Arrhythmia after modified total cavopulmonary connection without use of prosthetic material.
BACKGROUND
Although total cavopulmonary connection without use of prosthetic material appeared to be a promising surgical procedure that would retain potential growth of the intraatrial tunnel, midterm incidence of arrhythmia remains unknown.


METHODS
Twelve patients underwent modified total cavopulmonary connection. A prosthetic material was not used in 5 patients (group F) and was used in 7 patients (group P). A retrospective review of the perioperative electrocardiogram and ambulatory monitoring were performed.


RESULTS
All patients revealed regular sinus rhythm before the operation. In the early postoperative period, the incidence of sinus node dysfunction was higher in group F than in group P (80% versus 28.6%). This difference no longer existed by hospital discharge (group F, 20%; group P, 14.3%). In the midterm follow-up period, sinus node dysfunction was detected in 4 patients of group F (80%) and 1 patient of group P (14.3%). Transient tachyarrhythmia was detected in 1 patient of group F and 3 patients of group P.


CONCLUSIONS
Modified total cavopulmonary connection without use of prosthetic material affected unfavorably the sinus node in the early and midterm postoperative period.
Suzuki
Takaaki
T
Division of Cardiovascular Surgery, Tokyo Metropolitan Children's Hospital, Japan. suzukimd@blue.ocn.ne.jp
Murai
Takayasu
T
Sato
Masaaki
M
Ito
Tsutomu
T
Fukuda
Toyoki
T
D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000009:adverse effects* / Q000379:methods*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D018785:Tricuspid Atresia / Q000601:surgery