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Repair of tetralogy of Fallot after catheterization-induced complete heart block
Insights
A child with tetralogy of Fallot experienced complete heart block during catheterization. Surgical repair was successful, with normal heart rhythm returning post-surgery.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Congenital Heart Disease
Background:
- Tetralogy of Fallot is a complex congenital heart defect.
- Cardiac catheterization carries risks, including arrhythmias.
- Complete heart block is a serious complication requiring intervention.
Observation:
- A four-year-old boy with Tetralogy of Fallot developed complete heart block during cardiac catheterization.
- Surgical repair of Tetralogy of Fallot was performed while the patient had heart block.
- Continuous Holter monitoring documented the return to normal sinus rhythm.
Findings:
- The patient required a temporary transvenous pacemaker preoperatively.
- Systemic heparinization was administered prior to surgery.
- A permanent epicardial wire was placed during the surgical repair.
Implications:
- This case highlights the successful management of complete heart block in a pediatric patient undergoing Tetralogy of Fallot repair.
- It underscores the importance of continuous monitoring and proactive interventions like temporary pacing and permanent epicardial wires.
- The documentation of AV conduction recovery provides valuable insights into electrophysiological changes post-repair.
Abstract:
The case of a four-year-old boy with tetralogy of Fallot who developed complete heart block during cardiac catheterization and subsequently underwent surgical repair in the presence of heart block is presented. Return to normal sinus rhythm occurred on the 11th postoperative day, and the manner in which increased atrioventricular conduction appeared was documented with the use of a continuous Holter monitor. Placement of a temporary transvenous pacemaker, systemic heparinization in the preoperative period, and the insertion of a permanent epicardial wire during surgery were performed.