This single-center retrospective study conducted in Senegal in 2023 aimed to determine the incidence and risk factors of complete atrioventricular block (CAVB) following valve surgery under extracorporeal circulation in adults. Among the 51 included patients, the incidence of postoperative CAVB was high, reaching 19.6%. The study population was young (mean age 36.4 years) and predominantly female, presenting mainly with rheumatic valvulopathies. No statistically significant risk factors were identified, although a trend was observed for prolonged cardiopulmonary bypass and aortic cross-clamp times in patients with CAVB. The majority of blocks (90%) proved to be reversible, recovering either spontaneously or with corticosteroid therapy. Only one patient (10% of CAVB cases) required permanent pacemaker implantation. No deaths were reported. This complication is frequent in this Senegalese context but often transient. The absence of classic risk factors highlights the need for prospective multicenter studies to better identify predictive factors and standardize management protocols in this specific context.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Complete atrioventricular block (AVB) is a serious complication of cardiac surgery under cardiopulmonary bypass (CPB), characterized by a total interruption of electrical conduction between the atria and ventricles
[1]
Kim MH, Deeb M, Eagle KA, Bruckman D, Pelosi F, Oral H, et al. Complete atrioventricular block after valvular heart surgery and the timing of pacemaker implantation. Am J Cardiol. 2001; 87(5): 649-51, A10.
. Physiologically, myocardial contraction requires an impulse that propagates through specialized structures of the conduction system. Any disruption of this circuit, whether permanent or intermittent, can lead to severe clinical manifestations ranging from syncope to sudden death in cases of prolonged asystole
[2]
Merin O, Ilan M, Oren A, Fink D, Deeb M, Bitran D. Permanent pacemaker implantation following cardiac surgery: indications and long-term follow-up. Pacing Clin Electrophysiol. 2009 Jan; 32(1): 7-12.
Berdajs D, Schurr UP, Wagner A, Seifert B, Turina MI, Genoni M. Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty. Eur J Cardiothorac Surg. 2008 Jul; 34(1): 55-61.
. Valvular surgery is particularly prone to this risk due to the anatomical proximity between the valvular structures and the atrioventricular node, as well as the bundle of His
[4]
Koplan BA, Stevenson WG, Epstein LM, Aranki SF, Maisel WH, Michaud GF. Development and validation of a simple risk score to predict the need for permanent pacing after cardiac valve surgery. J Am Coll Cardiol. 2003 Mar 5; 41(5): 795-801.
. International literature reports a variable incidence of complete AV block, ranging from 1% to 3% after surgery for congenital heart disease and up to 23-37% after valve surgery
[6]
Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: Executive Summary. Heart Rhythm. 2008 Jun; 5(6): 934-55.
. Given this observation, and with the aim of improving local data, the present study was conducted to determine the incidence and risk factors of this complication following valve surgery under cardiopulmonary bypass in adults.
2. Patients and Methods
This retrospective, single-center, descriptive study was conducted at the Cuomo Cardiac Center (Fann University Hospital, Dakar) during 2023. It included adult patients who underwent valvular surgery under cardiopulmonary bypass (CPB). Data were extracted from medical records and anesthesia records using a standardized data collection form.
The standard protocol included a complete preoperative assessment, mixed intraoperative monitoring (invasive and non-invasive), general anesthesia with antibiotic prophylaxis (cefazolin) and administration of tranexamic acid, as well as immediate postoperative monitoring in intensive care.
The variables analyzed included demographic characteristics, preoperative clinical and paraclinical data (laboratory tests, ECG, echocardiography), and operative parameters (cardiopulmonary bypass and clamping durations, vasopressor support, transfusion). Atrioventricular block (AVB) was diagnosed by ECG in the operating room immediately after aortic declamping.
Statistical analysis was performed using R (v4.2.3). Risk factors were identified using Chi² and t-tests, with a significance threshold set at p < 0.05.
3. Results
Of a total of 98 patients who underwent valvular surgery under cardiopulmonary bypass during this period, only 51 (52.04%) were included in our study. The population was young (mean age 36.4 ± 10 years), predominantly female (68.6%), with an obesity rate of 9.8% (BMI > 30 kg/m²). Mitral valve disease was predominant (82.4%), followed by aortic (37.3%) and tricuspid (23.5%) disease. The most frequent procedures were mitral valve replacement (MVR) combined with tricuspid valve repair (31.4%) and isolated MVR (25.5%). Other types of procedures included: MVR + AVR + TVR (13.7%); MVR + AVR (13.7%); isolated AVR (13.7%); and isolated mitral valve repair (2.0%). Cardiovascular risk factors were infrequent: hypertension (9.8%), diabetes (1.96%), and smoking (3.92%). Preoperative ECG revealed left ventricular hypertrophy (LVH) in 33.3% of patients, left atrial hypertrophy in 25.5%, and atrial fibrillation in 19.6%. Echocardiography showed preserved left ventricular function in all patients (mean LVEF 64 ± 6%) and frequent pulmonary hypertension in 20 cases (39.2%), with a mean pulmonary arterial pressure (PASP) of 47 ± 18 mmHg.
During the procedure, anesthetic induction was routinely performed with propofol, combined with midazolam in 98% of cases and/or ketamine in 52.9% of cases. The mean duration of cardiopulmonary bypass (CPB) was 107 ± 43 min and aortic clamping lasted 86 ± 36 min. Vasoactive amines were required in 76.4% of patients, with a transfusion rate of 58.8%.
