Arrhythmias in adult patients after Rastelli surgery: a single-centre experience

被引:0
|
作者
Patloori, Sirish Chandra Srinath [1 ,2 ]
Kawada, Satoshi [1 ,2 ]
Chakraborty, Praloy [1 ,2 ]
Saeed, Yawer [1 ,2 ]
Denham, Nathan [1 ,2 ]
Joens, Christian [1 ,2 ]
Oechslin, Erwin N. [1 ,2 ]
Roche, Susan L. [1 ,2 ]
Silversides, Candice [1 ,2 ]
Wald, Rachel M. [1 ,2 ]
Alonso-Gonzalez, Rafael [1 ,2 ]
Thorne, Sara [1 ,2 ]
Mondesert, Blandine [3 ]
Khairy, Paul [3 ]
Selvaraj, Raja [4 ]
Nair, Krishnakumar [1 ,2 ]
机构
[1] Univ Hlth Network Toronto, Peter Munk Cardiac Ctr, Toronto, ON, Canada
[2] Univ Toronto, Toronto, ON, Canada
[3] Univ Montreal, Montreal Heart Inst, Adult Congenital Heart Dis Ctr, Dept Med, Montreal, PQ, Canada
[4] Jawaharlal Inst Postgrad Med Educ & Res, Dept Cardiol, Pondicherry, India
关键词
Rastelli surgery; tachyarrhythmias; intra-atrial reentrant tachycardias; right ventricle-pulmonary artery conduit; CONGENITAL HEART-DISEASE; VENTRICULAR-TACHYCARDIA; CATHETER ABLATION; ATRIAL ARRHYTHMIAS; RISK-FACTORS; FOLLOW-UP; REPAIR; TETRALOGY; TRANSPOSITION; OPERATION;
D O I
10.1017/S1047951124026623
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Rastelli surgery is used for the correction of several CHDs. Although late-onset cardiac arrhythmias have emerged as a major complication after corrective surgeries, there is a paucity of data on arrhythmias after Rastelli surgery.Methods: This retrospective cohort study was conducted on patients who had undergone Rastelli surgery and have been followed at the adult CHD clinic at our hospital.Results: A total of 55 patients (36.4% female, age 22.2 +/- 6.4 years) were followed for a median period of 24.2 (20.6-31.0) years. Tachyarrhythmias occurred in 21 (38.4 %) patients (n = 15 for atrial tachycardia, 5 for ventricular tachycardia, and 1 for both atrial and ventricular tachycardia). Older age at surgery was significantly associated with the risk of tachyarrhythmias (P = 0.022). Bradyarrhythmia occurred in 12 (21.8%) patients and consisted of perioperative AV block (n = 5), late AV block (n = 1), and sinus node dysfunction (n = 6). Nine (16.4%) patients underwent catheter ablation. The mechanisms of atrial arrhythmias include cavotricuspid isthmus-dependent and surgical scar-dependent intra-atrial reentrant tachycardias. Among the three patients who underwent ablation for ventricular tachycardia, all circuits were dependent on the scar at the base of the right ventricle to pulmonary artery conduit. Median survival free from any event (arrhythmia, death, or heart failure) was 31.6 (28.1-35.1) years after Rastelli surgery.Conclusions: The prevalence of arrhythmias late after Rastelli surgery is substantial and increases in the second decade after surgery. Older age at surgery is associated with a higher prevalence of arrhythmias.
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页数:5
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