Yang Zhou,Xiao Yunbin,Wang Yefeng,et al.Follow-up of complete atrioventricular block after transcatheter closure of perimembranous ventricular septal defect with different occluding devices[J].Journal of Clinical Pediatric Surgery,,18():878-883.[doi:10.3969/j.issn.1671-6353.2019.10.016]
Follow-up of complete atrioventricular block after transcatheter closure of perimembranous ventricular septal defect with different occluding devices
- Keywords:
- Heart Defects; Congenital; Heart Septal Defects; Ventricular; Heart Block; Treatment Outcome
- CLC:
- R541;R318.08
- Abstract:
- Objective To evaluate the incidence of complete atrioventricular block (CAVB) after transcatheter closure of perimembranous ventricular septal defect (pmVSD) with different occluding devices and explore the causes and interventions of complete atrioventricular block (CAVB).Methods From March 2013 to December 2016,500 children underwent pmVSD closure using different occluding devices.Clinical data,angiographic findings,follow-up records and ECG results were retrospectively analyzed.Results All of them were successfully managed with transcatheter closure.No statistic difference existed in age,gender,timing or occluder size.The overall incidence of CAVB was 2.2%,the incidence of CAVB with symmetric,edge type 4 and decentered occluder were 1.1% (4/359),4.2% (5/93) and 5.4% (2/48) respectively.All CAVB patients recovered after methylprednisolone dosing or occluder removing (symmetric,n=3; edge type 4,n=3; decentered,n=1).Among 11 CAVB cases on glucocorticoids,4 ineffective children were converted into surgery after 3 days.And symmetric (n=3),decentered (n=1) and thin-waist-big-side (n=3) occluders were utilized.Sinus rhythm resumed within 1 week.None required implanting a temporary or permanent pacemaker.Conclusion The incidence of CAVB after implanting an edge type 4 or decentered occluder is higher than symmetric occluder during pmVSD closure.
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Memo
收稿日期:2018-06-07。
通讯作者:陈智,Email:153673747@qq.com