A SURGICAL-PROCEDURE FOR THE PREVENTION OF COMPLETE RIGHT BUNDLE-BRANCH BLOCK FOLLOWING TOTAL CORRECTION OF TETRALOGY OF FALLOT

Complete right bundle branch block (CRBBB) has been reported as the mo st common sequelae following total correction of tetralogy of Fallot. A review of previous reports and our own experience have led us to bel ieve that it may be related to the fatal ventricular dysrhythmias whic h often occur during the postoperative follow-up period. Therefore, we have been trying to reduce the incidence of CRBBB, and we describe he rein our surgical procedure for the prevention of CRBBB and its result s. Of a total 28 consecutive patients who underwent intracardiac repai r by this procedure, only 4 (14%) developed surgically induced CRBBB, none of whom developed a left anterior hemiblock. At the time of this report, no severe ventricular arrhythmias have been found in this seri es during the postoperative follow-up period. These results suggest th at our operative procedure is feasible for the prevention of CRBBB. Wi th regard to the relationship between ventricular dysrhythmia and CRBB B, careful observation is necessary throughout the patients' lifetime.