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Complete heart block developing during aortic valvuloplasty.

R H Plack¹, J K Porterfield, J A Brinker

¹Department of Medicine, Johns Hopkins Medical Institution, Baltimore.

|November 1, 1989

Summary

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Balloon aortic valvuloplasty (BAV) can lead to complete heart block (CHB). This case study highlights CHB occurrence following BAV in a patient with calcific aortic stenosis, necessitating pacemaker implantation.

Area of Science:

Cardiology
Interventional Cardiology
Cardiac Electrophysiology

Background:

Calcific aortic stenosis is a common valvular heart disease.
Balloon aortic valvuloplasty (BAV) is a less invasive treatment option.
Aortic stenosis can be associated with conduction abnormalities.

Observation:

An 80-year-old female with calcific aortic stenosis underwent BAV.
Initial BAV with a 20 mm balloon resulted in modest valve area increase and gradient decrease.
The procedure was complicated by transient complete heart block (CHB), requiring temporary pacing.

Findings:

A second BAV with a 23 mm balloon was performed four weeks later.
This subsequent procedure resulted in persistent CHB.

Related Experiment Videos

Persistent CHB necessitated the implantation of a dual-chamber pacemaker.

Implications:

BAV, while effective for aortic stenosis, carries a risk of CHB.
The risk of CHB may be related to balloon size and repeated procedures.
Careful monitoring and consideration of permanent pacing are crucial after BAV in susceptible patients.