Evaluation of Early Complete Heart Block and the Use of TPM and PPM After Open Heart Surgery in Children

Congenital cardiac disorders are the most prevalent congenital disorders which require interventional or surgical treatments. The most common causes of complete heart block (CHB) are the degeneration of the cardiac conduction system, acute myocardial infarction, and congenital cardiac disorders. CHB after congenital heart surgery is very important and a major cause of post-operation death and heart failure. In addition, the application of a pacemaker is a standard treatment for CHB. Thus, the aim of this paper was to study the frequency of early postoperative CHB in patients with congenital cardiac diseases and the need for temporary (TPM) and permanent (PPM) pacemakers.

This descriptive-analytical and cross-sectional study was conducted on children with congenital heart defects who underwent open heart surgery in Shahid Madani hospital of Tabriz from 2011 to 2016. Patients with early postoperative CHB were included in the study. Further, those who improved on their own and those who needed TPM and PPM were identified, followed by assessing the frequency of CHB and the need for TPM and PPM.

In general, 109 out of 2100 operated patients developed early postoperative heart block and the frequency of early CHB after open heart surgery was 5.19%. Furthermore, 69 (63.3%) out of 109 patients with early postoperative CHB needed TPM and 9 patients needed PPM while 22 patients improved without pacemakers. This rate is acceptable from the occurrence of CHB and the use of PPM and TPM in comparison with other centers and studies. It can reduce mortality and morbidity in patients with timely diagnosis and interventions.

To conclude, the prevalence of early CHB in patients operated for congenital cardiac diseases was 5.19. Finally, the need for TPM was high and most of the patients improved cardiac rhythm with no need for PPM or TPM.