van Lier T A, Harinck E, Hitchcock J F, Moulaert A J, van Mill G J
Eur Heart J. 1985 Nov;6(11):959-62. doi: 10.1093/oxfordjournals.eurheartj.a061794.
The ECGs of a 100 consecutive children who had surgical repair of their ventricular septal defects (VSDs) were analyzed for postoperative right bundle branch block (RBBB). Seventy of them had an atriotomy and the other 23 also a ventriculotomy. The ventriculotomy always consisted of a transverse incision a short distance below the pulmonary annulus. Of these children 93 had a perimembranous VSD and the other 7 a pure muscular defect. The ECG results of the 93 children with perimembranous VSDs were statistically analysed. The incidence of postoperative complete RBBB (CRBBB) in the ventriculotomy group was not higher than in the atriotimy group. Infants operated in the first half year of life were more prone to the development of CRBBB than the older children, probably because the VSDs were relatively larger in the younger than the older children. The risk of postoperative CRBBB was less in the children who had direct suture closure of the VSD compared with those who needed a Dacron patch to close the defect. The data in the literature generally indicate a higher incidence of CRBBB after a ventriculotomy than an atriotomy. The absence of this difference and the lower incidence of CRBBB after a ventriculotomy in our series compared with those of several other authors are suggested to be due to the type of ventriculotomy.
对100例连续接受室间隔缺损（VSD）手术修复的儿童心电图进行分析，以观察术后右束支传导阻滞（RBBB）情况。其中70例进行了心房切开术，另外23例还进行了心室切开术。心室切开术总是在肺动脉瓣环下方短距离处做横向切口。这些儿童中，93例为膜周部VSD，另外7例为单纯肌部缺损。对93例膜周部VSD患儿的心电图结果进行了统计学分析。心室切开术组术后完全性RBBB（CRBBB）的发生率并不高于心房切开术组。1岁以内接受手术的婴儿比大龄儿童更易发生CRBBB，这可能是因为小婴儿的VSD相对比大龄儿童的大。与需要用涤纶补片关闭缺损的儿童相比，直接缝合VSD的儿童术后发生CRBBB的风险更低。文献数据一般表明，心室切开术后CRBBB的发生率高于心房切开术后。我们的系列研究中未出现这种差异，且心室切开术后CRBBB的发生率低于其他几位作者的研究结果，这可能是由于心室切开术的类型所致。
