[Atrio-ventricular disorders following surgery for congenital heart diseases with septal defect (author's transl)]

Abstract

Post-operative results in congenital heart diseases with septal defect are often darkened by the occurence of disorders in atrio-ventricular conduction. The incidence of these disorders is dependent upon the location of the septal defect, the anatomy of conduction pathways and the operative technique. Intracavitary recording of His bundle activity leads to a more precise localisation of the trouble. Such disorders are more frequent after cure of Fallot's tetralogy than after closure of an interventricular communication. They are rare after closure of an interatrial septal defect and more common after closure of the atrioventricular canal, where they are of atrial node type. The occurrence of an atrioventricular block, even transient, is of poor prognosis, and in case of proximal lesion the insertion of a pacemaker must be considered. The high incidence of conduction disorders justifies continuous per-operative recording and prolonged surveillance, if necessary by Holter's method. Locating the conductive tissue during surgery reduces the frequency.