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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Incidence and Chronic Implications of a Right Bundle Branch Block Occurring Following Orthotropic Heart Transplant in
Terence Truong1,2, Jennifer M Blake1,2, Diana M Torpoco-Rivera1,2
1Division of Cardiology, Children's Hospital of Michigan, Detroit, Michigan, USA.
Insights
Right bundle branch block (RBBB) in pediatric heart transplant (HT) recipients is linked to more biopsies and earlier transplant eras. This condition does not negatively impact long-term outcomes or mortality.
Area of Science:
- Pediatric Cardiology
- Transplant Medicine
- Electrophysiology
Background:
- Right bundle branch block (RBBB) is frequently observed after heart transplantation (HT).
- Risk factors and long-term outcomes of RBBB in pediatric HT recipients remain understudied.
Purpose of the Study:
- To investigate the development of RBBB in pediatric heart transplant recipients.
- To identify associated risk factors and evaluate the long-term implications of RBBB on patient outcomes.
Main Methods:
- Retrospective review of 99 pediatric HT recipients.
- Patients were grouped based on RBBB development.
- Data included demographics, surgical parameters, rejection episodes, biopsy frequency, and longitudinal outcomes (arrhythmias, graft function, mortality).
Main Results:
- RBBB prevalence was 49% in the study cohort.
- Increased biopsy frequency (median 15 vs. 11) and earlier HT era (pre-2014) were associated with RBBB development.
- No significant difference in mortality or coronary vasculopathy incidence was observed between RBBB and non-RBBB groups.
Conclusions:
- RBBB development in pediatric HT recipients is associated with frequent endomyocardial biopsies and the earlier transplant era.
- RBBB does not appear to confer a poor prognosis in this population.
Objective:
Right bundle branch block (RBBB) is commonly seen in post-heart transplant (HT) but the risk factors and long-term implications in pediatric recipients are poorly studied. This study examines the RBBB development and outcomes in pediatric HT patients.
Methods And Material:
A retrospective review included 99 pediatric HT recipients and were divided into two groups based on RBBB development. Data collected included demographics, surgical parameters, rejection episodes, biopsy frequency, and longitudinal outcomes such as arrhythmias, graft function, and mortality.
Results:
The RBBB prevalence was 49%. Higher number of biopsies (median 15 vs. 11; p = 0.002) and HT era (pre-2014: 58% vs. post-2014: 30%; p = 0.016) correlated with development of RBBB. There was no increased mortality (RBBB: 6 deaths vs. NRBBB: 13; p = 0.12) or incidence of coronary vasculopathy in RBBB patients.
Conclusion:
RBBB development in pediatric HT recipients is associated with frequent endomyocardial biopsies and earlier transplant era and does not pose a poor prognosis.
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