Incidence and risk factors of complete atrioventricular block after operative ventricular septal defect repair. Congenit Heart Dis 2014;9(3):211-5
Date
06/15/2013Pubmed ID
23764088DOI
10.1111/chd.12110Scopus ID
2-s2.0-84902544830 (requires institutional sign-in at Scopus site) 34 CitationsAbstract
BACKGROUND: Complete atrioventricular block (AVB) is a recognized complication of ventricular septal defect (VSD) repair. The objective of this study was to examine incidence and risk factors.
METHODS: This is a single-center, retrospective study. All pediatric patients (age <18 years) who underwent VSD repair between November 2001 and August 2009 with concordant atrioventricular and ventriculoarterial connections were included. Patients were classified as having no AVB or transient AVB, and outcomes of early pacemaker placement (before hospital discharge) or late pacemaker placement (after hospital discharge) were recorded.
RESULTS: Eight hundred twenty-eight patients (48.6% female) underwent VSD repair during the study period. Mean age at repair was 14 ± 29.4 months. A total of 64 patients (7.7%) developed surgical AVB. Among those patients who developed AVB, 48 (75%) had transient AVB. Sixteen patients (1.9%) required a pacemaker, 14 early (88%) and 2 late (12%). Patients <4 kg (4.2% vs. 1%, P ≤ .01) and those with inlet VSDs (11.6% vs. 1.4%, P ≤ .01) were more likely to develop surgical AVB. Surgical AVB was not influenced by the presence of chromosomal abnormalities or other congenital heart disease.
CONCLUSION: The overall incidence of surgical AVB is consistent with previous reports. Weight <4 kg and presence of an inlet VSD were significant risk factors.
Author List
Siehr SL, Hanley FL, Reddy VM, Miyake CY, Dubin AMAuthor
Stephanie S. Handler MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Atrioventricular Block
Body Weight
California
Cardiac Pacing, Artificial
Cardiac Surgical Procedures
Child
Child, Preschool
Female
Heart Septal Defects, Ventricular
Humans
Incidence
Infant
Infant, Newborn
Male
Pacemaker, Artificial
Patient Selection
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome