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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Bundle-branch block as a risk factor in noncardiac surgery
T Dorman1, M J Breslow, P J Pronovost
1Department of Anesthesiology-Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. tdorman@jhmi.edu
Archives of Internal Medicine
|May 2, 2000
Summary
Bundle-branch block (BBB) does not increase perioperative cardiac complications. Patients with left BBB may face risks from noncardiac complications, unlike those with right BBB.
Area of Science:
- Cardiology
- Perioperative Medicine
- Anesthesiology
Background:
- Limited data exists on conduction system abnormalities as perioperative risks.
- Coronary artery disease risk is well-studied, but bundle-branch block implications are overlooked.
Purpose of the Study:
- To determine the clinical significance of bundle-branch block (BBB) as a perioperative risk factor.
- To evaluate the association between BBB and adverse perioperative outcomes.
Main Methods:
- Retrospective, cohort-controlled study of adult patients with BBB.
- Analysis of medical charts for cardiovascular disease, surgical type, anesthesia, monitoring, and complications.
Main Results:
- 455 patients had BBB; right BBB (RBBB) was more common than left BBB (LBBB).
- No significant difference in mortality between BBB and control groups.
- Subgroup analysis indicated a potential increased risk of death for LBBB patients.
Conclusions:
- BBB presence is not linked to increased postoperative cardiac complications.
- Perioperative mortality is not elevated in RBBB patients.
- LBBB patients may be more vulnerable to noncardiac perioperative stress.
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