title: Analysis of arrhythmias after correction of partial anomalous pulmonary venous connection.
abstract: BACKGROUND
  Several methods for surgical repair of partial anomalous pulmonary venous connection have been described. Sinus node dysfunction is known as a cause of morbidity after surgical repair. In this retrospective study, we attempted to determine the incidence of arrhythmias after use of two different techniques for repair of partial anomalous pulmonary venous connection.
  
  
  METHODS
  Between 1988 and 2006, 119 patients (61 male, 58 female; aged 5 months to 66 years) with anomalous drainage of the pulmonary vein into the superior vena cava or the right atrium were analyzed. All patients had sinus rhythm before operation. In 64 patients (group 1), rerouting of the pulmonary veins was accomplished through a right atriotomy; and in 54 patients (group 2), the atriotomy incision was extended into the superior vena cava through the cavoatrial junction.
  
  
  RESULTS
  There were no perioperative deaths. New-onset nodal rhythm and atrial dysrhythmias developed significantly more often in patients with extended incision through the cavoatrial junction (group 1, 26.5%, versus group 2, 54.5%; p < 0.004). At discharge, the rate of dysrhythmias was 14% in group 1 and 32.7% in group 2 (p < 0.01). The hospital stay was longer in group 2. At 1-year follow-up of 58 patients, the rate of arrhythmias was 6.25% in group 1 versus 18.1% in group 2.
  
  
  CONCLUSIONS
  Extended incision through the cavoatrial junction increases atrial dysrhythmias, especially early postoperatively, but the incidence of such sinus node dysfunction decreased with time.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. buz@dhzb.de
authors.forename: Semih
authors.initials: S
authors.lastname: Buz
authors.forename: Vladimir
authors.initials: V
authors.lastname: Alexi-Meskishvili
authors.forename: Funda
authors.initials: F
authors.lastname: Villavicencio-Lorini
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yigitbasi
authors.forename: Michael
authors.initials: M
authors.lastname: Hübler
authors.forename: Yuguo
authors.initials: Y
authors.lastname: Weng
authors.forename: Felix
authors.initials: F
authors.lastname: Berger
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011667:Pulmonary Veins / Q000002:abnormalities / Q000601:surgery; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012587:Scimitar Syndrome / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000002:abnormalities / Q000601:surgery; D055815:Young Adult