The anatomical findings of the conduction system in a univentricular heart support the hypothesis that the primordium of the trabecula septomarginalis carries conduction tissue from the AV node to the trabecular septum.
Case report of dual nodes in univentricular heart warrants surgical caution; leaves open developmental role of trabecula septomarginalis.
The conduction tissue in a univentricular heart of the right ventricular type with a right-sided rudimentary chamber was studied. Both an anterior and conventional node were found, the anterior node being positioned in the atrial septum very close to the conventional node. Between the two nodes, a sling of conduction tissue passed through the annulus fibrosus but was not related to the trabecular septum. A non-branching bundle descended on to a free-running trabecula in the main ventricular chamber, the trabecular septum itself being devoid of conduction tissue. We believe it is likely that this trabecula represents the trabecula septomarginalis of the normal right ventricle. It has recently been suggested that during development the primordium of the trabecula septomarginalis is the structure which carries the conduction tissue from the atrioventricular node (whatever its position) to the trabecular septum. The present findings seem to support this.
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Essed et al. (1980) studied this question.
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