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A histopathologic study of the atrioventricular communication in two hearts
with the Wolff-Parkinson-White-syndrome, Lev, M, Kennamer, R, Prinzmetal, M and
Mesquita, QHde, Circulation, 1961;24:41-50
Contribuição inédita à literatura nacional.
Dois corações de portadores de Doença de Chagas e com WPW foram doados por nós a Myron Prinzmetal em 1954 tendo sido amplamente estudados por Maurice Lev, através de 17.235 lâminas.
Summary:
The
atrioventricular communications and the AV node, bundle and bundle branches of
two cases with the WPW syndrome were studied histologically. One case was that
of chronic Chagas myocarditis and the other possible chronic Chagas
myocarditis.
Accessory
muscular communications in the right atrioventricular junction were found in
one heart, and no communications outside the conduction system in the other.
Inflammatory
changes were found in the conduction system of both hearts.
The
literature of the anatomic changes in hearts with the WPW syndrome, and that
with the presence of accessory atrioventricular muscular communications without
the WPW syndrome are reviewed.
From the
study of the literature and of the WPW syndrome are associated with accessory
communications may be present without this syndrome. Of the four cases with
this syndrome, however, in which a thorough study has been made all possible
conduction pathways, three showed accessory communications. On the other band,
inflammatory changes in the pre-atrioventricular nodal area, AV node, bundle
and bundle branches have been found in many cases of the WPW syndrome.
It is thus
clear that an anatomic base has as yet no been established for the WPW
syndrome. It is possible that a different mechanism may be responsible in
different cases.
The high
incidence of inflammation of the conduction system in the studied cases makes
accelerated conduction an attractive hypothesis, where no accessory bundles
have been found. More correlative histologic and clinical work needs to be
performed on this field.