Timing for successful surgical management of heart block after placement of an Amplatzer occlusion device for secundum atrial septal defect repair Umang.

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Presentation transcript:

Timing for successful surgical management of heart block after placement of an Amplatzer occlusion device for secundum atrial septal defect repair Umang Gupta, MBBS, DCH, Shadda J. Al-anani, MD, Anastasios C. Polimenakos, MD The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 5, Pages 1319-1321 (May 2011) DOI: 10.1016/j.jtcvs.2010.07.080 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Intracardiac echocardiography showing about a 30-mm atrial septal defect with a small posteroinferior rim. B, Short-axis view showing a deficient posterior rim. C, Balloon sizing: the stop-flow balloon diameter is 38 mm. D, Left device disc deployed in the left atrium. E, Right device disc deployed in the right atrium. F, Long-axis view (intracardiac echocardiography) of the interatrial septum after release of the device demonstrating good device position. G, Short-axis view (intracardiac echocardiography) of the interatrial septum showing a tiny posterior residual atrial shunt. H, Follow-up transthoracic echocardiogram in 24-hour apical 4-chamber view demonstrating the right atrial disc of the device adjacent to the tricuspid valve septal leaflet. RA, Right atrium; LA, left atrium; AO, aorta. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1319-1321DOI: (10.1016/j.jtcvs.2010.07.080) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Electrocardiogram: A, Normal during the procedure. B, First-degree AV block 12 hours after the procedure. C, Second-degree AV block 36 hours after the procedure. D, AV block (2:1) a few hours after initiating steroid treatment. E, Immediate postoperative Wenckebach second-degree AV block. F, AV conduction completely recovered on the ninth postoperative day. AV, Atrioventricular. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1319-1321DOI: (10.1016/j.jtcvs.2010.07.080) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions