Why the study?
Twin atrioventricular nodes occasionally occur in ccTGA, but the implications for conduction system impairment and surgical planning are not well characterized.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
A posterior-dominant AV node, though uncommon, can exist in ccTGA and should be carefully considered when planning surgical interventions to avoid damaging the conduction system.
BACKGROUND: Twin atrioventricular nodes (AVNs) occasionally occur in congenitally corrected transposition of the great arteries (ccTGA). CASE SUMMARY: A 14-year-old adolescent girl with ccTGA died suddenly after cardiopulmonary arrest. The electrocardiogram showed QRS widening from age 6. At autopsy, a Rastelli conduit and a fibrotic scar from ventricular septal defect patch closure were present. Serial sections revealed isolated anterior and posterior AVNs. The posterior AVN continued into an elongated His bundle that was disrupted by fibrosis, whereas the anterior AVN was interrupted by fibrofatty tissue. DISCUSSION: QRS widening was likely caused by interruption of the elongated His bundle. Although posterior-dominant AVN is uncommon, it should be considered when planning surgery for ccTGA. TAKE-HOME MESSAGE: A posterior-dominant AVN is uncommon; however, it should be considered when planning surgery for ccTGA with usual atrial arrangement.
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Matsuyama et al. (2026) conducted a case report in Congenitally corrected transposition of the great arteries (ccTGA) (n=1). Congenitally corrected transposition of the great arteries (ccTGA) was evaluated.
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