Risk factors for atrioventricular block after occlusion for perimembranous ventricular septal defect

Lin, Li; Liu, Jianwen; Xin, Guo; Chen, Hang; Huang, Yu; Zheng, Hailing; Chen, Wanhua; Chen, Lianglong; Chen, Zhaoyang

doi:10.1016/j.hrthm.2021.11.027

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…Conversely, Wang et al ( 7 ) suggest that the late-onset CLBBB can be less likely recovered normal conduction. Additionally, some studies considered the late cAVB (>30 days) relatively difficult to recover to normal sinus rhythm ( 6 , 16 ). According to our follow-up study, none of 5 patients with late-onset heart block restored normal conduction.…”

Section: Discussionmentioning

confidence: 99%

“…However, it remains uncertain the exact occurrence time period of postprocedural heart blocks which are easy to recover. Moreover, recurring postprocedural heart blocks are also more difficult to recover ( 6 , 7 , 16 ), indicating that this type of heart block might be another risk factor for developing persistent heart block. In our opinion, the lower body weight of children with heart blocks is less likely to recover.…”

Section: Discussionmentioning

confidence: 99%

“…Ovaert et al ( 19 ) reported a case study of two children who presented with cAVB 4 days after the VSD closure, and surgical device removal was followed by a rapid and complete recovery of the atrioventricular conduction. A recent study showed that surgical device removal within 10 days followed by VSD closure was performed in 5 patients with cAVB, resulting in resolution of cAVB in 4 cases ( 16 ). Bai et al ( 6 ) described the case of one patient with late-onset cAVB, developed 3 years after VSD device closure.…”

Section: Discussionmentioning

confidence: 99%

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Predictors and long-term outcomes of heart block after transcatheter device closure of perimembranous ventricular septal defect

Jiang

Zhang²,

Zhang³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundHeart block is the most common and concerning complication associated with transcatheter device closure of perimembranous ventricular septal defect (pmVSD) and its occurrence remains a great challenge for device closure.MethodsBetween June 2002 and June 2020, 1076 pediatric patients with pmVSD, who successfully underwent transcatheter device closure in our center, were enrolled in this cohort study, with a median follow-up of 64 months (range: 1 to 19 years).ResultsOf 1076 patients, 234 (21.8%) developed postprocedural heart block, with right bundle branch block being the most common (74.8%), followed by left bundle branch block (16.2%), and atrioventricular block (5.6%). Complete atrioventricular block occurred in 5 cases, including 3 cases with permanent pacemaker implantation, 1 case with recovery to normal sinus rhythm, and 1 case with sudden cardiac death. Most patients (97.9%) developed heart block within 1 week of procedure. Finally, 138 cases returned to normal cardiac conduction. Multivariate logistic regression revealed that thin-waist occluders (odds ratio [OR]: 1.759; 95% confidence interval [CI]: 1.023 to 3.022; P = 0.041), and oversized devices (OR: 1.809; 95% CI: 1.322 to 2.476; P < 0.001) were independently associated with occurrence of postprocedural heart block. Moreover, heart block was less likely to occur when the left disk of occluder was placed within the aneurysmal tissue (OR: 0.568; 95% CI: 0.348 to 0.928; P = 0.024).ConclusionThe outcome of postprocedural heart block is favorable in most cases. Oversized devices and thin-waist occluders should be avoided. Placement of the left disk of the device should into the aneurysmal tissue is highly recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors and long-term outcomes of heart block after transcatheter device closure of perimembranous ventricular septal defect

Jiang

Zhang²,

Zhang³

et al. 2022

Front. Cardiovasc. Med.

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“…However, few studies have reported the incidence of delayed-onset CAVB in patients who showed recovery of the heart rhythm through steroid therapy. Permanent pacemaker implantation is the primary treatment for delayed-onset CAVB at present ( 5 , 6 , 19 ). Lin et al reported that the incidence of permanent CAVB after pmVSD and permanent pacemaker implantation occlusion were 0.7% and 0.5%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The cardiac rhythm was found to recover after the surgical removal of the occluder. This case report presents the longest duration till the occurrence of CAVB and postoperative recovery of heart rhythm after MITC of pmVSD ( 5 , 6 ). Through this case report, clinicians are reminded to pay attention to the safety of this surgery in young children.…”

Section: Introductionmentioning

confidence: 85%

Case report: Recovery of long-term delayed complete atrioventricular block after minimally invasive transthoracic closure of ventricular septal defect

Jin

Lian

Wen

et al. 2023

Front. Cardiovasc. Med.

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IntroductionLong-term delayed complete atrioventricular block (CAVB) is a serious complication of ventricular septal defect (VSD) closure treatment. Thus, cardiac surgeons have made significant efforts to explore its causes and reduce its incidence. In recent years, minimally invasive transthoracic closure (MITC) of VSD has been used widely and successfully in China as it is easy to repeat, ensures individualized closure, and can be debugged repeatedly. Theoretically, the possibility of the recurrence of CAVB is lower than that with transcatheter closure. Although the incidence of CAVB after MITC of VSD is inevitable, long-term delayed CAVB has rarely been reported.Case descriptionHerein, we report a case of delayed CAVB that occurred 2 years and 5 months after performing MITC of a perimembranous VSD. The cardiac rhythm recovered after the occluder was removed surgically.ConclusionThe findings of our case report emphasize that since delayed CAVB may occur in the long term after MITC of VSD, the safety of MITC of VSD should be reassessed, the indications for MITC should be strictly followed, and long-term follow-up, including lifelong follow-up, is recommended for patients postoperatively. In addition, the occluder should be removed surgically in patients with CAVB as it may restore normal heart rhythm.

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Update on percutaneous and perventricular device closure of congenital ventricular septal defect

Lozier

Sati

Cheifetz

et al. 2023

Expert Review of Cardiovascular Therapy

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Risk factors for atrioventricular block after occlusion for perimembranous ventricular septal defect

Cited by 4 publications

References 17 publications

Predictors and long-term outcomes of heart block after transcatheter device closure of perimembranous ventricular septal defect

Predictors and long-term outcomes of heart block after transcatheter device closure of perimembranous ventricular septal defect

Case report: Recovery of long-term delayed complete atrioventricular block after minimally invasive transthoracic closure of ventricular septal defect

Update on percutaneous and perventricular device closure of congenital ventricular septal defect

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