Department of Pediatrics and Medicine, Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, Chicago, Illinois 60612, USA.
Catheter Cardiovasc Interv. 2010 Apr 1;75(5):767-72. doi: 10.1002/ccd.22359.
Transcatheter device closure of atrial septal defects is now considered an alternative option to open heart surgery with good short-term and long-term results (Du et al., J Am Coll Cardiol 2002;39:1836-1844, Chessa et al., J Am Coll Cardiol 2002;39:1061-1065); in comparison with surgical closure, the complication rate is lower (Du et al., J Am Coll Cardiol 2002;39:1836-1844). Arrhythmias are known infrequent complications of device closure. However, complete heart block is a rare complication of both treatment modalities (Chessa et al., J Am Coll Cardiol 2002;39:1061-1065). We report two patients who developed atrioventricular (AV) block within 48 hr after uncomplicated device closure of ASD using the Amplatzer septal occluder (ASO) device. Despite trials of high dose steroids and non-steroidal anti-inflammatory agents in both patients, the response was inadequate and by the end of the first week, both patients were ultimately sent for surgical removal of their devices with complete resolution of their atrioventricular conduction abnormalities. We discuss the possible etiology and risk factors of AV block and propose recommendations for management of such a complication.
经导管房间隔缺损封堵术现已成为心脏直视手术的一种替代方法，具有良好的短期和长期效果（Du 等人，J Am Coll Cardiol 2002;39:1836-1844;Chessa 等人，J Am Coll Cardiol 2002;39:1061-1065）;与手术修复相比，并发症发生率较低（Du 等人，J Am Coll Cardiol 2002;39:1836-1844）。心律失常是器械封堵的已知罕见并发症。然而，完全性心脏传导阻滞是这两种治疗方法的罕见并发症（Chessa 等人，J Am Coll Cardiol 2002;39:1061-1065）。我们报告了两例患者，他们在使用 Amplatzer 房间隔封堵器（ASO）装置对 ASD 进行简单的器械封堵后 48 小时内发生了房室（AV）传导阻滞。尽管两名患者均尝试了大剂量类固醇和非甾体抗炎药，但反应不足，在第一周结束时，两名患者最终都被送往手术取出他们的设备，其房室传导异常完全得到解决。我们讨论了 AV 阻滞的可能病因和危险因素，并提出了处理这种并发症的建议。
