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FRANK GERBODE, MD; WILLIAM J. KERTH, MD; GERALD KEEN, MS, FRCS; TAKESHI OGATA, MD; ROBERT W. POPPER, MD; JOHN J. OSBORN, MD

AMA Arch Surg. 1963;86(6):890-896.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

As open heart surgery progresses, attention is focused not only on new procedures but also on reducing the mortality and morbidity of existing operations. One complication of the closure of ventricular septal defects and endocardial cushion defects is surgical heart block. This complication probably results in a higher mortality than the pre-existing intracardiac defect.

Historically, the conduction mechanism was identified at an early date. Lev¹ states that the position and course of the AV node, bundle, and bundle branches in various congenitally abnormal hearts was systematically investigated and found to be in a normal location by Mönckeberg and to a lesser extent by Keith. The early operations for the closure of ventricular septal defects, however, resulted in a high incidence, approximately 12%, of complete heart block.²

Techniques for the surgical closure of ventricular septal defects were modified, perfusion techniques were improved, and the position of the conduction system . . . [Full Text PDF of this Article]

Author Affiliations
SAN FRANCISCO

From the Department of Cardiovascular Surgery, Presbyterian Medical Center.

Footnotes
Presented at the 70th Annual Session of the Western Surgical Association, St. Louis, Nov 29-Dec 1, 1962.

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