Abstract
Preoperative and postoperative electrocardiograms of 29 patients who underwent transventricular aortic commissurotomy were reviewed. Fifteen of 26 tracings which showed normal ventricular depolarization forces preoperatively showed left axis deviation with significant changes in direction of the terminal depolarization forces postoperatively. In 3 patients in whom the electrocardiogram was monitored during operation, these changes were observed as soon as the aortic dilator was advanced toward the aortic valve. The tracings taken in a comparable number of patients who were subjected to right ventriculotomy or left atriotomy failed to show similar changes. The acute occurrence of this conduction defect in the apparent absence of myocardial infarction is attributed to the mechanical trauma to the fibers of the superior division of the left bundle caused by the dilator as it is passed through the outflow tract of the left ventricle.
Published Version
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