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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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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
PubMed

Insights

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.
Abstract

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