Junctional Rhythm Disturbances after Rotational Z-Flap versus Patch Repair of Sinus Venosus Atrial Defects

Objectives: Operative correction of the sinus venosus atrial septal defect can either be performed using a rotation advancement Z-flap method or using an intra-superior vena cava baffle and is associated with low morbidity and mortality. The aim of this retrospective study was to analyze occurrence of rhythm disturbances postoperatively undergoing one of these surgical procedures.

Methods: We reviewed 83 patients (age ranging from 3 months to 83 years) with sinus venosus atrial septal defect who underwent repair from 2000 to 2018 in our institution.

Result: In 35 patients, the rotational Z-flap method was used, while 48 patients were operated using a patch augmentation of the superior vena cava (intracaval baffle). No mortality occurred and only 2 (2.4%) patients corrected using the patch method needed surgical correction of a rest ASD. There were no new cases of atrial fibrillation post operatively. Twenty patients developed a partial right bundle branch block and 4 patients had an AV junctional rhythm after undergoing intra-caval baffle correction. Fourteen patients developed a partial right bundle branch block and 6 patients had an AV junctional rhythm after rotation advancement flap correction. No patients required implantation of a pacemaker. The method used for correction did not play a significant role in the development of rhythm disturbances (p = 0.92 for RBB and p = 0.28 for AV junctional rhythm) operatively.

Conclusion: Both methods used for the correction of sinus venosus atrial septal defect produce satisfactory results with comparable incidence of rhythm disturbances.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
19 February 2021