Conduction disorders after perimembranous ventricular septal defect closure: continuous versus interrupted suturing...

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Defects

Background:

• Ventricular septal defects (VSDs) are common congenital heart abnormalities.
• Outlet-type VSDs, particularly in tetralogy of Fallot (ToF), require surgical closure.
• Suturing techniques may influence postoperative conduction disturbances.

Purpose of the Study:

• To compare postoperative conduction disorder incidence between continuous and interrupted suturing for perimembranous outlet-type VSD closure.
• To evaluate differences in ToF and isolated VSD cases.

Main Methods:

• Retrospective review of 185 patients (aged ≤4 years) undergoing VSD closure.
• Comparison of continuous (C-ToF, C-VSD) versus interrupted (I-ToF, I-VSD) suturing groups.
• Electrocardiographic assessment of conduction parameters at discharge and 1-year postoperative.

Main Results:

• Continuous suturing in ToF (C-ToF) significantly reduced PQ intervals and QRS durations versus interrupted (I-ToF).
• C-ToF showed lower right bundle branch block incidence and heart rates at 1 year compared to I-ToF.
• No significant differences were observed between continuous (C-VSD) and interrupted (I-VSD) suturing for isolated VSDs.

Conclusions:

• Continuous suturing for outlet-type VSD in ToF is associated with improved postoperative conduction.
• This technique may mitigate risks of right bundle branch block and reduce PQ intervals and heart rate.
• Suturing technique appears less critical for isolated VSDs regarding conduction outcomes.