Naito Y, Fujiwara K, Takagaki Y, Sekii H, Yoshida S, Goto Y, Komai H, Nishioka T
Department of Thoracic and Cardiovascular Surgery, Wakayama Medical College, Japan.
Surg Today. 1993;23(8):693-6. doi: 10.1007/BF00311707.
Complete right bundle branch block (CRBBB) has been reported as the most common sequelae following total correction of tetralogy of Fallot. A review of previous reports and our own experience have led us to believe that it may be related to the fatal ventricular dysrhythmias which often occur during the postoperative follow-up period. Therefore, we have been trying to reduce the incidence of CRBBB, and we describe herein our surgical procedure for the prevention of CRBBB and its results. Of a total 28 consecutive patients who underwent intracardiac repair by this procedure, only 4 (14%) developed surgically induced CRBBB, none of whom developed a left anterior hemiblock. At the time of this report, no severe ventricular arrhythmias have been found in this series during the postoperative follow-up period. These results suggest that our operative procedure is feasible for the prevention of CRBBB. With regard to the relationship between ventricular dysrhythmia and CRBBB, careful observation is necessary throughout the patients' lifetime.
据报道，完全性右束支传导阻滞（CRBBB）是法洛四联症完全矫正术后最常见的后遗症。回顾既往报告及我们自己的经验，我们认为它可能与术后随访期间经常发生的致命性室性心律失常有关。因此，我们一直试图降低CRBBB的发生率，在此描述我们预防CRBBB的手术方法及其结果。在连续接受该手术进行心内修复的28例患者中，仅4例（14%）出现手术诱发的CRBBB，其中无一例发生左前分支阻滞。在本报告发布时，该系列患者术后随访期间未发现严重室性心律失常。这些结果表明，我们的手术方法对于预防CRBBB是可行的。关于室性心律失常与CRBBB之间的关系，在患者的整个生命过程中都需要仔细观察。
