Document Detail

Disturbances in atrial rhythm and conduction following the surgical creation of an atrial septal defect by the Blalock-Hanlon technique.
MedLine Citation:
PMID:  11712295     Owner:  NLM     Status:  MEDLINE    
Disturbances in atrial conduction or rhythm, or both, were found in 16 of 27 patients undergoing the surgical creation of an atrial septal defect by the Blalock-Hanlon technique. These included P-wave aberrations of intra-atrial block and ectopic atrial rhythm, A-V rhythm, A-V dissociation, sinus bradycardia, atrial flutter, escape-capture bigeminy, and atrial premature beats. Some of these were transient and occurred within 2 weeks after surgery. It seems likely that tissue trauma engendered by the clamp and resection of the atrial septum with possible injury to the internodal conducting pathways may be the genesis of these early postoperative disturbances. Of the eight cases with transient disturbances, six occurred in this period. Later changes, such as intra-atrial block, sinus bradycardia, and atrial flutter, may be attributed to changes in atrial size secondary to the postoperative pathophysiology. Digitalis intoxication and congestive heart failure cannot be excluded as contributory factors in either the early or the late disturbances. It was not possible to correlate the incidence and nature of these disturbances with morbidity and mortality. In such severely ill, cyanotic infants, irregularities, however slight, may have altered cardiac function significantly and contributed to their deaths.
S D Hamilton; T D Bartley; R H Miller; G L Schiebler; H J Marriott
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  38     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1968 Jul 
Date Detail:
Created Date:  2001-11-19     Completed Date:  2001-12-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-81     Citation Subset:  AIM; IM    
Departments of Surgery, Pediatrics, and the Human Development Center, University of Florida College of Medicine, Gainesville, Florida, USA.
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MeSH Terms
Bradycardia / diagnosis,  mortality*
Cardiac Surgical Procedures / adverse effects*
Heart Atria / surgery
Heart Block / diagnosis,  mortality*
Heart Septal Defects, Atrial / mortality,  surgery*
Postoperative Complications / mortality*
Transposition of Great Vessels / mortality,  surgery
Grant Support
1-T12-HE5774-01//PHS HHS; 2T1-HE5108//PHS HHS; GM 50-05 S2/GM/NIGMS NIH HHS; T1-HD-0054/HD/NICHD NIH HHS

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