Impaired Atrioventricular Conduction System in a Postoperative Heart With Congenitally Corrected Transposition of the Great Arteries
4 affiliations
- 1Department of Legal Medicine, Showa Medical University School of Medicine, Tokyo, Japan
- 2Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- 3Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
- 4Cardiac Morphology Unit, Royal Brompton Hospital, London, United Kingdom
Abstract
Background: Twin atrioventricular nodes (AVNs) occasionally occur in congenitally corrected transposition of the great arteries (ccTGA).
Case Summary: A 14-year-old adolescent girl with ccTGA died suddenly after cardiopulmonary arrest. The electrocardiogram showed QRS widening from age 6. At autopsy, a Rastelli conduit and a fibrotic scar from ventricular septal defect patch closure were present. Serial sections revealed isolated anterior and posterior AVNs. The posterior AVN continued into an elongated His bundle that was disrupted by fibrosis, whereas the anterior AVN was interrupted by fibrofatty tissue.
Discussion: QRS widening was likely caused by interruption of the elongated His bundle. Although posterior-dominant AVN is uncommon, it should be considered when planning surgery for ccTGA.
Take-Home Message: A posterior-dominant AVN is uncommon; however, it should be considered when planning surgery for ccTGA with usual atrial arrangement.
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BibTeX
@article{matsuyama2026impaired,
title = {{Impaired Atrioventricular Conduction System in a Postoperative Heart With Congenitally Corrected Transposition of the Great Arteries}},
author = {Taka-aki Matsuyama and Yohsuke Makino and Eri Nakamura and Hatsue Ishibashi-Ueda and Siew Yen Ho},
journal = {JACC Case Reports},
year = {2026},
month = sep,
doi = {10.1016/j.jaccas.2026.110002},
url = {https://doi.org/10.1016/j.jaccas.2026.110002},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Impaired Atrioventricular Conduction System in a Postoperative Heart With Congenitally Corrected Transposition of the Great Arteries
AU - Taka-aki Matsuyama
AU - Yohsuke Makino
AU - Eri Nakamura
AU - Hatsue Ishibashi-Ueda
AU - Siew Yen Ho
PY - 2026
DA - 2026/09/09
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.110002
UR - https://doi.org/10.1016/j.jaccas.2026.110002
AB - Background: Twin atrioventricular nodes (AVNs) occasionally occur in congenitally corrected transposition of the great arteries (ccTGA). Case Summary: A 14-year-old adolescent girl with ccTGA died suddenly after cardiopulmonary arrest. The electrocardiogram showed QRS widening from age 6. At autopsy, a Rastelli conduit and a fibrotic scar from ventricular septal defect patch closure were present. Serial sections revealed isolated anterior and posterior AVNs. The posterior AVN continued into an elongated His bundle that was disrupted by fibrosis, whereas the anterior AVN was interrupted by fibrofatty tissue. Discussion: QRS widening was likely caused by interruption of the elongated His bundle. Although posterior-dominant AVN is uncommon, it should be considered when planning surgery for ccTGA. Take-Home Message: A posterior-dominant AVN is uncommon; however, it should be considered when planning surgery for ccTGA with usual atrial arrangement.
SN - 2666-0849
ER -