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Study on the Frequency of Right Bundle Branch Block After Surgical Closure of Ventricular Septal Defect

Journal of the Korean Pediatric Society 1993;36(1):88-93.
Published online January 15, 1993.
Study on the Frequency of Right Bundle Branch Block After Surgical Closure of Ventricular Septal Defect
Ho Joon Im, Jin Nyoung Park, Nam Su Kim, Jeh Hoon Shin, In Joon Seol, Soo Ji Moon
Department of Pediatrics, Hanyang University, College of Medicine, Seoul, Korea
심실중격결손증의 수술후 심전도상 우각블록 발생빈도에 관한 연구
임호준, 박진녕, 김남수, 신재훈, 설인준, 문수지
한양대학교 의과대학 소아과학교실
The purpose of this study is to evaluate the ventricular conduction abnormalities, especially RNNN, observed electrocardiographically after sugical closure of VSD. The present study population consists of 92 patients with VSD who were surgically corrected at the Hanyang University Hospital during 6 years period from Jan. 1985 to Dec. 1990. We reviewed their clinical records including surgical notes and EKG findings before and after operations. The results of the study were as follow: 1) Male to female ratio was 1.1:1 (48:44) 2) Out of total of 92 cases of VSD, 65 cases(70.7%) were perimembranous type and 27 cases(29.3%) were subarterial type. 3) The normal preoperative EKG findings were seen in 22 patients, LVH in 21 patients, BVH in 47 patients, and RVH in 3 patiens. 4) A transatrial approach was performed in 55 cases, right ventriculotomy with or without resection of mscles in right ventricle in 13 cases, and pulmonary arteriotomy alone in 24 cases 5) The right bundle branch block after operation developed in 33 patients out of the 65 patinets with perimembranous defect and 5 patients out of the 27 patients with subarterial defects. Postoperative RBBB developed more frequently in perimembranous defect than in subarterial defect. 6) Postoperative RBBB occured in 31.8% of the patients with normal preoperative EKG findings, 23.8% with preoperative LVH, 52.1% with BVH and 66.7% with RVH. Postoperative RBBB was more frequencntly observed in the patients group with preoperative BVH or RVH than the patients with normal or LVH. 7) Postoperative RBBB was observed in 84.6% after right ventriculotomy, in 43.6% after right atriotomy and in 12.5% with pulmonary arteriotomy alone.
Key Words: Postoperative RBBB, Ventricular Septal Defect

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