Berdajs et al reported risk factors for atrioventricular block (AVB) following mitral valve surgery. These can help to identify a patient who may benefit from closer monitoring or alternative therapy. The authors are from University Hospital Zurich and the University of Zurich.


Patient selection: mitral valve surgery with replacement or annuloplasty with quadrangular resection


About a quarter of patients undergoing mitral valve replacement or annuloplasty devlop a new atrioventricular block.


Factors associated with an increased risk for AVB:

(1) preoperative therapy with amiodarone

(2) preoperative therapy sotalol

(3) prolonged cross-clamp time (mean 81 minutes vs 55 minutes with no AVB)


Factors associated with a reduced risk:

(1) preoperative therapy with digoxin


The authors speculated that damage to the AV node artery was the cause for AVB in some patients. This can occur if the artery runs in close proximity to the mitral valve annulus.


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