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Ann Thorac Surg 2002;73:102-106
© 2002 The Society of Thoracic Surgeons

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Original article: cardiovascular

Arrhythmia after modified total cavopulmonary connection without use of prosthetic material

^a Division of Cardiovascular Surgery, Tokyo Metropolitan Children’s Hospital, Tokyo, Japan
^b Division of Cardiology, Tokyo Metropolitan Children’s Hospital, Tokyo, Japan

Accepted for publication September 19, 2001.

* Address reprint requests to Dr Suzuki, Division of Pediatric Cardiovascular Surgery, University of Michigan Medical Center, F 7830 Mott Children’s Hospital, 1500 East Medical Center Dr, Ann Arbor, MI 48109-0223, USA
e-mail: suzukimd{at}blue.ocn.ne.jp

Background. Although total cavopulmonary connection without use of prosthetic material appeared to be a promising surgical procedure that would retain potential growth of the intraatrial tunnel, midterm incidence of arrhythmia remains unknown.

Methods. Twelve patients underwent modified total cavopulmonary connection. A prosthetic material was not used in 5 patients (group F) and was used in 7 patients (group P). A retrospective review of the perioperative electrocardiogram and ambulatory monitoring were performed.

Results. All patients revealed regular sinus rhythm before the operation. In the early postoperative period, the incidence of sinus node dysfunction was higher in group F than in group P (80% versus 28.6%). This difference no longer existed by hospital discharge (group F, 20%; group P, 14.3%). In the midterm follow-up period, sinus node dysfunction was detected in 4 patients of group F (80%) and 1 patient of group P (14.3%). Transient tachyarrhythmia was detected in 1 patient of group F and 3 patients of group P.

Conclusions. Modified total cavopulmonary connection without use of prosthetic material affected unfavorably the sinus node in the early and midterm postoperative period.