Risk Factors and Outcomes of Post-Procedure Heart Blocks After Transcatheter Device Closure of Perimembranous Ventricular Septal Defect

Abstract

The outcome of PPHBs after transcatheter closure of pmVSD was satisfactory, as most patients recovered to normal conduction. Measurements of DLRD-SLTV, DAVD, and DDOV may be useful in predicting the incidence of PPHBs.

Complete atrioventricular block after percutaneous device closure of perimembranous ventricular septal defect: A single-center experience on 1046 cases

“…This fact should be considered when counseling patients, their parents, and their personal physicians about symptoms that might develop and that need appropriate evaluation. Yang et al, 7 reporting on a series of 244 patients, deduced that the time of AV block emergence was an independent predictor of cAVB persistence. They showed that the earlier a cAVB developed after closure of the pmVSD, the more difficult was a recovery to normal conduction.…”

“…[4][5][6] Previous literature has described that cAVB can occur immediately or later after transcatheter occluder closure. [7][8][9] Since the exact mechanism of postoperative cAVB is not fully investigated, the occurrence of cAVB in patients treated with percutaneous interventions is unpredictable. Additionally, there is a lack of studies describing incidence of cAVB and predictors of pacemaker requirement following ventricular septal defect (VSD) closure.…”

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

“…Percutaneous device closure of perimembranous ventricular septal defect is increas ingly used as a successful alternative to surgical clo sure. 248 Arrhythmic complications, including BBB and e300 atrioventricular block, occur in 11% during the proce dure 248 and in 15% after the procedure, 249 with a 1% to 5.7% incidence of highgrade atrioventricular block. Time to the development of atrioventricular block ranged from intraprocedural to up to 7 days after the procedure, with most occurring by 3 days.…”

“…Time to the development of atrioventricular block ranged from intraprocedural to up to 7 days after the procedure, with most occurring by 3 days. Although atrioventricular block resolution often occurs with ste roids, certain characteristics of the ventricular septal defect and placement of the occluder 249 250 In a metaanalysis of 172 series comprising >13 000 patients, the incidence of atrioventricular block was 0.4%. 251 The overall risk of major periprocedural complications was 0% to 9.4% in the studies, with a pooled risk of 1.6%.…”

Percutaneous Closure of a Perimembranous Ventricular Septal Defect Through Arm Approach (Radial Artery and Basilic Vein)

“…Over the last decade the success rate of transcatheter closure of pmVSD has increased significantly, while complications, such as aortic or tricuspid regurgitation and device motion, have decreased . Though the incidence of heart block after closure of pmVSD has remained the most concerning complication (approximately 4–5%), little consideration is given to the access‐related complications and access choices . We report, to the best of our knowledge, the first ever pmVSD closure performed through radial artery (RA) and basilic vein (BV) access (arm access).…”