Right bundle branch block (RBBB) is usually considered almost unaviodable after repair of teralogy of Fallot (TOF). By modifications of the standard technique, its frequency has been decreased to 32% in a series of 1000 consecutive patients. These modifications are: (1) a very short right ventricular incision avoiding the ventriculotomy-induced RBBB pattern; (2) an infundibular resection limited to the septal attachment of the infundibular septum; and (3) closure of the ventricular septal defect with a patch sutured to the very edge of the muscular septum, avoiding injury to the right bundle along the right aspect of the septum. No patient in this series sustained permanent complete atrioventricular heart block. Among patients with RBBB, five had a left anterior hemiblock. Postoperative intraventricular conduction was related to age at operation: The incidence of RBBB was significatively higher in infants. The beneficial effects of a low incidence of postoperative RBBB after repair of TOF are not known.
Medicine is an art full of probabilities and a science full of uncertainties. " Sir William OslerAt the end of the 198Os, cardiac surgery entered its scientific era.' Science in cardiac surgery is based mainly upon the statistical study of all measurable phenomena that can influence the indications, accomplishments, and results of operations. It is easy to argue the advantages of such a scientific approach: statistical analysis introduces a logical method to the thinking process which stratifies and organizes the clinical and biological data. Decisions may then be based upon objective criteria and the results analyzed. In other words, the chaos is rationalized. This endeavor has proved very effective in improving the quality of cardiothoracic surgical literature. But now, perhaps, a word of caution is needed in the face of the increasing, almost systematic and monopolistic, use of statistics in the cardiothoracic surgical literature. Fax: 33-91 -75-53-63. theoretical basis. (A few discussions among professional statisticians support this point.6) At times it seems, when reading an article, a J CARD SURG 1994.9 288-291 EEX. ET AL STATISTICS IN CARDIAC SURGERY
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.