Song Zhi-Yuan, Li Yong-Hua, Chai Hong, Li Hua-Kang, Yao Qing, Zhong Li, Jing Tao, Ran Bo-Li, Tong Shi-Fei, Liu Jian-Ping
Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Nov;37(11):990-3.
To investigate the prognostic impact of heart block during the transcatheter closure of ventricular septal defect (VSD).
Forty three patients developed complete left or right bundle branch block (CLBBB, CRBBB), incomplete left or right bundle branch block (ILBBB, IRBBB), and atrioventricular block (AVB) during and within 1 week post procedure were followuped at 1, 6, 12, 24, 36, 48 and 60 months post procedure. Electrocardiogram, dynamic electrocardiogram and transthoracic echocardiography were made.
Bundle branch block and atrioventricular block were detected in 26 patients (CLBBB n = 4, CRBBB n = 5, ILBBB n = 2, IRBBB n = 10 and third-degree AVB n = 5) during the transcatheter closure of VSD, and in 17 patients (CLBBB n = 5, CRBBB n = 2, first-degree AVB n = 3, second-degree I-type AVB n = 1 and third-degree AVB n = 6) within 1 week post procedure. Heart block disappeared in 33 patients (76.7%) before discharge, in 37 patients (86.1%) at 1 month and in 41 patients (95.4%) at 6 months post procedure. CLBBB or CRBBB was seen in two cases at 24 months after closure. There was no heart failure and serious cardiac dilatation during follow up.
The heart block occurred during the periprocedure period of transcatheter closure of VSD was a benign phenomenon without prognostic importance.