Alp et al identified a number of risk factors associated with early postoperative arrhythmias in children undergoing cardiac surgery for congenital heart disease. The authors are from Necmettin Erbakan University in Turkey.


Prevalence: 44% in study period


Patient selection: pediatric (<= 17 years)


Risk factors:

(1) female gender

(2) type of surgical repair (increasing with surgical complexity and/or mechanical irritation of the conduction system and/or “humoral factors”)

Defect or Surgical Repair


secundum atrial septal defect

supraventricular extrasystoles, supraventricular tachycardia, junctional rhythm, atrial flutter

ventricular septal defect

supraventricular extrasystoles, ventricular extrasystoles, wandering atrial pacemaker

tetralogy of Fallot

supraventricular extrasystoles, wandering atrial pacemaker, atrial fibrillation

atrioventricular septal defect

supraventricular extrasystoles, atrial fibrillation

atrial septal defect with PAPVR (partial anomalous pulmonary venous return)

atrial fibrillation, supraventricular extrasystole

Rastelli procedure

supraventricular tachycardia

pulmonary valve commissurotomy

supraventricular extrasystole

Blalock Taussig shunt

supraventricular extrasystole, atrial flutter

double outlet right ventricle (non-Rastelli)

supraventricular extrasystole



• The Rastelli procedure can be used to correct Taussig-Bing heart (double outlet right ventricle with pulmonary stenosis), dextro-transposition of the great arteries , overriding aorta, and some other types of congenital heart disease.


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