| Shallow stitching close to the rim of the ventricular septal defect eliminates injury to the right bundle branch. | |
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MedLine Citation:
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PMID: 12173843 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Complete right bundle branch block carries a deleterious effect on the long-term outcome of patients who undergo surgical treatment of the perimembranous ventricular septal defect. We describe a novel suturing method to reduce the prevalence of complete right bundle branch block. METHODS: From March 1996 through December 2000, 48 consecutive patients with perimembranous ventricular septal defect underwent patch closure using shallow stitches placed close to the rim (group 1). The same number of patients was randomly selected from those who had previously undergone surgery using deep stitches placed distant from the rim (group 2). Postoperative electrocardiograms were reviewed to compare the prevalence of complete right bundle branch block between groups. A morphologic study of the conduction system was performed to identify the vulnerable segment of the right bundle branch where the surgical damage tended to occur. Additional analyses were made to determine whether younger age and right ventriculotomy increased the prevalence of complete right bundle branch block. RESULTS: The prevalence of complete right bundle branch block in group 1 (6.3%) was significantly (p < 0.0001) lower than in group 2 (43.8%). The result was consistent with the morphologic finding that stitches of group 2 tended to damage the right bundle branch and those of group 1 did not. The younger age and right ventriculotomy did not increase the prevalence of complete right bundle branch block. CONCLUSIONS: Shallow stitches placed close to the rim of the perimembranus ventricular septal defect eliminate injury to the right bundle branch. |
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Authors:
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Toyoki Fukuda; Takaaki Suzuki; Ichiro Kashima; Masaaki Sato; Yukihiko Morikawa |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 74 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2002 Aug |
Date Detail:
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Created Date: 2002-08-13 Completed Date: 2002-09-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 550-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Surgery, Tokyo Metropolitan Kiyose Children's Hospital, Kiyose-shi, Japan. fukuda@chp-kiyose-tokyo.jp |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Bundle-Branch Block / epidemiology, etiology*, prevention & control Electrocardiography Heart Conduction System* / injuries Heart Septal Defects, Ventricular / physiopathology, surgery* Humans Infant Intraoperative Complications / prevention & control Postoperative Complications / epidemiology, etiology*, prevention & control Prevalence Suture Techniques* |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2004 Jun;77(6):2259-60; author reply 2260
[PMID:
15172325
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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