New Onset Complete Heart Block and Corrected Transposition of Great Arteries in the Seventh Decade

AbstractBalloon pulmonary valvoplasty was performed in a patient with congenitally corrected transposition, aged 28 years, who had already undergone surgical closure of a ventricular septal defect and implantation of a conduit between the pulmonary arteries and the right-sided morphologically left ventricle. The patient developed stenosis of the conduit 22 years after the procedure as confirmed by cardiac catheterization and angiocardiography, which also showed stenosis of the native pulmonary valve. A balloon valvoplasty of the native valve was carried out with improvement of the gradient from the ventricle to the pulmonary arteries. The patient developed complete heart block immediately after the procedure, which reverted to first degree block in one week and to the previous cardiac rhythm within 21 days.

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Complete Heart Block as a Clinical Feature in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients: A Case Series of Three Cases

Case Reports in Critical Care ◽

10.1155/2021/9955466 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Farook Ahmad ◽

Priti Gandre ◽

Julien Nguekam ◽

Alanna Wall ◽

ShiYu Ong ◽

...

Keyword(s):

Respiratory Failure ◽

Medical History ◽

Critically Ill ◽

Heart Block ◽

Complete Heart Block ◽

Case Series ◽

Coronary Syndrome ◽

Cardiovascular Morbidity And Mortality ◽

Hypoxic Respiratory Failure ◽

New Onset

Background. Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. However, there have been very few reports on complete heart block (CHB) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of critically ill COVID-19 patients complicated by CHB. Case Summary. We present three cases of new-onset CHB in critically ill COVID-19 patients. Patient 1 is a 41-year-old male with well-documented history of Familial Mediterranean Fever (FMF) who required mechanical ventilator support for acute hypoxic respiratory failure from severe COVID-19 pneumonia. He developed new-onset CHB without a hemodynamic derangement but subsequently had acute coronary syndrome complicated by cardiogenic shock. Patient 2 is a 77-year-old male with no past medical history who required intubation for severe COVID-19 pneumonia acute hypoxic respiratory failure. He developed CHB with sinus pause requiring temporary pacing but subsequently developed multiorgan failure. Patient 3 is 36-year-old lady 38 + 2 weeks pregnant, gravida 2 para 1 with no other medical history, who had an emergency Lower Section Caesarean Section (LSCS) as she required intubation for acute hypoxic respiratory failure. She exhibited new-onset CHB without hemodynamic compromise. The CHB resolved spontaneously after 24 hours. Discussion. COVID-19-associated CHB is a very rare clinical manifestation. The potential mechanisms for CHB in patients with COVID-19 include myocardial inflammation or direct viral infiltration as well as other causes such as metabolic derangements or use of sedatives. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and hemodynamic instability.

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Transcatheter closure of perimembranous ventricular septal defects with ductal occluders

Cardiology in the Young ◽

10.1017/s1047951114001255 ◽

2014 ◽

Vol 25 (5) ◽

pp. 918-926 ◽

Cited By ~ 8

Author(s):

Jayaranganath Mahimarangaiah ◽

Anand Subramanian ◽

Srinivasa Kikkeri Hemannasetty ◽

Subhash Chandra ◽

Satish Karur ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Tricuspid Regurgitation ◽

Heart Block ◽

Complete Heart Block ◽

Ductus Arteriosus ◽

Amplatzer Duct Occluder ◽

Ventricular Septal Defects ◽

Septal Defects ◽

Patent Ductus ◽

New Onset

AbstractBackground: To study the feasibility and complications associated with the use of ductal occluders for closure of perimembranous ventricular septal defects. Methods: A total of 126 patients, ranging from 1 to 41 years of age (median – 8 years), underwent closure of ventricular septal defects from August 2010 to April 2013. Small- and moderate-sized defects were closed using first-generation Patent ductus arteriosus occluders or Amplatzer Duct Occluder-II. Patients were followed up for the development of complications such as heart block, aortic regurgitation, and tricuspid regurgitation. Results: Patent ductus arteriosus occluders were used in 81 patients, and the Amplatzer Duct Occluder-II device in 45 patients. The devices were successfully deployed in 99.2% of the cases. One patient had embolisation of an Amplatzer Duct Occluder-II device soon after deployment. There was one case of transient complete heart block (0.8%) needing temporary pacing, and two cases of isoarrhythmic atrioventricular dissociation (1.6%). One patient developed late-onset complete heart block 15 months after the procedure and underwent permanent pacemaker implantation. There were no instances of new-onset aortic regurgitation. New-onset mild tricuspid regurgitation was seen in two patients. Of the patients, three had small residual shunts on follow-up, without haemolysis. Conclusions: Duct occluders can be used to effectively close small- and moderate-sized ventricular septal defects. The incidence of complete heart block and valvular regurgitations are much less than reported with other devices, and they are cost-effective.

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