scholarly journals Conduction system disorders after surgical patch closure of ventricular septal defects; a comparison between two suturing techniques

2019 ◽  
Vol 1 (4) ◽  
pp. 140-145
Author(s):  
Abdallah Nosair ◽  
Mohamed Elkahely ◽  
Rezk Abu-Gamila

Background: Ventricular septal defect (VSD) is the most common congenital heart disease, and conduction disorder is one of the frequent complications after VSD closure. Suturing technique used for VSD closure may affect the occurrence of this complication. The aim of this study was to compare the outcome of VSD surgical patch closure using continuous versus interrupted suture techniques. Methods: The study included 150 VSD patients who had surgical patch closure between December 2014 and March 2017. They were subclassified into two groups according to the suture technique; continuous suture technique (n= 75) and interrupted suture technique (n= 75). Preoperative, operative, and postoperative variables were reviewed and analyzed. The postoperative rhythm was recorded using contіnuous electrocardiogram during intensive care unit stay. 12-leads electrocardiogram and echocardiography were performed immediately after surgery and repeated before discharge and after 3, 6, 12 months then yearly. The follow-up period ranged from 1 to 3.25 years (2.04 ± 0.84 years). Results: Aortіc cross-clamp tіme was longer in the interrupted technique group (51.40±15.21 vs. 42.32±13.86 minutes; p <0.01). 7 (9.3%) patients in the continuous technique group had an atrioventricular block during ICU stay, and 2 (2.7 %) had complete heart block. However, one patient  (1.3%) in the interrupted technique group had an atrioventricular block, and no patient had complete heart block (p=0.006). Incidence of conduction defects during follow-up was insignificantly different between the groups. There was no significant difference in the postoperative complications between the groups. Conclusions: Complete heart block is an infrequent complication after VSD patch closure. The interrupted suture technique was associated with a lower incidence of conduction defects during the early postoperative period

2013 ◽  
Vol 20 (03) ◽  
pp. 332-340
Author(s):  
ATIF SITWAT HAYAT ◽  
MUHAMMAD ADNAN BAWANY ◽  
JAWAD AHMED QADRI ◽  
Kiran Khalil

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.


2021 ◽  
pp. 1-10
Author(s):  
Sezen Gulumser Sisko ◽  
Sezen Ugan Atik ◽  
Cem Karadeniz ◽  
Alper Guzeltas ◽  
Yakup Ergul

Abstract A young child presented with hepatomegaly, ascites, and bradycardia in the setting of coronavirus disease-2019. Permanent complete atrioventricular block and severe right heart failure were diagnosed. He was treated with surgical epicardial pacemaker implantation. This report is the first description of coronavirus disease-2019–induced permanent complete atrioventricular block in a child.


PEDIATRICS ◽  
1978 ◽  
Vol 61 (4) ◽  
pp. 599-603
Author(s):  
Cora C. Lenox ◽  
James R. Zuberbuhler ◽  
Sang C. Park ◽  
William H. Neches ◽  
Robert A. Mathews ◽  
...  

In spite of general complacency about first-degree heart block in acute rheumatic fever, abnormal conduction with dysrhythmias, occasional complete heart block, and, rarely, Stokes-Adams attacks are important early signs of acute rheumatic fever and may precede other signs. Every person with episodic fainting is entitled to an ECG, and frequent ECGs are imperative in any case of rheumatic fever with signs of arrhythmias. Changing atrioventricular block necessitates continuous monitoring for dysrhythmias. A 13-year-old boy who appeared with Stokes-Adams attacks secondary to acute rheumatic fever was successfully treated by temporary pacing.


2019 ◽  
Vol 12 (4) ◽  
pp. e228642
Author(s):  
Rayan Hejazi ◽  
Marwan Balubaid ◽  
Jameel Alata ◽  
Rahaf Waggass

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease beyond the age of 3 months. Complete heart block (CHB) is rare but a serious sequalae post-repair of TOF. We present a case of an 18-month-old child who developed late CHB after around 1 year of the corrective surgery of the congenital anomaly. On the regular follow-up visit, the patient assessment was unremarkable. However, there was bradycardia, 55 beats/min. The ECG showed complete atrioventricular dissociation. Echocardiogram was done and demonstrated severe tricuspid regurgitation (TR). The patient required a permanent pacemaker and he is currently well. We are presenting this case as a late unexpected CHB, with a possibility of progressive right-side dilatation as a contributing factor to CHB due to severe TR.


