Electrocardiogram changes post surgical repair of tetralogy of Fallot with valve-sparing versus transannular patch: A...

Introduction: Long-term survival after tetralogy of Fallot (TOF) repair depends on several factors including the extent of chronic right ventricular adaptation to surgery. QRS duration (QRSd) is an important determinant of life-threatening arrhythmia post-TOF repair. This single-center retrospective study was designed to evaluate changes in QRSd post-TOF repair using either a pulmonary valve-sparing approach (VSA) or transannular patch (TAP). Methods and results: Data from patients who underwent TOF repair between January 2016 and December 2019 were analyzed to compare the changes in the QRSd following intracardiac repair after VSA (Group 1) or TAP (Group 2). Among the 105 patients who underwent TOF surgical repair, 60 were included in the study (Group 1:30 vs. Group 2:30). Electrocardiograms (ECGs) were recorded pre- and post-surgery. The primary outcome was to compare the change in QRSd (ΔQRSd) before and after surgery between the two groups. The mean length of postoperative follow-up was 35.9 months in group 1 and 34.47 months in group 2. The mean [SD] difference in QRSd values (QRSd2 - QRSd1) was shorter in Group 1 (45.67 [22.79] ms) than in Group 2 (49.63 [23.76] ms); however, these differences were not statistically significant (p = 0.428). The PR interval was similar between the two groups in both preoperative and postoperative ECG. Conclusion: At the short-term follow-up, both surgical approaches (VSA and TAP) resulted in similar QRSd post-TOF repair. Studies with longer follow-up periods are required to evaluate the association of the surgical approach with prolongation of QRSd and mortality.