{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T10:28:02Z","timestamp":1768040882615,"version":"3.49.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n               <jats:p>This study aims to review the anatomical variations of the right bundle branch (RBB) in normal hearts and various ventricular septal defect (VSD) subtypes through a systematic literature review. Additionally, it seeks to propose hypotheses for optimizing surgical approaches to minimize conduction disturbances during VSD closure, based on anatomical evidence. We performed a systematic literature review of peer-reviewed articles published up to October 2024, focusing on the anatomy of the cardiac conduction system and its variations in association with VSD subtypes. The review encompassed 30 articles, analysing anatomical data from over 100 reported cases of normal and VSD hearts. In the normal heart, the RBB courses posterior to Lancisi\u2019s muscle, which originates at the junction of the anterior-basal and posterior-basal limbs of the trabecular septomarginalis (TSM). In perimembranous inlet VSDs, the medial papillary muscle (MPM) does not reliably indicate the RBB\u2019s course; instead, the RBB runs close to the membranous flap, positioning it on the edge of the VSD. In perimembranous outlet VSDs, the posterior limb of the TSM covers the branching and bifurcating bundles and the base of the RBB, causing these components to deviate towards the left ventricle beneath the defect\u2019s edge, maintaining a distance of 3\u20135\u2009mm. The RBB then courses intramurally, emerging at the base of the MPM. In tetralogy of Fallot cases with perimembranous outlet VSDs, the RBB consistently courses approximately 2\u2009mm anterior to the MPM in 63\u201386% of cases. In normal hearts, the RBB runs posterior to Lancisi\u2019s muscle; however, in perimembranous outlet VSDs (especially ToF), the RBB typically courses about 2\u2009mm anterior to the MPM, a critical detail to consider during VSD repair to avoid conduction system injury.<\/jats:p>","DOI":"10.1093\/ejcts\/ezaf105","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T20:56:32Z","timestamp":1743195392000},"source":"Crossref","is-referenced-by-count":3,"title":["Right bundle branch in ventricular septal defects"],"prefix":"10.1093","volume":"67","author":[{"given":"Fumiya","family":"Yoneyama","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Surgery, Texas Children\u2019s Hospital, Baylor College of Medicine , Houston,","place":["USA"]},{"name":"Department of Cardiovascular Surgery, University of Tsukuba Hospital , Tsukuba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9803-4871","authenticated-orcid":false,"given":"Hideyuki","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University of Tsukuba Hospital , Tsukuba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9879-8289","authenticated-orcid":false,"given":"Bryan J","family":"Mathis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University of Tsukuba Hospital , Tsukuba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuminaga","family":"Suetsugu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Suetsugu Clinic , Fukuoka,","place":["Japan"]},{"name":"Department of Anatomy, Faculty of Medicine, Saga University , Saga,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4323-1098","authenticated-orcid":false,"given":"Yuji","family":"Hiramatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University of Tsukuba Hospital , Tsukuba,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"2025041817064177200_ezaf105-B1","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/S0003-4975(02)03687-1","article-title":"Shallow stitching close to the rim of the ventricular septal defect eliminates injury to the right bundle branch","volume":"74","author":"Fukuda","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"2025041817064177200_ezaf105-B2","first-page":"e28735","article-title":"Conduction disorders in continuous versus interrupted suturing technique in ventricular septal defect 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