Elsevier

American Heart Journal

Volume 109, Issue 6, June 1985, Pages 1323-1326
American Heart Journal

Long-term follow-up of dysrhythmias following the Mustard procedure

https://doi.org/10.1016/0002-8703(85)90359-XGet rights and content

Abstract

Earlier reports have suggested that the incidence of dysrhythmias after the Mustard procedure can be reduced if the sinoatrial node (SAN) is protected during surgery. To determine if these initial differences continue after longer follow-up, we examined all ECGs available for three groups of patients operated upon from January, 1965, through December, 1977. Group A included 37 patients who survived the operation prior to January, 1972, when surgical modifications were initiated to protect the SAN; group B included 44 patients available for follow-up who were operated upon from 1972 through 1974; and group C consisted of the 39 patients available for follow-up operated upon from 1975 to 1977. Dysrhythmias were classified as passive (failure of initiation or propagation of the SAN impulse), active (atrial flutter or supraventricular tachycardia), or atrioventricular (AV) conduction defects. Results were expressed as the incidence per number of different rhythms during follow-up intervals. The incidence of sinus rhythm in groups B and C (80%) was much greater than in group A (27%) during the first 2 years. However, after 8 years, less than 50% of the rhythms were sinus. Both brady- and tachydysrhythmias were common. Seven patients (6%) required pacemaker insertion for symptomatic sick sinus syndrome. Therefore despite efforts to protect the sinus node, late occurring dysrhythmias remain a significant problem in the postoperative Mustard patient.

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Supported in part by three grants from the National Institutes of Health: General Clinical Research and Branch Grant No. RR-00188, United States Public Health Service Grant No. HL-07190, and Research Career Development Award Grant No. HL-00571.

Present address: 830 North Tejon, Colorado Springs, CO 80903.

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