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The effects of surgically induced right bundle branch block on left ventricular function after closure of the

Thais A L Pedersen1, Niels H Andersen, Mette R Knudsen

  • 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. thais.a.pedersen@ki.au.dk

Cardiology in the Young
|June 26, 2008
PubMed

Insights

Children with repaired ventricular septal defects show reduced long-axis systolic function, regardless of right bundle branch block. Postoperative right bundle branch block is linked to diastolic dysfunction in these pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Echocardiography
  • Cardiac Electrophysiology

Background:

  • Surgical closure of ventricular septal defects (VSDs) is common in children.
  • Long-term effects on cardiac function, particularly with postoperative arrhythmias like right bundle branch block (RBBB), require further investigation.

Purpose of the Study:

  • To assess the long-term impact of RBBB on left ventricular (LV) systolic and diastolic function in children post-VSD repair.
  • To compare cardiac function in children with and without RBBB after VSD surgery against healthy controls.

Main Methods:

  • A cohort of 26 children who underwent VSD closure was studied 11 years post-surgery.
  • Conventional and tissue Doppler echocardiography were used to evaluate LV function.
  • Findings were compared between children with (n=14) and without RBBB, and a control group.

Main Results:

  • Reduced mitral annular systolic velocity was observed in all post-VSD repair patients compared to controls, irrespective of RBBB.
  • Children with RBBB showed significantly impaired diastolic function (elevated early septal velocity/early diastolic mitral annular velocity ratio) compared to controls.
  • Fractional shortening was similar across all groups; functional changes were not linked to age at surgery, follow-up duration, or surgical technique.

Conclusions:

  • Surgical VSD repair in children leads to persistent reduction in LV systolic long-axis function, independent of RBBB.
  • Postoperative RBBB is associated with diastolic dysfunction in pediatric patients following VSD repair.
Abstract

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