Hobbins S M, Izukawa T, Radford D J, Williams W G, Trusler G A
Br Heart J. 1979 Mar;41(3):289-93. doi: 10.1136/hrt.41.3.289.
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.
经心室途径矫正室间隔缺损后已记录到传导障碍。最近，室间隔缺损的修复是通过右心房进行的，以避免对传导系统的损伤和右心室切开术。39例5岁以下室间隔缺损患儿经心房途径进行手术（第1组）。将该组传导障碍的发生率与19例年龄相仿、经右心室切开术修复室间隔缺损的患儿（第2组）的发生率进行比较。第1组39例患儿中有13例（33.3%）发生完全性右束支传导阻滞，而第2组19例患儿中有15例（78.9%）发生。第1组完全性右束支传导阻滞的发生率在统计学上显著降低。完全性右束支传导阻滞伴左轴偏移的发生率在统计学上也同样降低。两组中短暂性完全性心脏传导阻滞和心律失常在统计学上无差异。经心房途径修复室间隔缺损显著降低了单独发生以及伴有左轴偏移的完全性右束支传导阻滞的发生率。
