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The effects of surgically induced right bundle branch block on left ventricular function after closure of the ventricular septal defect

Published online by Cambridge University Press:  01 August 2008

Thais A. L. Pedersen ,
Niels H. Andersen ,
Mette R. Knudsen ,
Thomas D. Christensen ,
Keld E. Sørensen  and
Vibeke E. Hjortdal
Thais A. L. Pedersen*
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Skejby, Aarhus, Denmark
Niels H. Andersen
Affiliation:
Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
Mette R. Knudsen
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Skejby, Aarhus, Denmark
Thomas D. Christensen
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Skejby, Aarhus, Denmark
Keld E. Sørensen
Affiliation:
Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Skejby, Aarhus, Denmark
*
Correspondence to: Thais A. L. Pedersen, Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, DK-8200 Aarhus, Denmark. Tel: +45 8949 5481; Fax: +45 8949 6016; E-mail: thais.a.pedersen@ki.au.dk
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Abstract

Objective

To determine the long-term significance of right bundle branch block on left ventricular systolic and diastolic function in children subsequent to surgical closure of ventricular septal defect.

Methods

We studied 26 children who underwent surgical closure of a ventricular septal defect 11 ± 2 years postoperatively by use of conventional and tissue Doppler echocardiography, comparing the findings to those obtained from a control group. Of those having surgical correction 14 had postoperative right bundle branch block.

Results

Irrespective of the presence of right bundle branch block, the peak systolic velocity of the mitral ring was lower in those undergoing surgical correction, with values of 5.2 ± 1.4 cm/s in those with right bundle branch block, 5.4 ± 1.2 cm/s in those without right bundle branch block after surgical correction, and 6.6 ± 1.0 cm/s in the control subjects (p < 0.01). In terms of diastolic function, the early septal velocity of transmitral inflow divided by the early diastolic mitral annular velocity was significantly higher in children with right bundle branch block, at 12 ± 3.0 cm/s compared to 8.4 ± 1.5 cm/s in the control subjects (p < 0.01), but not significantly higher in the children without right bundle branch block after correction compared to the control group. The fractional shortening percentage was similar in both patients and control subjects. The changes noted in left ventricular function were not significantly related to age at surgery, the period of follow-up, or the surgical method.

Conclusions

Systolic long axis function is significantly reduced in children after surgical closure of ventricular septal defects, irrespective of the presence of right bundle branch block. Diastolic dysfunction, in contrast, was observed primarily in children with post-operative right bundle branch block.

Keywords

Congenital heart diseaseechocardiographysurgerypost operative complications.
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 4 , August 2008 , pp. 430 - 436
Copyright
Copyright © Cambridge University Press 2008

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