Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-4042
Berdajs, D; Schurr, U P; Wagner, A; Seifert, Burkhardt; Turina, M I; Genoni, M (2008). Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty. European Journal of Cardio-Thoracic Surgery, 34(1):55-61.
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BACKGROUND: In this retrospective study we evaluate the causative mechanisms underlying postoperative atrioventricular block (AVB) following mitral valve replacement and mitral valve annuloplasty. METHODS: Between January 1990 and December 2003, 391 patients underwent mitral valve replacement or ring annuloplasty and quadrangular resection. Exclusion criteria were preoperative AV block, two or three valvular procedures, reoperations and procedures combined with coronary artery bypass grafting. The presence of the postoperative AVB was compared with preoperative and intraoperative variables. On 55 post-mortem specimens the relationship between the AV node, AV node artery and mitral valve annulus was investigated. RESULTS: The mean age was 59+/-14 years and 44% of patients were female. Postoperatively AVB occurred in 92 (23.5%) patients. AVB III was found in 17 (4%) patents, in whom a pacemaker was implanted within median interval of 4 days. Second degree AVB occurred and first degree AVB in five (1.3%) and in 70 (18%) patients respectively. In dry dissected human hearts in 23% of investigated cases the AV node artery was discovered to run close to the annulus of the mitral valve. CONCLUSIONS: Data collected in this study showed that, sotalol and amiodarone as well as a prolonged cross-clamp time may slightly influence the 23% incidence of postoperative AVB. The morphological investigation showed that the AV node artery runs in close proximity to the annulus in 23% of cases. We speculate that damage of the AV node artery may play a role in development of AVB.
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|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)|
|Dewey Decimal Classification:||610 Medicine & health|
|Deposited On:||07 Oct 2008 13:04|
|Last Modified:||26 Mar 2014 06:49|
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