Zhou Yong, Qin Yongwen, Zhao Xianxian, Lang Xilong, Zhu Ni, Bai Yuan, Zheng Xing, Guo Zhifu, Wu Hong
Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, P.R. China.
J Invasive Cardiol. 2015 Nov;27(11):E231-5.
Complete atrioventricular block (cAVB) is considered the most serious adverse event after transcatheter closure of ventricular septal defect (VSD).
To evaluate the incidence of postprocedure cAVB and its relationship with different waist lengths of transcatheter occluders.
This is a retrospective study of patients with VSD who had been treated with transcatheter closure at the Shanghai Changhai Hospital from December 2001 to December 2010. Patients were treated with short-waist (n = 234) or long-waist occluders (n = 571). All patients were monitored by electrocardiogram (ECG) within 7 days post procedure.
Nine patients (3.8%) treated with short-waist occluders suffered from cAVB and 3 patients (1.3%) required permanent pacemaker implantation, compared with 4 patients (0.7%) and 1 patient (0.2%), respectively, in the long-waist occluder group (P<.001). There was a significantly higher incidence of postprocedure incomplete right bundle branch block (IRBBB) in patients treated with short-waist occluders compared with patients treated with long-waist occluders. There were no significant differences in other procedure-related complications between the two groups.
Long-waist VSD occluders are beneficial in the prevention of cAVB and the need for pacemaker implantation after transcatheter closure of VSD.
完全性房室传导阻滞（cAVB）被认为是室间隔缺损（VSD）经导管封堵术后最严重的不良事件。
评估术后cAVB的发生率及其与不同腰长的经导管封堵器的关系。
这是一项对2001年12月至2010年12月在上海长海医院接受经导管封堵治疗的VSD患者的回顾性研究。患者接受短腰封堵器（n = 234）或长腰封堵器（n = 571）治疗。所有患者在术后7天内进行心电图（ECG）监测。
短腰封堵器治疗的9例患者（3.8%）发生cAVB，3例患者（1.3%）需要植入永久起搏器，相比之下，长腰封堵器组分别为4例患者（0.7%）和1例患者（0.2%）（P<0.001）。与长腰封堵器治疗的患者相比，短腰封堵器治疗的患者术后不完全性右束支传导阻滞（IRBBB）的发生率显著更高。两组之间其他与手术相关的并发症无显著差异。
长腰VSD封堵器有利于预防VSD经导管封堵术后的cAVB和起搏器植入需求。
