Postoperative complete heart block among congenital heart disease patients: Contributing risk factors, therapies and long-term sequelae in the current era. (June 2018)

• Record Type: Journal Article
• Authors: Garcia, Richard U.; Safa, Raya; Karpawich, Peter P.
• Is Part Of: Progress in pediatric cardiology. Volume 49(2018)
• Page Start: 66
• Page End: 70
• Publication Date: 2018-06
• Subjects: Congenital heart disease -- Congenital heart surgery -- Pediatric cardiology -- Post operative complete heart block -- Pacemaker -- Atrioventricular node; Pediatric cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; Infant; Child; Cardiologie pédiatrique -- Périodiques; 618.9212005
• DOI: 10.1016/j.ppedcard.2018.04.003
• Languages: English
• ISSNs: 1058-9813

Abstract

Abstract: Although postoperative complete heart block is a relatively rare complication after cardiac surgery for congenital heart disease in the current era, it has significant repercussions if there is no recovery of atrioventricular conduction in the early postoperative period. Insertion of a permanent pacemaker in an infant, child or adolescent remains an important medical decision considering all potential adverse physical and physiological side effects commonly associated with device implant among these younger patients. In this review, the current incidence, morbidity and mortality of postoperative complete heart block is presented as well as contributing anatomical and perioperative risk factors along with potential therapies and long-term sequelae of this unwanted complication. Highlights: Postoperative complete heart block (CHB) incidence has remained stable last 10 years. There is high association to surgeries involving repair of a ventricular septal defect. Late loss or late recovery of atrioventricular conduction can be seen in patients. Research required to determine the effect of medical therapy in CHB natural history