Volume 11 Issue 2
Incidence of complete heart block requiring permanent pacemaker after surgical closure of ventrticular septal defect: 2 years’ experience in high volume center in Pakistan
1Dr Faiz Rasool, 2Dr Syed Sardar Rahim, 3Dr Muhammad Sarwar, 4Dr Salman Ahamd Shah, 5Dr Mohammad Asim Khan
1Assistant professor of pediatric cardiac surgery Children’s Hospital / institute of child health Lahore Pakistan
2Senior registrar pediatric cardiac surgery University of child health sciences
3Associate professor of pediatric intensive care
4Assistant professor of pediatric cardiac surgery Children’s Hospital / institute of child health Lahore Pakistan
5Associate professor of pediatric cardiac surgery Children’s Hospital / institute of child health Lahore Pakistan
Corresponding author:
Faiz Rasool. Associate Professor of Pediatric Cardiac/Cardiovascular Surgery, Children’s Hospital Lahore
Abstract
Background: surgical closure of VSD is the most common pediatric cardiac operation performed all over the world. Permanent complete heart block (CHB) is a significant complication of VSD closure. The incidence of complete heart block after surgical closure was upto 25% in 1970s. It is now less than 1%. In this article we will provide the data of our institute and compare our results with other studies
Patients and methods: files of the patients who had surgical closure of VSD, from January 2021 to December 2023, were studied retrospectively. Great care was taken to avoid injury to the conduction system.
Results: 276 patients had VSD closure. 2 (0.7%) developed complete heart block that required permanent pacemaker.
Conclusion: The operating surgeon must have good knowledge of conduction system and should know how to avoid complete heart block. Using larger patch, using Dacron or pericardial pledgets instead of Teflon , and using transitional stitches can help avoiding the complete heart block. This does decrease the morbidity and hospital stay.
Keywords: ventricular septal defect, complete heart block, bundle of His, permanent pacemeker