Background: This study was undertaken to determine that maintaining coronary sinus on the right atrial side during the surgical repair of complete atrioventricular septal defect (AVSD) does not increase the risk of postoperative complete heart block.
Methods: This is a retrospective study of 51 consecutive patients who underwent biventricular repair of complete AVSD from September 2000 to January 2005. Electrocardiograms and operative data were analyzed.
Results: The mean age was 13.3 months (4 to 60). In all the 51 patients, except 13 cases, repair was performed using the two-patch technique. All atrial septal defects were closed using the patch technique with the coronary sinus maintained on the right atrial side in 48 (94%) cases. The cleft in the neomitral valve was closed in all patients. Associated lesions were repaired in four patients (7.8%); coarctation of aorta in two patients; multiple ventricular septal defects (VSD) with coronary sinus type-total anomalous pulmonary venous drainage and right-sided diaphragmatic eventration in one patient; and tetralogy of Fallot in one patient. There were five deaths (9.8%) in a series. The mean hospital stay was 11.8 days. During the same hospitalization, reintervention was required in two cases: one for residual VSD and the other for a severely dysplastic regurgitant mitral valve. Mean follow-up was 11.3 months. One patient required reoperation for residual VSD, residual atrial septal defect, and moderate mitral regurgitation 5 months after the initial repair. Except for first-degree heart block documented in nine cases and right bundle branch block in two cases, all patients remained in sinus rhythm on follow-up electrocardiography as preoperatively documented. No patient required prolonged cardiac pacing in the postoperative period.
Conclusion: We believe that maintenance of the coronary sinus on the right side can be safely accomplished in the majority of complete AVSD repair as long as careful attention is paid to the anatomy of the conduction system. This technique did not increase the risk of postoperative heart block and permanent pacemaker insertion was not required.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1540-8191.2006.00293.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Feasibility of anchoring active fixation quadripolar lead to the main body of the dilated coronary sinus in a patient with persistent left superior vena cava: a case report.
Eur Heart J Case Rep
January 2025
Department of Cardiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-Ku, Yokohama city, Kanagawa 236-0004, Japan.
Background: Coronary sinus (CS) lead placement in persistent left superior vena cava (PLSVC) cases is challenging because of the poor backup force of the guiding catheter within the enlarged CS. Active fixation Quadripolar leads (Attain Stability™ Quad 4798, Medtronic) can expand choice to CS branches with limited access; however, no cases of anchoring to the main body of the CS have been published to date.
Case Summary: We describe a case of cardiac resynchronization therapy pacemaker upgrade in a 79-year-old female who developed pacing-induced cardiomyopathy after pacemaker implantation via the right superior vena cava (SVC) for atrioventricular block eight years ago wherein PLSVC was revealed during the procedure.
Severe bradycardia in patients with obstructive sleep apnoea and good early response to CPAP.
Sleep Breath
January 2025
Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, Kraków, 31-202, Poland.
Background: Obstructive sleep apnoea (OSA) may lead to heart rhythm abnormalities including bradycardia. Our aim was to ascertain clinical and echocardiographic parameters in patients with OSA in whom severe bradycardia was detected in an outpatient setting, as well as to evaluate the efficacy of CPAP therapy on heart rate normalization at the early stages of treatment.
Methods: Fifteen patients mild, moderate or severe OSA and concomitant bradycardia were enrolled.
Acute Nonsustained Mitral Isthmus Block Obtained With Sphere-9 Lattice-Tip Catheter Completed With Vein of Marshall Ethanol Infusion.
J Cardiovasc Electrophysiol
January 2025
Hôpital Cardiologique du Haut Léveque, CHU de Bordeaux, L'Institut de RYthmologie et modelisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.
Background: Achieving a durable mitral line block using radiofrequency as a part of an anatomical approach for ablation in patients with persistent atrial fibrillation or for treating peri-mitral flutter has always been challenging due to the complex anatomy of the mitral isthmus. Epicardial ablation via the coronary sinus and the vein of Marshall has been proposed to help create durable lesions. Recently, a novel lattice-tip catheter using pulsed field ablation has shown promising results for creating mitral lines, despite limited data.
View Article and Find Full Text PDFCardiovascular complications in chronic active Epstein-Barr virus disease: a case report and literature review.
Front Pediatr
January 2025
Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education (MOE), West China Institute of Women and Children's Health, Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, Department of Pediatrics, Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Cardiovascular involvement is a rare but severe complication of Epstein-Barr virus (EBV) infections. Patients with chronic active EBV (CAEBV) are at increased risk of developing cardiovascular complications and have a poor prognosis. Here, we report the rare case of a pediatric patient with CAEBV and EBV- hemophagocytic lymphohistiocytosis (HLH) complicated with a giant coronary artery aneurysm (CAA) and thrombosis, a giant Valsalva sinus aneurysm, and ascending aorta dilation seven years after the disease onset.
View Article and Find Full Text PDFChallenges in extracting a defective ventricular lead after CRT-D: a case report.
Front Cardiovasc Med
January 2025
Department of Cardiology, University of Health Sciences, Erzurum Bolge Training and Research Hospital, Erzurum, Turkey.
Background: Our aim in this case was to remove the defective ventricular lead and the ruptured coronary sinus lead.
Methods: Entering through the right femoral vein and removing the coronary sinus lead with a pigtail catheter.
Results: In our attempt to extract the coronary sinus lead, it fractured.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!