Conduction Disorders in Continuous Versus Interrupted Suturing Technique in Ventricular Septal Defect Surgical Repair

Ventricular septal defects (VSD) is one of the most frequent congenital cardiac malformations and cardiac conduction disorders are still one of the serious postoperative complications in this surgery.

This study aimed to compare the incidence of conduction disorders with the use of continuous compared to interrupted suturing techniques in VSD surgical repair.

Previously recorded data of 231 patients who underwent surgical closure of VSD between January 2009 and January 2012 at the Rajaie cardiovascular medical and research center were retrospectively reviewed. VSD surgical repair was performed using continues suturing technique in group A patients (n = 163, 70.6%) and interrupted suturing technique in group B patients (n = 68, 29.4%).

The most common concomitant congenital anomaly was Tetralogy of Fallot (27.3%). Twenty-four (10.4%) patients had intraoperative cardiac arrhythmia, including 19 (8.2%) transient and 5 (2.2 %) permanent arrhythmia. During their ICU stay, ventricular arrhythmia and complete heart block were observed in 34 (14.7%) and 5 patients (2.2%), respectively. At the time of the last follow-up, incomplete right bundle branch block (RBBB), complete RBBB, RBBB with left anterior hemi-block, and complete heart block were identified in 84 (36.4%), 42 (18.2%), 29 (12.6%), and 5 patients (2.2%), respectively. The results revealed that group A patients were most likely to have had cardiac arrhythmias during their ICU stay and at the time of last follow-up (P < 0.001), while the intraoperative incidence of cardiac arrhythmia during surgery was not statistically significant between the two groups (P = 0.06).

In the absence of any statistical differences in the other risk factors between the two groups, the difference in the incidence of conduction disorders can be attributed to the type of suturing used during the procedure.