PMID: 2500097May 1, 1989Paper

Arrhythmia disorders after repair of ventricular septal defects. Comparison of atrial and ventricular approaches

Archives des maladies du coeur et des vaisseaux
G VaksmannA Davignon

Abstract

Post-operative disorders of conduction and of ventricular and supraventricular excitability were studied in 50 patients operated upon for ventricular septal defect (VSD). The VSD was approached by right ventriculotomy in 29 patients aged 4.4 +/- 3.1 years at surgery and 15.1 +/- 6.5 years at evaluation. The VSD was closed by the atrial route in 21 patients aged 6.6 +/- 3.9 years at surgery and 12.1 +/- 6.8 years at evaluation. Complete right bundle branch block (CRBB) was significantly more frequent in patients who underwent ventriculotomy (62 p. 100 vs 33 p. 100, p less than 0.05), but 2 late complete atrioventricular blocks were observed in patients in whom the atrial route was used. 34 p. 100 of the patients with ventriculotomy and 26.5 p. 100 of those without ventriculotomy had significant ventricular arrhythmias on Holter recordings (greater than or equal to Lown's grade 2, p = NS). The occurrence of ventricular arrhythmias in the patient population as a whole increased significantly with age at surgery and age at evaluation (p less than 0.05); this increase was also noted in each group (p = 0.06). Pre-operative right ventricular systolic pressure, severity of intraventricular disorders of conduction or duration of extraco...Continue Reading

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