Bink-Boelkens M T, Meuzelaar K J, Eygelaar A
Department of Pediatrics, University of Groningen, The Netherlands.
Am Heart J. 1988 Mar;115(3):629-33. doi: 10.1016/0002-8703(88)90814-9.
A retrospective study performed in our institution showed a significant correlation between venous cannulation and the incidence of arrhythmias after atrial septal defect (ASD) repair. We now report the results of a prospective study in 50 children operated on for ASD with selective cannulation of the superior vena cava. ECGs and Holter recordings were made before and after surgery, with a mean follow-up of 2.6 years. We found a significant decrease in postoperative arrhythmias (p less than 0.05) after changing the cannulation technique. Severe arrhythmias, present in 10% of the children in the retrospective group, were not found in the prospective study. Six children had asymptomatic arrhythmias on the Holter recording 1 year after surgery. Three of them, however, already had arrhythmias before the operation. We conclude that the incidence and severity of arrhythmias after ASD repair can be reduced significantly by surgical modifications, at least for the follow-up period of this study. The long-term significance has to be awaited.
在我们机构进行的一项回顾性研究表明，房间隔缺损（ASD）修复术后静脉插管与心律失常的发生率之间存在显著相关性。我们现在报告一项对50例接受ASD手术并选择性插管上腔静脉的儿童进行的前瞻性研究结果。在手术前后进行了心电图和动态心电图记录，平均随访2.6年。我们发现改变插管技术后术后心律失常显著减少（p小于0.05）。回顾性组中10%的儿童出现的严重心律失常在前瞻性研究中未发现。6名儿童在术后1年的动态心电图记录中有无症状心律失常。然而，其中3名儿童在手术前就已经有心律失常。我们得出结论，至少在本研究的随访期内，通过手术改良可显著降低ASD修复术后心律失常的发生率和严重程度。其长期意义还有待观察。
