Transient complete atrioventricular block during liver transplantation

Area of Science:

• Cardiology
• Hepatology
• Anesthesiology

Background:

• Intraoperative dysrhythmias are common in congenital heart disease surgery and can occur in other procedures.
• Transient insults like hypoxemia, ischemia, and acidosis can trigger arrhythmias during surgery.
• Complete atrioventricular block (CAVB) is a severe dysrhythmia with life-threatening potential across all age groups.

Observation:

• A 30-month-old boy undergoing living-related liver transplantation for bile duct paucity-associated liver cirrhosis experienced transient CAVB.
• The CAVB developed during the surgical procedure, indicating a potential link to the transplantation process or associated physiological changes.

Findings:

• The case demonstrates that transient CAVB can occur even in pediatric patients during complex procedures like liver transplantation.
• The report aims to elucidate the probable etiological factors contributing to CAVB in the context of liver transplantation.

Implications:

• Understanding the specific triggers for CAVB during liver transplantation is crucial for timely diagnosis and intervention.
• This case underscores the importance of vigilant cardiac monitoring and preparedness for managing severe dysrhythmias in liver transplant recipients.
• Further research into the mechanisms and optimal management of CAVB in liver transplantation may improve patient outcomes.