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Systematic Mapping of Conduction Tissue Regions During Congenital Heart Surgery.
Annals of Thoracic Surgery 2022 June 12
PURPOSE: Damage to cardiac conduction system is a major risk of congenital cardiac surgery. Localization of conduction system is commonly based on anatomical landmarks which are variable in congenital heart diseases. We introduce a novel technique for identification of conduction tissue regions based on real-time fiberoptic confocal microscopy (FCM).
DESCRIPTION: We developed FCM-based technique to document conduction tissue regions and deployed it in pediatric patients undergoing repair of common congenital heart defects. The technique applies clockface schematics for intraoperative documentation of the location of conduction tissue regions.
EVALUATION: We created clockface schematics for 11, 6, and 10 patients with ventricular septal defects, tetralogy of Fallot, and atrioventricular canal defects, respectively. The approach revealed substantial variability in the location of the conduction system in hearts with congenital defects. The clockface schematics were used to create plans for the subsequent surgical repair.
CONCLUSIONS: The clockface schematic provides a reliable fiducial system to document and communicate variability of conduction tissue regions in the heart and apply this information for decision-making during congenital cardiac surgery.
DESCRIPTION: We developed FCM-based technique to document conduction tissue regions and deployed it in pediatric patients undergoing repair of common congenital heart defects. The technique applies clockface schematics for intraoperative documentation of the location of conduction tissue regions.
EVALUATION: We created clockface schematics for 11, 6, and 10 patients with ventricular septal defects, tetralogy of Fallot, and atrioventricular canal defects, respectively. The approach revealed substantial variability in the location of the conduction system in hearts with congenital defects. The clockface schematics were used to create plans for the subsequent surgical repair.
CONCLUSIONS: The clockface schematic provides a reliable fiducial system to document and communicate variability of conduction tissue regions in the heart and apply this information for decision-making during congenital cardiac surgery.
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