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Vital Staining of the Conduction Tissue of the Heart

TAKASHI IWA, M.D.; ZWI STEIGER, M.D.; MILTON WEINBERG JR., M.D.; EGBERT H. FELL, M.D.
Arch Surg. 1961;82(6):833-838. doi:10.1001/archsurg.1961.01300120047006.
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Surgical correction of ventricular septal defects, with or without pulmonary stenosis, is complicated by the production of complete heart block in approximately 10% of cases, in most instances due to direct injury to the conduction system of the heart. Dramatic reduction of the mortality associated with the complication has been achieved with the use of artificial pacemakers, but the occurrence of this conduction disturbance continues to be serious, and, as with most complications, its prevention is preferable to its treatment.1-4

In 1959, Allen and his associates5,6 reported the use of a solution of 5% elemental iodine with 10% sodium iodide to demonstrate the conduction system of the heart in 5 patients during open operation for closure of ventricular septal defects, with satisfactory demonstration of the bundle of His and the right bundle branch and avoidance of a block in 4 of the 5 patients. At that time he

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