ArticleFrontiers in cardiovascular medicine2026
Same-same, but different? Postoperative rhythm disturbances and other analysis after rotational Z-flap vs. patch repair of sinus venosus atrial defects.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and aims: Surgical correction of sinus venosus atrial septal defects (SVASD), often associated with partial anomalous pulmonary venous return (PAPVR), is characterized by low mortality but carries a risk of postoperative rhythm disturbances due to the proximity of the sinus node. This study aimed to compare the clinical outcomes and incidence of postoperative arrhythmias between two surgical techniques: the conventional patch repair (baffle) and the rotational "Z" flap technique. Methods: A retrospective, single-center non-inferiority analysis was conducted on 110 patients (adult and pediatric) who underwent isolated SVASD correction between 2000 and 2025 in northern Bavaria, Germany. Patients with preoperative arrhythmias or concomitant procedures were excluded. Subjects were divided into two cohorts: the baffle group ( Results: Operative times were significantly shorter in the "Z" flap group compared to the baffle group (Total time: 182.6 vs. 209 min; Bypass time: 71.4 vs. 96.1 min; Cross-clamp time: 35.7 vs. 46 min; all Conclusion: Both surgical methods are effective and contain inherent advantages and disadvantages for SVASD correction. While the "Z" flap technique is surgically more efficient with shorter ischemic times, it is associated with a significantly higher risk of developing postoperative junctional rhythms compared to the conventional baffle repair.
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