title: The Impact of Short or Long Transcatheter Occluder Waist Lengths on Postprocedure Complete Atrioventricular Block: A Retrospective Study.
abstract: BACKGROUND
  Complete atrioventricular block (cAVB) is considered the most serious adverse event after transcatheter closure of ventricular septal defect (VSD).
  
  
  OBJECTIVE
  To evaluate the incidence of postprocedure cAVB and its relationship with different waist lengths of transcatheter occluders.
  
  
  METHODS
  This is a retrospective study of patients with VSD who had been treated with transcatheter closure at the Shanghai Changhai Hospital from December 2001 to December 2010. Patients were treated with short-waist (n = 234) or long-waist occluders (n = 571). All patients were monitored by electrocardiogram (ECG) within 7 days post procedure.
  
  
  RESULTS
  Nine patients (3.8%) treated with short-waist occluders suffered from cAVB and 3 patients (1.3%) required permanent pacemaker implantation, compared with 4 patients (0.7%) and 1 patient (0.2%), respectively, in the long-waist occluder group (P<.001). There was a significantly higher incidence of postprocedure incomplete right bundle branch block (IRBBB) in patients treated with short-waist occluders compared with patients treated with long-waist occluders. There were no significant differences in other procedure-related complications between the two groups.
  
  
  CONCLUSIONS
  Long-waist VSD occluders are beneficial in the prevention of cAVB and the need for pacemaker implantation after transcatheter closure of VSD.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.forename: Yongwen
authors.initials: Y
authors.lastname: Qin
authors.forename: Xianxian
authors.initials: X
authors.lastname: Zhao
authors.forename: Xilong
authors.initials: X
authors.lastname: Lang
authors.forename: Ni
authors.initials: N
authors.lastname: Zhu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Bai
authors.forename: Xing
authors.initials: X
authors.lastname: Zheng
authors.forename: Zhifu
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, P.R. China. wuhong021398853@163.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D054537:Atrioventricular Block / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006328:Cardiac Catheterization / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D055989:Septal Occluder Device / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult