The occurrence and treatment of atrioventricular block during and after transcatheter occlusion of ventricular septal defect
- VernacularTitle:室间隔缺损介入封堵术中及术后房室传导阻滞的转归与防治
- Author:
Xiaozhou ZHENG
;
Jiali LIANG
;
Bo ZHANG
- Publication Type:Journal Article
- Keywords:
Ventricular septal defect;
Heart catheterization;
Atrioventricular block
- From:
Chinese Journal of Interventional Cardiology
2003;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the cause and development of atrioventricular block (AVB) occurred during and after transcatheter closure of ventricular septal defect (VSD), and to explore its feasible prevention and treatment. Methods From Mar, 2005 to Dec, 2005, 157 patients who suffered from congenital VSD underwent transcatheter interventional occlusion. Transient Ⅲ degree AVB occurred in 2 patients during the transcatheter therapy and Ⅱ degree AVB in 2 patients and Ⅲ degree AVB in 3 patients were observed 4 hours to 8 days after the therapy. Two of them suffered from Adams-Stokes syndrome. All patients were treated by intravenous injection of glucocorticosteroid, diuretic and dehydrator. One of them was also treated with temporary pacing. Results AVB did not re-occurred after the transcatheter closure in 2 patients who suffered from transient Ⅲ degree AVB during the transcatheter interventional therapy. The cardiac rhythm in 3 patients who suffered from Ⅲ degree AVB after the transcatheter closure reverted to sinus rhythm in 7, 8 and 18 days after the operation respectively. However, 2 of them suffered recurrent Ⅲ degree AVB after discharge, and one of them could not be restored to sinus rhythm. Three patients who suffered from the Ⅱ degree AVB resumed to sinus rhythm in 5, 7 and 8 days after the transcatheter closure respectively, and the type Ⅰ and the type Ⅱ of Ⅱ degree AVB alternated before the rhythm completely reverted. Conclusion AVB is a frequent complication during and after transcatheter closure of VSD. AVB occurred after transcatheter occlusion should be treated actively, or it may become permanent AVB. Improving the cardiac transcatheter interventional device and technique can prevent the high degree AVB in certain degree.
