Clinical Trial: Right Bundle Branch Block After Surgical Closure of Ventricular Septal Defect

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Postoperative Right Bundle Branch Block - Long-term Effect on the Right Ventricle in Children Operated for Ventricular Septal Defect

Brief Summary:

The most common congenital heart disease is the ventricular septal defect, and after surgical closure of a such defect, an arrythmia called the right bundle branch block, is very frequent. Therefore the aim of this study is to investigate if this group of patients has inferior outcomes compared to the group without this arrythmia after surgical closure and compared to a group of healthy control subjects.

All patients will be undergoing 1. exercise testing, 2. echocardiography, 3. echocardiography during exercise, and 4. MRI. The perspective is the ability to point out a group of patients with a possible need of further intervention, and additionally to increase the awareness of protecting the electrical system of the heart during the operation.


Detailed Summary:

Right bundle branch block is an exceedingly frequent complication in heart surgery, and especially in patients who have undergone surgical closure of a ventricular septal defect which is the most common congenital heart disease. How this bundle branch block effects the right ventricle of the heart on a long-term basis for this group of patients, is still unknown.

As a part of a PhD-study we therefore will try to illustrate this by echocardiography, MRI, exercise testing and other investigations 15 to 20 years after the surgical procedure. The study population thus consists of three different groups: 1. Patients whom undergone surgical closure of ventricular septal defect without postoperative right bundle branch block, 2. VSD-operated patients with right bundle branch block and 3. Healthy controls with no significant medical issues matched on age and sex. By carrying out the tests mentioned the right ventricles systolic function, diastolic function, the patients maximal exercise capacity and a lot of other parameters will be evaluated in the three groups of patients and compared amongst each other. The perspective therefore is the ability to point out a specific group of patients with an inferior outcome and with a possible need for further intervention. An additional perspective is to increase the awareness of protecting the bundle branch during the operation.


Sponsor: University of Aarhus

Current Primary Outcome: Systolic function at rest measured by echocardiography [ Time Frame: All patients are tested only once about 20 years post to surgery ]

Dimensions of all 4 chambers, inspiratory collapse, and gradient over the tricuspidale valve is measured. Tricuspid Annulus Plane Systolic Excursion(TAPSE) and Tricuspid Annular peak Systolic Motion(TASM) is measured as well.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Maximal oxygen consumption during exercise [ Time Frame: All patients are tested only once about 20 years post to surgery ]
    Maximal oxygen consumption is measured during on a bicycle. Prior to the test a spirometry is performed to rull out potentiel diffenrences in pulmonary function between the cohorts. During the test pulse, blood pressure, saturation, and EKG are monitored. Ventilatory volume, oxygen consumption and carbondioxide excretion are measured. Anaerobic threshold is calculated at the end of the test.
  • Force-frequency-relation during exercise [ Time Frame: All patients are tested only once about 20 years post to surgery ]
    TASM is measured during exercise along with pulse measurements to evaluate the force-frequency-relation.
  • Diastolic function at rest measured by MRI [ Time Frame: All patients are tested only once about 20 years post to surgery ]
    Dimensions of all 4 chambers are measured at end-systole and end-diastole. Blood flow measurements through the aortic and the pulmonary valve are made as well. No use of contrast.
  • Diastolic function at rest measured by echocardiography [ Time Frame: All patients are tested only once about 20 years post to surgery ]
    Dimensions of all 4 chambers, inspiratory collapse, and gradient over the tricuspidale valve is measured. Tricuspid Annulus Plane Systolic Excursion(TAPSE) and Tricuspid Annular peak Systolic Motion(TASM) is measured as well.
  • Systolic function at rest measured by MRI [ Time Frame: All patients are tested only once about 20 years post to surgery ]
    Dimensions of all 4 chambers are measured at end-systole and end-diastole. Blood flow measurements through the aortic and the pulmonary valve are made as well. No use of contrast.


Original Secondary Outcome: Same as current

Information By: University of Aarhus

Dates:
Date Received: November 16, 2011
Date Started: June 2011
Date Completion:
Last Updated: December 2, 2014
Last Verified: August 2013