Conduction disturbances after surgical correction of ventricular septal defect by the atrial approach.

Abstract

Conduction disturbances have been documented after correction of ventricular septal defects by the ventricular route. Recently, repair of the ventricular septal defect has been through the right atrium to overcome damage to the conduction system and a right ventriculotomy. Thirty-nine children with ventricular septal defects under the age of 5 years were operated upon by the atrial route (group 1). The incidence of conduction disturbances in this group was compared with that occurring in 19 children of comparable age with a ventricular septal defect repaired via a right ventriculotomy (group 2). Complete right bundle-branch block developed in 13 of 39 children (33.3%) in group 1, compared with 15 of 19 children (78.9%) in group 2. This was a statistically significant reduction in complete right bundle-branch block in group 1. The incidence of left axis deviation occurring with complete right bundle-branch block was similarly statistically reduced. Transient complete heart block and arrhythmias were not statistically different in the two groups. The atrial approach to the repair of the ventricular septal defect significantly reduced the incidence of complete right bundle-branch block alone and occurring with left axis deviation.

Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder

“…The rate of permanent conduction disturbances of 2.6% is below the incidence after surgical closure of VSDs (16). However, current data on the incidence of conduction disturbances solely after the closure of muscular VSDs is not available, and therefore comparisons are difficult to make.…”

Follow-Up of Patients with Interventional Closure of Ventricular Septal Defects with Amplatzer Duct Occluder II

“…However, although it is generally a safe procedure, it does have some potential risks: complete AVB in 1-5 % of the patients, significant residual VSD in 1-5 % with the necessity to reoperate in 2 %, and perioperative death in 0.5 %. Furthermore sternotomy, general anesthesia and cardiopulmonary bypass may initiate significant co-morbidities, such as infection, tachyarrhythmias, and neurologic complications [12,18,22].…”

Safety and efficacy of amplatzer duct occluder for percutaneous closure of ventricular septal defects with tunnel shape aneurysm: Medium term follow up

“…Surgical repair has been the gold standard for VSD closure and although it's generally a safe procedure, it does have potential risks including heart block in 1% -5%, significant residual shunt in 1% -5%, the necessity for reoperation in 2% and death in 0.5% of the patients. Furthermore, infections, tachyarrhythmias and neurologic complications may occur [11,12]. Perimembranous VSDs are located near the conduction tissue and aortic valve, and if there is an aneurysmal tissue around the VSD, it makes its morphology even further complex [13].…”