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- Title:
Postoperative atrioventricular block after surgery for congenital heart disease: incidence, recovery and risks.
- Document type:
- Journal Article
- Author(s):
- Kruse, Kristin; Matsubara, Muneaki; Schaeffer, Thibault; Palm, Jonas; Klawonn, Frank; Osawa, Takuya; Niedermaier, Carolin; Heinisch, Paul Philipp; Piber, Nicole; Balling, Gunter; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi
- Abstract:
- OBJECTIVES: We aimed to determine the incidence of postoperative complete atrioventricular block, the time to recovery or permanent pacemaker implantation and the predictors for postoperative atrioventricular block after congenital heart surgery. METHODS: Patients who underwent open-heart surgery from January 2001 to January 2024 were analysed and predictors of atrioventricular block were identified using a logistic regression model. RESULTS: Among 9765 congenital heart surgeries, 333 (3.4%) were complicated by atrioventricular block, and 193 patients (1.9%) underwent permanent pacemaker implantation. The highest rates of atrioventricular block were found in patients who underwent repair of congenitally corrected transposition of the great arteries (27.3%), followed by Konno procedure (20.0%), mitral valve replacement (16.0%) and arterial switch with closure of ventricular septal defect and arch repair (15.0%). In 134 (1.4%) patients with transient atrioventricular block, the median time to resolution was 4 days (interquartile range: 2-8 days). After 7 postoperative days, 75% had resolved, and after 12 postoperative days, 90% had resolved. Risk factors for the development of atrioventricular block were older age at operation (odds ratio: 1.012, P = 0.001), preoperative endocarditis (2.422, P < 0.001), longer aortic cross-clamp time (1.018, P < 0.001) and high-risk procedures (1.397, P = 0.012). CONCLUSIONS: Postoperative atrioventricular block is not rare after congenital heart surgery, with more than half of them needing permanent pacemaker implantation. Older age at operation, preoperative endocarditis, longer aortic cross-clamp time and high-risk procedures were risks for the development of atrioventricular block. Pacemaker implantation should be delayed to the 12th postoperative day, when 90% of transient blocks have resolved.
- Journal title abbreviation:
- Eur J Cardiothorac Surg
- Year:
- 2025
- Journal volume:
- 67
- Journal issue:
- 3
- Fulltext / DOI:
- doi:10.1093/ejcts/ezaf059
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/39992228
- Print-ISSN:
- 1010-7940
- TUM Institution:
- Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer)
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