title: Risk factors and prognosis of atrioventricular block after atrial septum defect closure using the Amplatzer device.
abstract: Amplatzer septal occluder (ASO)-induced complications have been observed. However, little attention is paid to the atrioventricular block (AVB) induced by atrial septum defect (ASD) closure using the Amplatzer device. This study aimed to analyze the risk factors and prognosis of AVB after catheter closure and to reduce the incidence of adverse events. In this study, 706 ASD patients who received closure in our division were investigated retrospectively for the relationship between AVB and factors such as age, size of the ASD (D(d)), diameter of the occluder (D(o)), diameter of the septum (D(s)), D(o)/D(d) ratio, and D(o)/D(s) ratio. Data distribution was evaluated with the Kolmogorov-Smirnov normality test. The Wilcoxon rank sum test was used to compare non-normal distribution data. A p value lower than 0.05 was considered significant. Of the 706 patients, six had experienced the development of AVB, giving an incidence of 0.85%. The risk factors included younger age, larger size of the ASD, larger size of the device, and the D(o)/D(s) ratio (≥0.45). The milder AVB is, the better the prognosis. An AVB of III° and an unchanged electrocardiogram (ECG) within 3 days after the procedure are poor prognostic indicators. More attention should be paid to AVB induced by ASD closure. Younger age, size of the ASD, size of the device, and a D(o)/D(s) ratio of 0.45 or higher are the risk factors associated with AVB after closure. A timely retrieval of the device should be considered for a good prognosis.
authors.affiliation: Division of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Szechuan, China.
authors.forename: Yibin
authors.initials: Y
authors.lastname: Wang
authors.forename: Yimin
authors.initials: Y
authors.lastname: Hua
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Wang
authors.forename: Lina
authors.initials: L
authors.lastname: Qiao
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Shi
authors.forename: Jiping
authors.initials: J
authors.lastname: Hua
authors.forename: Yi
authors.initials: Y
authors.lastname: Qu
authors.forename: Dezhi
authors.initials: D
authors.lastname: Mu
mesh_terms: D000293:Adolescent; D054537:Atrioventricular Block / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055989:Septal Occluder Device; D016896:Treatment Outcome