EP Europace ◽  
1999 ◽  
Vol 1 (1) ◽  
pp. 26-29 ◽  
Author(s):  
H. J. Marshall ◽  
M. J. Griffith

Abstract Atrioventricular junctional ablation is an attempt to interrupt conduction from the atrium to the ventricle using radiofrequency energy. The objective is to ablate the compact atrioventricular node as high as possible, leaving a stable ventricular escape rhythm. The compact node is identified in part by its relation to His recordings and partly through the known anatomy. In our series of 115 consecutive patients, atrioventricular block was achieved from the right side in 96% of patients and the remainder had the atrioventricular node ablated from the left side. Long-term success, i.e. complete heart block, was achieved in all patients. Complications in this and other series are rare, but there remains concern about sudden death in these patients.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Rashed Al Bannay ◽  
Aysha Husain ◽  
Saeed Khalaf

Thyrotoxicosis complicated by advance degree atrioventricular block, a rare complication of a common disease. The term apathetic thyrotoxicosis, where palpitations and cardiac involvement are the sole manifestations of disease, is well known. Thyroxin's ability to sensitize the catecholamine receptors causing tachyarrhythmias is well addressed. However, as an aetiology for advanced heart block, thyrotoxicosis is ranked as one of the rarest.


2018 ◽  
Vol 11 (2) ◽  
pp. 85-92
Author(s):  
Yuriy Yu Kulyabin ◽  
Ilya A Soynov ◽  
Alexey V Zubritskiy ◽  
Alexey V Voitov ◽  
Nataliya R Nichay ◽  
...  

OBJECTIVES: This study aimed to assess mitral valve function after repair of ventricular septal defect (VSD) combined with mitral regurgitation (MR) in the mid-term follow-up period, to evaluate the clinical utility of simultaneous mitral valve repair (MVR). METHODS: From June 2005 to March 2014, 60 patients with VSD and MR underwent surgical treatment. After performing propensity score analysis (1:1) for the entire sample, 46 patients were selected and divided into 2 groups: those with VSD closure and MVR - 23 patients and those with VSD closure without mitral valve intervention - 23 patients. The follow-up period - 32 (28;40) months. RESULTS: There was no postoperative mortality in either group. There was no significant difference in the duration of the postoperative period between groups. Mean cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the 'VSD + MVR' group (cardiopulmonary bypass, P=0.023; aortic cross-clamp, P< 0.001). There was no significant difference in regurgitation area (P=0.30) and MR grade (P= 0.76) between groups postoperatively. There was no significant difference in freedom from MR ≥ 2+ between groups (log-rank test, P= 0.28). The only significant risk factor for recurrent MR ≥ 2+ during the follow-up period was mild residual MR in the early postoperative period ( P=0.037). CONCLUSIONS: In infants with VSD combined with MR, simultaneous MVR has no benefits simultaneous MVR provided no advantage over that of isolated VSD closure. We found that the presence of mild residual MR in the early postoperative period predisposes the development of MR ≥ 2+ in follow-up period.


2003 ◽  
Vol 13 (4) ◽  
pp. 380-383 ◽  
Author(s):  
Jacintha Sivarajah ◽  
Ian C. Huggon ◽  
Eric Rosenthal

At 32 weeks, a fetus was found to be hydropic with congenitally complete heart block in an asymptomatic mother who was positive to anti-Ro antibodies. Maternal therapy with oral salbutamol was successful in prolonging gestation for a period of 3 weeks so that preterm delivery was delayed until the 35th week of gestation. Following treatment with inotropes and diuretics, a permanent transvenous pacemaker was implanted at 8 weeks of age. The child is now thriving at 20 months of age.


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