Right Bundle Branch Block After Surgical Closure of Ventricular Septal Defect

• Systolic function at rest measured by echocardiography [ Time Frame: All patients are tested only once about 20 years post to surgery ] [ Designated as safety issue: No ]
  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.
  
  

• Maximal oxygen consumption during exercise [ Time Frame: All patients are tested only once about 20 years post to surgery ] [ Designated as safety issue: No ]
  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 ] [ Designated as safety issue: No ]
  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 ] [ Designated as safety issue: No ]
  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 ] [ Designated as safety issue: No ]
  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 ] [ Designated as safety issue: No ]
  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.
  
  

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.