Document Detail


Frequency and significance of complete atrioventricular block after coronary artery bypass grafting.
MedLine Citation:
PMID:  2784025     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Three hundred forty-eight consecutive patients were evaluated during 1985 and 1986 for the development of complete atrioventricular (AV) block after coronary artery bypass grafting. Cold (4 degrees) asanguineous potassium cardioplegia with temperature monitoring was used uniformly. AV block developed in 56 instances (16%). In 32 patients (group 1) the block was transient (less than 6 hours) and in 24 it was persistent (group 2). Left main coronary artery stenosis in conjunction with total obstruction of a dominant right coronary artery occurred more commonly in patients manifesting AV block (18 of 56, 32%) than in those without it (35 of 292, 12%) (p less than 0.05). Complete occlusion of a dominant right coronary artery was observed with equal frequency in patients with and without AV block. The presence of an ungraftable right coronary artery, however, was significantly more frequent in the AV block group: 16 of 37 (47%) vs 6 of 194 (3%) (p less than 0.01). Endarterectomy of the right coronary artery was performed in 8 of 24 patients (33%) with persistent AV block versus none in the patients with transient AV block (n = 32) or normal sinus rhythm postoperatively (n = 292) (p less than 0.0001). Persistent AV block (greater than 6 hours) was associated with myocardial infarction in 6 patients (25%) (p less than 0.05) and with low cardiac output in 18 patients (75%) (p less than 0.0001). In conclusion, AV block after myocardial revascularization was frequently associated with the presence of multivessel coronary disease and an ungraftable dominant right coronary artery. Persistent (greater than 6 hours) AV block was correlated with both perioperative myocardial infarction and low cardiac output.
Authors:
J Caspi; R Amar; A Elami; T Safadi; G Merin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  63     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-03-30     Completed Date:  1989-03-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  526-9     Citation Subset:  AIM; IM    
Affiliation:
Carmel Hospital, Haifa, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Output, Low / etiology
Cardioplegic Solutions / adverse effects*
Coronary Artery Bypass / adverse effects*
Heart Arrest, Induced / adverse effects*
Heart Block / etiology*
Humans
Hypothermia, Induced / adverse effects*
Middle Aged
Potassium / adverse effects
Potassium Compounds*
Time Factors
Chemical
Reg. No./Substance:
0/Cardioplegic Solutions; 0/Potassium Compounds; 0/potassium cardioplegic solution; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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