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Title: Permanent complete heart block following surgical correction of congenital heart disease
Authors: Edwin, F.
Aniteye, E.
Tettey, M.
Sereboe, L.
Kotei, D.
Tamatey, M.
Entsua-Mensah, K.
Frimpong-Boateng, K.
Keywords: Complete Heart Block, Congenital heart defect, Morbidity, Pacemaker, Ventricular Septal Defect
Issue Date: 2010
Citation: Edwin, F., Aniteye, E., Tettey, M., Sereboe, L., Kotei, D., Tamatey, M., Entsua-Mensah, K., & Frimpong-Boateng, K. (2010). Permanent complete heart block following surgical correction of congenital heart disease. Ghana Medical Journal, 44(3), 109-114.
Abstract: BACKGROUND: The risk of complete heart block (CHB) from congenital heart repairs in Ghana is unknown. This information is important for referring physicians and in pre-operative counselling of patients and facilitates the process of obtaining informed consent for such repairs. OBJECTIVES: This study was undertaken to determine the incidence of permanent post-operative CHB requiring pacemaker implantation; and the post-operative problems related to the pacemaker. DESIGN: Retrospective study design. SETTING: The National Cardiothoracic Centre (NCTC), Korle-Bu Teaching Hospital, Accra, Ghana. METHOD: Review of all patients who had intra-cardiac repair of congenital heart disease known to predispose to post-operative complete heart block from January 1993 to December 2008 was carried out with computation of the frequency of complete heart block according to the intra-operative diagnoses. RESULTS: Six out of 242 patients (2.5%) developed permanent post-operative CHB. All underwent closure of a large perimembranous ventricular septal defect (VSD) either as an isolated defect (2 of 151 or 1.3%) or in the setting of conotruncal anomalies (4 of 73 or 5.5%). The dominant parental concern relating to the implanted device was the financial implications of future multiple surgeries to replace a depleted pulse generator. CONCLUSION: Permanent post-operative complete heart block occurred in 1.3% of patients undergoing VSD repair and 5.5% of those undergoing repair of conotruncal anomalies (Fallot's tetralogy). The dominant anatomic risk factor was a large perimembranous VSD as an isolated defect or as part of a conotruncal anomaly. Permanent pacemaker implantation in this setting is attended by a low morbidity.
Appears in Collections:Department of Anaesthetics 9

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