|Evaluation of Early Complete Heart Block And The Use of TPM and PPM After Open Heart Surgery in children|
|Ahmad Jamei Khosroshah1, Mahmoud Samadi1|
|1Department of Pediatric cardiology, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran|
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Keywords : Congenital cardiac diseases, Complete heart block, Temporary pacemaker, Permanent pacemaker
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Objectives:Congenital cardiac disorders are the most prevalent congenital disorders which require interventional or surgical treatments. The most common causes of complete heart block (CHB) are degeneration of cardiac conduction system, acute myocardial infarction and congenital cardiac disorders. CHB after congenital heart surgery is very important and a major cause of post-operation death and heart failure.
Application of a pacemaker is a standard treatment for CHB. The aim of this paper is to study the frequency of early postoperative CHB in patients with congenital cardiac diseases and also the need for temporary (TPM) and permanent (PPM) pacemakers.
Materials and Methods: This descriptive-analytical and cross-sectional study was conducted on children with congenital heart defects who had undergone open heart surgery in Tabriz’s Shahid Madani Hospital from 2011 to 2016.Patients with early postoperative CHB were included in the study. Those who had improved on their own and those who needed TPM and PPM were identified and at the end, the frequency of CHB and the need for TPM and PPM were assessed.
Results:Of the 2100 operated patients, 109 patients developed early postoperative heart block. The frequency of early CHB after open heart surgery was 5.19%. Of the 109 patients, 69 patients (63.3%) with early postoperative CHB needed TPM, 9 patients needed PPM and 22 patients improved without pacemaker. This rate is acceptable from the occurrence of complete heart block and the use of PPM and TPM in comparison with other centers and studies. It can reduce mortality and morbidity in patients with timely diagnosis and interventions.
Conclusion:The prevalence of early CHB in patients operated for congenital cardiac diseases was 5.19. The need for TPM was high and most of the patients had improved cardiac rhythm with no need for PPM or TPM.
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