Complete heart block after occlusion and repair for perimembranous ventricular septal defect.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta cardiologica Pub Date : 2025-03-31 DOI:10.1080/00015385.2025.2480961

Li Lin, Wanhua Chen, Hang Chen, Jianwen Liu, Kanghui Chen, Lianglong Chen, Liangwan Chen, Zhaoyang Chen

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引用次数: 0

Abstract

Background: Complete atrioventricular conduction block (CAVB) is a major complication of the repair and occlusion of perimembranous ventricular septal defects (pmVSDs).

Objective: This study aimed to analyse the incidence and risk factors of CAVB after occlusion and repair of pmVSD.

Methods: We reviewed patients with pmVSDs who underwent occlusion and repair between January 2010 and January 2022. Permanent CAVB was defined as a CAVB requiring permanent pacemaker implantation or occluder extraction.

Results: Of 2436 patients who underwent pmVSD repair, 7 (0.3%) developed permanent CAVB. In all, 16 (0.7%) of the 2200 patients in the device group developed permanent CAVBs. All permanent CAVBs in the repair group occurred during hospital stay. In contrast, eight (50%) permanent CAVBs in the device group occurred over 1 month. A large pmVSD size (odds ratio [OR], 1.575; 95% confidence interval [CI], 1.260-1.970, p < 0.001) and device/defect ratio (OR, 2.608; 95% CI, 1.587-4.287, p < 0.001) were independent risk factors for permanent CAVB after surgical repair and device occlusion, respectively. Multivariate regression showed that device occlusion versus surgical repair was associated with a significantly higher risk of permanent CAVBs (OR, 4.675; 95% CI, 1.586-13.780, p = 0.005).

Conclusion: The incidence rates of permanent CAVB after device occlusion and surgical repair were 0.7% and 0.3%, respectively. Large VSD size and device/defect ratio were independently associated with permanent CAVB after surgical repair and device occlusion, respectively. Compared with surgical repair, device occlusion was associated with a significantly higher risk of permanent CAVB after pmVSD closure.

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膜周围室间隔缺损的完全性心脏传导阻滞和修复。

背景：完全性房室传导阻滞（CAVB）是膜周围室间隔缺损（pmVSDs）修复和闭塞的主要并发症。目的：分析pmVSD闭塞修复后房颤的发生率及危险因素。方法：我们回顾了2010年1月至2022年1月期间接受闭塞和修复的pmvsd患者。永久性房颤定义为需要植入永久性起搏器或拔除闭塞器的房颤。结果：在2436例接受pmVSD修复的患者中，7例（0.3%）发生永久性CAVB。总的来说，装置组2200例患者中有16例（0.7%）发生永久性cavb。修复组永久性cavb均发生在住院期间。相比之下，器械组在1个月内发生了8例永久性cavb（50%）。较大的pmVSD大小(优势比[OR]， 1.575；95%可信区间[CI]， 1.260 ~ 1.970, p p p = 0.005)。结论：器械闭塞和手术修复后永久性腔静脉血栓的发生率分别为0.7%和0.3%。较大的VSD大小和器械/缺损比分别与手术修复和器械闭塞后的永久性CAVB独立相关。与手术修复相比，装置闭塞与pmVSD关闭后永久性CAVB的风险显著增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta cardiologica 医学-心血管系统

CiteScore

2.50

自引率

12.50%

发文量

115

审稿时长

2 months

期刊介绍： Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.