Key result
Autopsies of three children link postoperative His bundle tachycardia to surgical stitches invading the AV bundle.
Case Report (n=3)
Histopathological evidence suggests that surgical stitches placed close to conduction tissue can cause haemorrhagic tracks into the atrioventricular bundle, potentially leading to postoperative His bundle tachycardia.
Stitch-related hemorrhage into the AV bundle may trigger fatal His bundle tachycardia; leaves open whether modified suture placement prevents this.
This report concerns three children with His bundle tachycardia who died following cardiac surgery. At autopsy the conduction system was examined in detail. In all three, the sinus node was intact and supplied by a well-formed artery. Haemorrhagic tracks were identified invading the penetrating atrioventricular bundle. The tracks originated from stitches placed close to the conduction tissue. The hypothesis that disruption of the conduction tissue results in an arrhythmogenic focus is discussed.
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Till et al. (1992) conducted a case report in His bundle tachycardia following cardiac surgery (n=3). Cardiac surgery (stitches placed close to conduction tissue) was evaluated on Histopathological findings at autopsy. Autopsy of three children with postoperative His bundle tachycardia revealed haemorrhagic tracks invading the penetrating atrioventricular bundle originating from surgical stitches.
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