Amplatzer septal occluder and atrioventricular block: A case report and literature review

Akhfash, Ali A. Al; Almesned, Abdulrahman; Fayadh, Majid Al

doi:10.1016/j.jsha.2013.01.002

Cited by 7 publications

(10 citation statements)

References 15 publications

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“…In our case AV‐block appeared early within 48 hr after implantation, like typically reported in several case descriptions and small patient series . As in other cases AV‐conductance improved spontaneously, demonstrating structural integrity of the AV‐conduction system.…”

Section: Discussionsupporting

confidence: 87%

“…The extent to which the type of device affects the risk of CHB is unknown. CHB has been described after the use of Amplatzer devices as well as after the use of Helex devices and ASDOS devices . To our knowledge, this is the first report of CHB with the new GSO.…”

Section: Discussionmentioning

confidence: 88%

“…After interventional ASD closure, CHB is discussed to be caused from continued pressure or friction of atrial disks on the AV‐node, leading to edema, inflammation, or scarring. Several groups have reported cases of CHB after implantation of ASD devices in the last 14 years . In some observations, CHB after interventional ASD closure has disappeared spontaneously and permanently .…”

Section: Discussionmentioning

confidence: 99%

“…Atrioventricular (AV)‐block is a rare but clearly recognized complication after transcatheter closure of atrial septal defect (ASD) . Compression of the AV‐node as well as inflammatory foreign body reaction or scarring has been discussed as possible reasons.…”

Section: Introductionmentioning

confidence: 99%

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Late complete atrioventricular block after closure of an atrial septal defect with a gore septal occluder (GSO™)

Dittrich

Sigler

Prießmann

2015

Cathet Cardio Intervent

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Temporary intermittent complete heart block (CHB) occurred the day after interventional closure of an ASD with a 30 mm Gore Septal Occluder (GSO™) in a 2 years and 11‐month‐old female. CHB disappeared without further treatment and stable sinus rhythm recovered within 3 days. Only short episodes of 2nd degree AV‐block (Wenckebach periodicity) at rare intervals were documented in Holter‐monitors the following 2 months. Eleven months after device implantation the patient suffered from long lasting episodes of CHB. Surgical removal of the device resulted in incomplete recovery of AV‐conduction. Histopathological work‐up of the explanted GSO showed complete endothelialization of the device and regular scar formation. One year after surgery, the child had sinus rhythm during daytime but needed VVI‐pacing while sleeping. Young age, inferior localization of the defect, and use of a large device have been individual risk factors for CHB in this patient. Clinical course and histologic findings indicate that mechanical compression was the only cause for CHB. The cumulative number of reports of CHB after use of different ASD‐devices supports the recommendation to postpone the intervention in asymptomatic patients to preschool‐age. Early removal of a pushing device may increase the chance of complete recovery from CHB. © 2015 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Late complete atrioventricular block after closure of an atrial septal defect with a gore septal occluder (GSO™)

Dittrich

Sigler

Prießmann

2015

Cathet Cardio Intervent

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“…However, in 2013, Al Akhfash et al . [ 15 ] reported a case of 7 years old ASD patient who underwent device closure procedures and developed second-degree AV block immediately after the procedure. Patient was subjected to 3 days treatment with corticoids and close monitoring.…”

Section: Discussionmentioning

confidence: 99%

Value of the Ratio of Occluder Versus Atrial Septal Length for Predicting Arrhythmia Occurrence after Transcatheter Closure in Children with Ostium Secundum Atrial Septal Defect

Jin

Ding

Wang

et al. 2015

Chinese Medical Journal

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Background:Transcatheter occlusion has been applied to treat ostium secundum atrial septal defect (OS ASD) since 1997. During the clinical practice, several postoperative complications including arrhythmia have been reported. This study aimed to evaluate the value of the ratio of atrial septal occluder (ASO) versus atrial septal length (ASL) for predicting arrhythmia occurrence after transcatheter closure in children with OS ASD.Methods:Six hundred and fifty-one children diagnosed with OS ASD underwent occlusion procedures after completing routine examinations. The onsets and types of arrhythmia both during and after the occlusion procedures were monitored. Treatments were given based on the individual types of arrhythmia. The binary logistic regression analysis and receiver-operating characteristic (ROC) curve were used in the analysis of value of the ratio of ASO/ASL for predicting postoperative arrhythmia occurrence.Results:Transcather occlusions were conducted in 651 children, among whom 7 children had different types and degrees of arrhythmia, with an incidence of 1.1%. The types of arrhythmia included sinus bradycardia, atrial premature beats, bundle branch block, and different degrees of atrioventricular block. Normal electrocardiograph findings were resumed in these 7 patients following active therapies such as corticoids, nutrition, and surgeries. The binary logistic regression and ROC analysis suggested that the ratio of ASO/ASL exhibited an intermediate predictive value for predicting arrhythmia occurrence after occlusion procedures. A cut-off value of 0.576 in the ratio provided a sensitivity of 87.5% and a specificity of 76.2% with an area under the ROC curve of 0.791 (95% confidence intervals, 0.655–0.926; P < 0.05) in predicting arrhythmia occurrence after the closure procedures.Conclusions:The ratio of ASO/ASL might be a useful index for predicting arrhythmia occurrence after closure procedures in children with OS ASD.

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Complete Heart Block Following Transcatheter Closure of Atrial Septal Defect Due to Growth of Inflammatory Tissue

2014

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Transcatheter closure of atrial septal defect (ASD) is the most common approach to close the defects worldwide. In this approach, persistent conduction disturbance is extremely rare, but an acute increase in supraventricular ectopy and minimal risk of atrioventricular conduction disturbance, as complete heart block, has been seen. Here, we report a patient who underwent ASD closure with device and presented with persistent complete heart block 10 days after device occlusion due to inflammatory tissue formation just near the atrioventricular node area at the floor of the right atrium without any direct compression on the triangle of Koch.

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Amplatzer septal occluder and atrioventricular block: A case report and literature review

Cited by 7 publications

References 15 publications

Late complete atrioventricular block after closure of an atrial septal defect with a gore septal occluder (GSO™)

Late complete atrioventricular block after closure of an atrial septal defect with a gore septal occluder (GSO™)

Value of the Ratio of Occluder Versus Atrial Septal Length for Predicting Arrhythmia Occurrence after Transcatheter Closure in Children with Ostium Secundum Atrial Septal Defect

Complete Heart Block Following Transcatheter Closure of Atrial Septal Defect Due to Growth of Inflammatory Tissue

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