMEL, N ; GUIRAUDON, C. M ; YEE, R ; VERMEULEN, F. E. E</creatorcontrib><description>We report our combined experience with operative therapy foratrioventricular nodal tachycardia using an anatomically guided procedure.The operative rationale was to dissect the AV node with the intent ofmodifying perinodal tissues (skeletonization). The anterior septal andposterior septal regions were initially approached epicardially tofacilitate endocardial dissection. Under normothermic cardiopulmonarybypass, the right atrial septum was mobilized and the intermediate AV nodewas exposed anterior to the tendon of Todaro. Ablation of concomitantaccessory pathways was done prior to AV nodal skeletonization. Forty-sixpatients aged 9-71 years (mean 36) were operated upon. Five patients hadaccessory pathways in addition to AV nodal reentry. Atelectro-physiological study prior to discharge, no patient had an AV blockalthough anterograde and retrograde Wenckebach cycle lengths weresignificantly prolonged. Ten patients had a retrograde AV block. The 46patients were free of arrhythmia and not taking antiarrhythmic medicationafter a follow-up of 1-45 months (mean 17). Three patients had a recurrenceof the tachycardia 10 days, 2 months and 7 months post-operatively,respectively. All patients had a subsequently successful reoperation.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/1010-7940(90)90166-W</identifier><identifier>PMID: 2223125</identifier><identifier>CODEN: EJCSE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Science B.V</publisher><subject>Adolescent ; Adult ; Aged ; Anatomy, Regional ; Animals ; Atrioventricular Node - anatomy & histology ; Atrioventricular Node - surgery ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Chick Embryo ; Child ; Female ; Heart ; Humans ; Male ; Medical sciences ; Methods ; Middle Aged ; Prognosis ; Recurrence ; Reoperation ; Tachycardia, Atrioventricular Nodal Reentry - diagnosis ; Tachycardia, Atrioventricular Nodal Reentry - physiopathology ; Tachycardia, Atrioventricular Nodal Reentry - surgery ; Tachycardia, Supraventricular - diagnosis ; Tachycardia, Supraventricular - physiopathology ; Tachycardia, Supraventricular - surgery</subject><ispartof>European journal of cardio-thoracic surgery, 1990-01, Vol.4 (9), p.461-464</ispartof><rights>1991 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,23929,23930,25139,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19479570$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2223125$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GUIRAUDON, G. M</creatorcontrib><creatorcontrib>KLEIN, G. J</creatorcontrib><creatorcontrib>VAN HEMEL, N</creatorcontrib><creatorcontrib>GUIRAUDON, C. M</creatorcontrib><creatorcontrib>YEE, R</creatorcontrib><creatorcontrib>VERMEULEN, F. E. E</creatorcontrib><title>Anatomically guided surgery to the AV node. AV nodal skeletonization: experience in 46 patients with AV nodal reentrant tachycardia</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>We report our combined experience with operative therapy foratrioventricular nodal tachycardia using an anatomically guided procedure.The operative rationale was to dissect the AV node with the intent ofmodifying perinodal tissues (skeletonization). The anterior septal andposterior septal regions were initially approached epicardially tofacilitate endocardial dissection. Under normothermic cardiopulmonarybypass, the right atrial septum was mobilized and the intermediate AV nodewas exposed anterior to the tendon of Todaro. Ablation of concomitantaccessory pathways was done prior to AV nodal skeletonization. Forty-sixpatients aged 9-71 years (mean 36) were operated upon. Five patients hadaccessory pathways in addition to AV nodal reentry. Atelectro-physiological study prior to discharge, no patient had an AV blockalthough anterograde and retrograde Wenckebach cycle lengths weresignificantly prolonged. Ten patients had a retrograde AV block. The 46patients were free of arrhythmia and not taking antiarrhythmic medicationafter a follow-up of 1-45 months (mean 17). Three patients had a recurrenceof the tachycardia 10 days, 2 months and 7 months post-operatively,respectively. All patients had a subsequently successful reoperation.