An Experimental Study on Rapid Localization of the Atrioventricular Node During Open-Heart Surgery

Authors

  • Qihong Huang, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Yangyang Li, MD Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang City, Henan Province, China
  • Chunhui Xiao, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Yingjie Yang, MD Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang City, Henan Province, China
  • Minghua Zhu, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Guirong Lu, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Ke Chen, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Shaohui Song, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Libo Jin, MM Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • Hao Wu, MD Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou City, Zhejiang Province, China

DOI:

https://doi.org/10.1532/hsf.3123

Keywords:

open heart surgery, atrioventricular node, mechanical compression, atrioventricular block, localization

Abstract

Background: To verify the validity and feasibility of using a mechanical compression method to locate the atrioventricular node in open-heart surgery.

Methods: Ten healthy miniature pigs were used to establish an animal model of the beating heart under cardiopulmonary bypass. During the operation, the atrioventricular node and its surrounding areas were stimulated by mechanical compression (mechanical compression method), and the occurrence of complete atrioventricular block was judged by real-time electrocardiograph monitoring and direct observation of the heart rhythm to identify the position of the atrioventricular node. The final localization of the atrioventricular node was determined using the iodine staining method, and the results were used as the "gold standard" to test the effectiveness and feasibility of the mechanical compression method for locating the atrioventricular node.

Results: With the beating heart model, complete atrioventricular block occurred after mechanical compression of the "atrioventricular node" area in 10 pigs. Nine pigs regained normal conduction immediately after the compression was released, and one pig failed to recover. No atrioventricular block or other arrhythmias occurred after mechanical compression of the "non-atrioventricular node" area. The sensitivity of the method was 86.6%, specificity was 100.0%, misdiagnosis rate was 0.0%, missed diagnosis rate was 13.4%, positive predictive value was 100.0%, negative predictive value was 97.9%, positive likelihood ratios were +∞, negative likelihood ratios were 13.4%, accuracy was 98.1%, and diagnostic odds ratio was +∞.

Conclusion: This study innovatively proposes the application of the mechanical compression method to locate the atrioventricular node during operation and preliminarily proves that this method is effective and feasible through animal experiments.

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Published

2020-10-08

How to Cite

Huang, Q., Li, Y., Xiao, C. ., Yang, Y., Zhu, M. ., Lu, G. ., Chen, K., Song, S., Jin, L., & Wu, H. (2020). An Experimental Study on Rapid Localization of the Atrioventricular Node During Open-Heart Surgery. The Heart Surgery Forum, 23(6), E725-E730. https://doi.org/10.1532/hsf.3123

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