Original articleThe forgotten interleaflet triangles: A review of the surgical anatomy of the aortic valve
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Cited by (234)
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2021, Heart Lung and CirculationCitation Excerpt :Atrio-ventricular (AV) conduction disturbances generally originate in a triangular area bounded posteriorly by the anterior attachment of the non-coronary cusp (NCC), anteriorly by the posterior margin of the right coronary cusp (RCC) and inferiorly by the junction of the membranous and muscular portions of the interventricular septum [14–16]. Consequently, it must be expected that AVR with stented valve prostheses and a standard implantation technique can impair the AV conduction bundles by either direct trauma or mechanical stress to the His bundle at the region of the membranous septum and the right trigone beneath the NCC and RCC during valve excision and decalcification, or when interrupted vertical pledget-enforced mattress sutures are placed through the aortic annulus [3,5–7,9,14,15]. The occurrence of new-onset conduction abnormalities following AVR must be assumed to be causally linked to the surgical procedure, particularly in the absence of pre-existing conduction disturbances.
- 1
During the course of this investigation, Dr John P. Sutton was a visiting fellow from the Medical University of South Carolina.
- 2
Doctors Siew Y. Ho and Robert H. Anderson are supported by the British Heart Foundation.