The conduction system in tricuspid atresia with and without regular (d-) transposition

Abstract

This is a serial section examination of conduction system in six hearts with tricuspid atresia. Four had regular (d-) complete transposition and two did not have transposition. The conduction system was more or less the same in all the hearts. The atrioventricular (A-V) node was in the normal position posteriorly and was short. The A-V bundle was situated in the left ventricular aspect of the subendocardium and passed posteriorly to the ventricular septal defect. Even though this type of conduction system is abnormal in some respects, it is not the type one finds in single ventricle with small outlet chamber with regular (d-) transposition. In those hearts an anteriorly located A-V node is present. These findings further substantiate the concept that tricuspid atresia with or without transposition is not a form of single (primitive) ventricle.