Sinus node dysfunction during transcatheter assessment and stent correction of sinus venosus atrial septal defects.

Autor: Sandoval JP; Imaging and Intervention in Congenital and Structural Heart Disease, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico., Rosenthal E; Paediatric & Adult Congenital Heart Disease, Evelina London Children's Hospital, Guy's & St Thomas' Hospital Trust, London, UK., Arias E; Imaging and Intervention in Congenital and Structural Heart Disease, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico., García-Montes JA; Imaging and Intervention in Congenital and Structural Heart Disease, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico., Rodríguez-Zanella H; Imaging and Intervention in Congenital and Structural Heart Disease, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico., Zabal C; Imaging and Intervention in Congenital and Structural Heart Disease, Ignacio Chavez National Institute of Cardiology, Mexico City, Mexico., Kabir S; Paediatric & Adult Congenital Heart Disease, Evelina London Children's Hospital, Guy's & St Thomas' Hospital Trust, London, UK., Yong SF; Paediatric & Adult Congenital Heart Disease, Evelina London Children's Hospital, Guy's & St Thomas' Hospital Trust, London, UK., Jones M; Paediatric & Adult Congenital Heart Disease, Evelina London Children's Hospital, Guy's & St Thomas' Hospital Trust, London, UK., Qureshi S; Paediatric & Adult Congenital Heart Disease, Evelina London Children's Hospital, Guy's & St Thomas' Hospital Trust, London, UK.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2023 Oct; Vol. 102 (4), pp. 683-687. Date of Electronic Publication: 2023 Jul 28.
DOI: 10.1002/ccd.30790
Abstrakt: Covered stent correction of a superior sinus venosus atrial septal defect is increasingly performed as an alternative to surgical repair. While sinus node dysfunction requiring pacemaker implantation may be required after surgical repair, this has not been previously reported after covered stent implantation. We reviewed the experience in two interventional centers. Balloon inflation in the superior vena cava was used to confirm the anomalous pulmonary vein drainage would be unobstructed after stent implantation. During balloon testing in 62 consecutive patients, we assessed gradients across the pulmonary vein to left atrium while monitoring the rhythm. We observed the outcomes after covered stent correction in 51 patients. In a single patient, significant bradycardia and pauses developed on repeat balloon testing and the procedure was abandoned without stent implantation. In another patient, there was no sign of sinus node dysfunction during balloon testing but several hours after stent implantation, the patient became symptomatic from sinus bradycardia and pauses and had a pacemaker implanted 3 days later. Over a year later there are some signs of improvement in sinus node function. While sinus node dysfunction has not been described previously during balloon testing or after stent implantation, this report demonstrates for the first time that it may occur. Larger registries are therefore required to monitor for this uncommon complication.
(© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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