OBJECTIVES The aim of this study was to investigate postoperative conduction disorder differences between continuous and interrupted suturing techniques for the closure of perimembranous outlet-type ventricular septal defects (VSDs) in both tetralogy of Fallot (ToF) and isolated VSD cases. METHODS Patients aged 4 years or younger who underwent VSD closure for ToF (n = 112) or isolated perimembranous outlet-type VSD (n = 73) from April 2010 to December 2018 at 3 centres were reviewed. Patients either received continuous suturing for ToF (C-ToF, n = 58) or isolated VSD (C-VSD, n = 50), or interrupted suturing for ToF (I-ToF, n = 54) or isolated VSD (I-VSD, n = 23). Cohorts did not differ in preoperative characteristics. Postoperative conduction disorder differences upon discharge and postoperative year 1 (POY1) were evaluated by electrocardiography. RESULTS The C-ToF group showed significantly shorter PQ intervals (124.0 vs 133.5 ms; P = 0.042 upon discharge, 125.3 vs 133.5 ms; P = 0.045 at POY1) and QRS durations (98.0 vs 106.2 ms; P = 0.031 upon discharge, 97.3 vs 102.5 ms; P = 0.040 at POY1) than the I-ToF group. Right bundle branch block incidence was significantly lower in the C-ToF versus I-ToF groups (56.8 vs 75.9; P = 0.045 upon discharge, 56.8 vs 75.9; P = 0.045 at POY1). Heart rates were significantly lower in the C-ToF versus I-ToF groups at POY1 (109.2 vs 119.3 bpm; P < 0.001). No parameters significantly differed between C-VSD and I-VSD groups. Multivariable analyses confirmed the group (C-ToF versus I-ToF) as a significant covariate in postoperative heart rate, PQ interval, QRS duration and right bundle branch block outcomes at POY1 (P = 0.013, 0.027, 0.013 and 0.014, respectively). CONCLUSIONS A continuous suturing technique for the closure of outlet-type VSD in ToF could reduce the incidence of postoperative right bundle branch block, shorten the PQ interval and lower heart rate. Subject collection 110, 138, 139.

中文翻译：

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膜周室间隔缺损闭合后的传导障碍：连续与间断缝合技术

目的 本研究的目的是调查法洛四联症 (ToF) 和孤立的 VSD 病例中连续和间断缝合技术在闭合膜周出口型室间隔缺损 (VSD) 中术后传导障碍的差异。方法 回顾 2010 年 4 月至 2018 年 12 月在 3 个中心因 ToF（n = 112）或孤立的膜周出口型 VSD（n = 73）接受 VSD 封堵术的 4 岁或以下患者。患者要么接受 ToF（C-ToF，n = 58）或孤立 VSD（C-VSD，n = 50）的连续缝合，要么接受 ToF（I-ToF，n = 54）或孤立 VSD（I-VSD）的间断缝合, n = 23)。队列在术前特征方面没有差异。通过心电图评估出院时和术后第 1 年 (POY1) 的术后传导障碍差异。结果 C-ToF 组的 PQ 间期显着缩短（124.0 vs 133.5 ms；出院时 P = 0.042，125.3 vs 133.5 ms；POY1 时 P = 0.045）和 QRS 持续时间（98.0 vs 106.2 ms；出院时 P = 0.031，97.3 vs 102.5 ms；POY1 时 P = 0.040）比 I-ToF 组。与 I-ToF 组相比，C-ToF 组的右束支传导阻滞发生率显着降低（56.8 vs 75.9；出院时 P = 0.045，56.8 vs 75.9；POY1 时 P = 0.045）。POY1 时，C-ToF 组的心率显着低于 I-ToF 组（109.2 对 119.3 bpm；P < 0.001）。C-VSD 和 I-VSD 组之间的参数没有显着差异。多变量分析证实该组（C-ToF 与 ​​I-ToF）是术后心率、PQ 间期、QRS 持续时间和 POY1 右束支传导阻滞结果的显着协变量（P = 0.013、0.027、0.013 和 0.014，分别）。结论 ToF中出口型VSD的连续缝合技术可降低术后右束支传导阻滞的发生率，缩短PQ间期，降低心率。主题集合 110、138、139。