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anatomy, Regional</subject><subject>Animals</subject><subject>Atrioventricular Node - anatomy & histology</subject><subject>Atrioventricular Node - surgery</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Chick Embryo</subject><subject>Child</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Reoperation</subject><subject>Tachycardia, Atrioventricular Nodal Reentry - diagnosis</subject><subject>Tachycardia, Atrioventricular Nodal Reentry - physiopathology</subject><subject>Tachycardia, Atrioventricular Nodal Reentry - surgery</subject><subject>Tachycardia, Supraventricular - diagnosis</subject><subject>Tachycardia, Supraventricular - physiopathology</subject><subject>Tachycardia, Supraventricular - surgery</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1990</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1PxCAQhonR-P0PNOGi0UMVSguLt83GVaPGg5_x0iBMXbRLV6DR9eofl8SqF2Yyz8Mk8yK0RckBJZQfpodkQhZkT5J9mSY8u19Aq3QgWCZY8bCY-l9lBa2F8EII4SwXy2g5z3NG83IVfQ2diu3UatU0c_zcWQMGh84_g5_j2OI4ATy8w641cNA3qsHhFRqIrbOfKtrWHWH4mIG34DRg63DB8SwBcDHgdxsn_x89pKFXLuKo9GSulTdWbaClWjUBNvu6jm7Hxzej0-zi6uRsNLzIJowMYsaNkfDEtACRl1IArw0RuYFS6kLVrNampgwGOlcgeam1rGnCgmiiDOe0Zuto92fvzLdvHYRYTW3Q0DTKQduFapDiEZLJJG73Yvc0BVPNvJ0qP6_61BLf6bkKKbg6HaRt-NOoLIQsBUle9uPZEOHjjyv_WnHBRFmdPjxWN2w8vr68O6-u2TdDRY4d</recordid><startdate>19900101</startdate><enddate>19900101</enddate><creator>GUIRAUDON, G. 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Vascular system</topic><topic>Chick Embryo</topic><topic>Child</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Recurrence</topic><topic>Reoperation</topic><topic>Tachycardia, Atrioventricular Nodal Reentry - diagnosis</topic><topic>Tachycardia, Atrioventricular Nodal Reentry - physiopathology</topic><topic>Tachycardia, Atrioventricular Nodal Reentry - surgery</topic><topic>Tachycardia, Supraventricular - diagnosis</topic><topic>Tachycardia, Supraventricular - physiopathology</topic><topic>Tachycardia, Supraventricular - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GUIRAUDON, G. M</creatorcontrib><creatorcontrib>KLEIN, G. J</creatorcontrib><creatorcontrib>VAN HEMEL, N</creatorcontrib><creatorcontrib>GUIRAUDON, C. M</creatorcontrib><creatorcontrib>YEE, R</creatorcontrib><creatorcontrib>VERMEULEN, F. E. E</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GUIRAUDON, G. M</au><au>KLEIN, G. J</au><au>VAN HEMEL, N</au><au>GUIRAUDON, C. M</au><au>YEE, R</au><au>VERMEULEN, F. E. E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anatomically guided surgery to the AV node. AV nodal skeletonization: experience in 46 patients with AV nodal reentrant tachycardia</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>1990-01-01</date><risdate>1990</risdate><volume>4</volume><issue>9</issue><spage>461</spage><epage>464</epage><pages>461-464</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><coden>EJCSE7</coden><abstract>We report our combined experience with operative therapy foratrioventricular nodal tachycardia using an anatomically guided procedure.The operative rationale was to dissect the AV node with the intent ofmodifying perinodal tissues (skeletonization). The anterior septal andposterior septal regions were initially approached epicardially tofacilitate endocardial dissection. Under normothermic cardiopulmonarybypass, the right atrial septum was mobilized and the intermediate AV nodewas exposed anterior to the tendon of Todaro. Ablation of concomitantaccessory pathways was done prior to AV nodal skeletonization. Forty-sixpatients aged 9-71 years (mean 36) were operated upon. Five patients hadaccessory pathways in addition to AV nodal reentry. Atelectro-physiological study prior to discharge, no patient had an AV blockalthough anterograde and retrograde Wenckebach cycle lengths weresignificantly prolonged. Ten patients had a retrograde AV block. The 46patients were free of arrhythmia and not taking antiarrhythmic medicationafter a follow-up of 1-45 months (mean 17). Three patients had a recurrenceof the tachycardia 10 days, 2 months and 7 months post-operatively,respectively. All patients had a subsequently successful reoperation.</abstract><cop>Amsterdam</cop><pub>Elsevier Science B.V</pub><pmid>2223125</pmid><doi>10.1016/1010-7940(90)90166-W</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Anatomy, Regional Animals Atrioventricular Node - anatomy & histology Atrioventricular Node - surgery Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Chick Embryo Child Female Heart Humans Male Medical sciences Methods Middle Aged Prognosis Recurrence Reoperation Tachycardia, Atrioventricular Nodal Reentry - diagnosis Tachycardia, Atrioventricular Nodal Reentry - physiopathology Tachycardia, Atrioventricular Nodal Reentry - surgery Tachycardia, Supraventricular - diagnosis Tachycardia, Supraventricular - physiopathology Tachycardia, Supraventricular - surgery |
| title | Anatomically guided surgery to the AV node. AV nodal skeletonization: experience in 46 patients with AV nodal reentrant tachycardia |
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