title: Complete atrioventricular block during renal transplantation in a patient with Alport's syndrome: case report.
abstract: BACKGROUND
  Patients with Alport's syndrome (causing 5% of end-stage renal disease) have a higher risk of heart conduction abnormalities.
  
  
  OBJECTIVE
  To report a case of Alport's syndrome developing complete atrioventricular block during renal transplantation.
  
  
  METHODS
  A 21-year-old man with chronic renal failure due to Alport's syndrome was submitted to a renal transplantation under epidural anesthesia and, during the intraoperative period, a complete atrioventricular block was diagnosed and promptly treated with a transcutaneous pacemaker. This extensive sympathetic block can contribute towards disturbances in the heart conduction system, particularly in patients with chronic renal disease in hemodialysis. Even in patients with a normal preoperative electrocardiogram or no conduction system disturbances, some degree of atrioventricular block, including complete atrioventricular block, can occur. In this situation, a transcutaneous pacemaker provides rapid and effective treatment in the operating room, thereby permitting the planning of a definitive treatment.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, Brazil. fferrari@laser.com.br
authors.forename: F
authors.initials: F
authors.lastname: Ferrari
authors.forename: P
authors.initials: P
authors.lastname: Nascimento
authors.forename: P T
authors.initials: PT
authors.lastname: Vianna
mesh_terms: D000328:Adult; D006327:Heart Block / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009394:Nephritis, Hereditary / Q000150:complications*; D010138:Pacemaker, Artificial