Pacemaker implantation post congenital heart disease surgical repair: tertiary center experience

Surgical Outcomes of Congenital Heart Disease in Down Syndrome: Tertiary Centre Experience – Focus on the Electrical Conduction System

“…During the same study period, the incidence of PMI in this DS cohort is high at 6%, versus the overall 1.8% incidence for all patients undergoing intra-cardiac repair at CDH [10]. While smaller age, less weight and longer surgical times are potentially important risk factors accounting for this higher incidence (Table 6) [10], the associated electroanatomic variations commonly seen in DS patients are likely to be also contributing.…”

“…Recently, the rate for post-operative PMI for all intra-cardiac surgeries performed at CDH had been published [10]. It was noteworthy that the proportion of patients with DS in the pacemaker group was signi cantly higher [10].…”

“…Recently, the rate for post-operative PMI for all intra-cardiac surgeries performed at CDH had been published [10]. It was noteworthy that the proportion of patients with DS in the pacemaker group was signi cantly higher [10]. Therefore, we thought to look at all DS patients' surgical outcomes and focus on the main pre-and post-operative electrical conduction disturbances.…”

“…Furthermore, the SAD mostly seen in DS with AVSD lesions is thought to be partly related to the posterior displacement of the atrioventricular node (AVN), along with the associated hypoplastic left anterior fascicle and the early onset of the left posterior fascicle branch [13,14]. Perhaps the mere inferior displacement of the AVN is the main culprit for the higher risk of post-operative heart block, rather than DS itself as its been previously shown that the incidence of PMI in non-syndromic AVSD patients is rather similar [10].…”