The Annals of Thoracic Surgery, Vol 42, 412-418, Copyright © 1986 by The Society of Thoracic Surgeons
A new method of conduction system staining
K Ishii, H Kurosawa, H Koyanagi, M Kawada, E Koh, N Sakakibara, K Nakano, E Imamura and H Kaizuka
Visualization of the conduction bundle is advantageous in the prevention of
surgical trauma to the conduction system during open- heart surgery.
Because vital staining using an iodine starch complex has been known to
result in tissue damage, we have evaluated the effects of iodine gas on the
specialized conduction system. The conduction bundle was stained, well
enough to be identified, with iodine tincture, with Lugol's solution, and
with iodine gas. However, all these agents except for iodine gas caused
marked electrophysiological changes. Similar changes occurred with the use
of ethanol and of 10% potassium iodine solution, which are the solvents of
iodine tincture and Lugol's solution, respectively. Microscopic examination
showed that iodine tincture, Lugol's solution, and their solvents caused
marked histological changes in the conduction tissue. However, no
significant changes in the conduction tissue were noted from iodine gas
spraying. Therefore, tissue damage caused by iodine tincture and Lugol's
solution was thought to be due not to a reaction to the iodine starch
complex itself, but to their solvents. In a long- term experimental study
of 10 dogs, we found that iodine gas caused no electrophysiological
disturbances or damage of microscopic tissue. Of the agents we tested, only
iodine gas is free from harmful effects and can be used clinically.
