Related Experiment Videos
Coronary Sinus Catheter-Induced Heart Block During Aortic Valve Replacement: A Case Report
Aaron B Dahl1, Teresa Murray-Torres, Daniel A Emmert
1From the Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
A&A Practice
|October 14, 2017
Summary
Cardiac surgery can cause conduction abnormalities, sometimes requiring permanent pacemakers. This case highlights complete heart block after coronary sinus catheter placement in a high-risk patient with left bundle branch block and heart failure.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Conduction abnormalities are frequent after cardiac surgery, with many resolving spontaneously.
- 1%-3% of patients necessitate permanent pacemaker implantation.
- Risk factors for permanent pacemaker include pre-existing conduction issues, reoperation, pulmonary hypertension, and mitral/aortic valve surgery.
Purpose of the Study:
- To report the first case of complete heart block following coronary sinus catheter placement in a patient with specific pre-existing conditions.
- To highlight potential risks in high-risk cardiac surgery patients.
Main Methods:
- Case report presentation.
- Review of patient's pre-operative conditions and post-operative complications.
Main Results:
- A patient with pre-existing left bundle branch block and reduced ejection fraction (25%) developed complete heart block after coronary sinus catheter placement.
- This represents a novel complication in the literature.
Conclusions:
- Coronary sinus catheterization can precipitate complete heart block in high-risk patients.
- Careful monitoring and consideration of pre-existing conditions are crucial in patients undergoing cardiac procedures.