Is right bundle branch block aviodable in surgical correction of tetralogy of Fallot?

Author:

Hazan E,Bical O,Bex J P,Dubuis C,Lecompte Y,De Riberolles C,Neveux J Y

Abstract

Right bundle branch block (RBBB) is usually considered almost unaviodable after repair of teralogy of Fallot (TOF). By modifications of the standard technique, its frequency has been decreased to 32% in a series of 1000 consecutive patients. These modifications are: (1) a very short right ventricular incision avoiding the ventriculotomy-induced RBBB pattern; (2) an infundibular resection limited to the septal attachment of the infundibular septum; and (3) closure of the ventricular septal defect with a patch sutured to the very edge of the muscular septum, avoiding injury to the right bundle along the right aspect of the septum. No patient in this series sustained permanent complete atrioventricular heart block. Among patients with RBBB, five had a left anterior hemiblock. Postoperative intraventricular conduction was related to age at operation: The incidence of RBBB was significatively higher in infants. The beneficial effects of a low incidence of postoperative RBBB after repair of TOF are not known.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Reference11 articles.

1. Horowitz LN Edmunds LH Alexander JA Josephson ME Simson MB Kastor JA Spear JF Moore EN: Postoperative right bundle branch block: identification of three levels of block. (abstr) Circulation 56 (suppl III): II-171 1977

2. Further Observations on the Etiology of the Right Bundle Branch Block Pattern Following Right Ventriculotomy

3. Transatrial repair of ventricular septal defects with reference to their anatomic classification;Lincoln C;J Thorac Cardiovasc Surg,1977

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