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(Circulation. 1970;42:895.)
© 1970 American Heart Association, Inc.

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Right Bundle-Branch Block and Left Anterior Fascicular Block (Left Anterior Hemiblock) Following Tricuspid Valve Replacement

V. ARAVINDAKSHAN M.D.¹; MARCELO V. ELIZARI M.D.¹; MAURICIO B. ROSENBAUM M.D.¹

¹ From the Cardiovascular Division, Department of Medicine, University of Kentucky College of Medicine, Lexington, Kentucky.

Right bundle-branch block occurred in 42.8% and left anterior hemiblock in 35% of 14 patients after surgical replacement of the tricuspid valve. The combination of RBBB with left anterior hemiblock is caused by injury to the branching portion of the bundle of His or more likely, by a lesion involving the pseudobifurcation. This study provides further proof that left anterior hemiblock may be produced by a "central" lesion of the conduction system. An attempt was made to re-define the relationships of the bundle of His and bundle branches to the membranous septum and septal leaflet of the tricuspid valve and to correlate the site of surgical injury with the type of conduction disturbances produced.

Key Words: Atrioventricular block • Bundle of His • Pseudobifurcation • Surgical heart block

Submitted on June 9, 1970
Accepted on July 23, 1970

This article has been cited by other articles:

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