Ten patients (19.6%) experienced complete AV block at the end of cardiopulmonary bypass (CPB). These patients were characterized by: a mean age of 35.1 years; a female predominance (male/female ratio = 0.6); mitral valve disease in 8 patients; smoking in 2 patients; left heart hypertrophy in 5 patients; a mean LVEF of 66%, a mean pulmonary artery systolic pressure (PASP) of 51.4 mmHg, a mean TAPSE of 24.7 mm; a longer CPB duration (127 ± 35 min vs 102 ± 44 min, p=0.078) and a longer aortic clamping (102 ± 32 min vs 82 ± 37 min, p=0.118). No other sociodemographic, echocardiographic or valvular disease-related factors were significantly associated with AV block, although a marginal association was noted with smoking (p=0.035), interpreted with caution given the small sample size (2 smoking patients, both with AV block).
Postoperatively, among the 10 cases of AV block, 2 patients experienced spontaneous remission before admission to the intensive care unit, and the others (8 patients) received corticosteroid therapy (methylprednisolone 2 mg/kg/day), resulting in complete recovery in 7 of them. Thus, only one patient (10% of those with AV block) required implantation of a permanent pacemaker on day 15. No deaths were recorded in our series, and the average length of stay in the intensive care unit was 4 ± 2 days.
4. Discussion
This retrospective, single-center study, conducted at the Cuomo Cardiac Center in Dakar, aimed to determine the incidence and risk factors of complete atrioventricular block (AVB) after valve surgery with cardiopulmonary bypass (CPB). Although its retrospective nature resulted in the absence of certain clinical and paraclinical data, thus limiting the scope of some analyses, it nevertheless offers valuable insights in a context where local data are scarce.
From an epidemiological standpoint, the mean age of our population was 36.4 ± 10 years, significantly lower than that observed in Western studies, where it often exceeds 60 years
[7]
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
Beatriz T, Felipe B, Maria LC, Carlos L, Elisabet B, Carolina GM, Roger V, Axel S, Teresa O, Damià, Xavier R, Antoni BG. Incidence and predictors of new-onset atrioventricular block requiring pacemaker implantation after sutureless aortic valve replacement. Interactive CardioVascular and Thoracic Surgery 23 (2016) 861–868. 22.
. This difference is explained by the predominance of valvular heart disease of rheumatic origin in our region, unlike the more frequent degenerative etiologies in developed countries
[10]
Diagne PA. Results and evaluation of quality of life after heart valve replacement. Medical thesis, Dakar, 2012.
[10]
. Furthermore, we noted a female predominance (male/female ratio = 0.7), consistent with the results of Florian et al.
[11]
Florian EM, Helen G, Petra WM, Sebastian S, Christian H and Gerd J. Atrioventricular Block after Tricuspid Valve Surgery Is it a Significant Outcome? Int Heart J 2021; 62: 57-64.
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
Regarding diagnoses, mitral valve disease was the most frequent (82.4%), followed by aortic (37.3%) and tricuspid (23.5%) valve disease. This profile is consistent with that reported by Sahar et al.
[12]
Sahar M, Ibtissam F, Mouhamed C. Atrioventricular block after cardiac surgery: a report of 23 cases. Pan Afr Med J 2014; 19: 297.
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
, where aortic valve disease predominated. Furthermore, only 20% of our patients presented with at least one cardiovascular risk factor, a proportion much lower than that observed by Pierre
[13]
Pierre S, Florence N, Pierre B, Philippe E, Alain B, Pierre S and Lee SN. Frequency of Recovery from Complete Atrioventricular Block After Cardiac Surgery. Am J Cardiol 2017; 120: 1841–1846.
, where more than half of the patients were affected.
The preoperative examination revealed dyspnea in 15.3% of patients and signs of heart failure in 3.9%. These figures were lower than those reported by Andres
[7]
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
Beatriz T, Felipe B, Maria LC, Carlos L, Elisabet B, Carolina GM, Roger V, Axel S, Teresa O, Damià, Xavier R, Antoni BG. Incidence and predictors of new-onset atrioventricular block requiring pacemaker implantation after sutureless aortic valve replacement. Interactive CardioVascular and Thoracic Surgery 23 (2016) 861–868. 22.
, likely due to optimized preoperative cardiological management. Paraclinical findings on ECG revealed left ventricular hypertrophy in 33.3% of cases and left atrial hypertrophy in 25.5%, reflecting the hemodynamic impact of the valvular heart disease. The preoperative incidence of complete tachyarrhythmia due to atrial fibrillation was 19.6%, comparable to the data reported by Sahar
[12]
Sahar M, Ibtissam F, Mouhamed C. Atrioventricular block after cardiac surgery: a report of 23 cases. Pan Afr Med J 2014; 19: 297.
. Preoperative echocardiography showed a very high incidence of pulmonary arterial hypertension, at 90%. This rate was higher than that reported in Kim's study
[1]
Kim MH, Deeb M, Eagle KA, Bruckman D, Pelosi F, Oral H, et al. Complete atrioventricular block after valvular heart surgery and the timing of pacemaker implantation. Am J Cardiol. 2001; 87(5): 649-51, A10.
Intraoperative management was characterized by systematic intravenous induction, often with co-induction (propofol, midazolam, ketamine), allowing for reduced doses and adverse effects. Anesthetic maintenance frequently combined sevoflurane and propofol, although sevoflurane is recognized for its superiority in myocardial protection
[14]
De Hert SG, Van der Linden PJ, Cromheecke S, Meeus R, ten Broecke PW, De Blier IG, et al. Preconditioning with sevoflurane decreases postoperative cardiac troponin I release in patients undergoing coronary artery bypass surgery. Anesthesiology. 2004 Aug; 101(2): 299-310.
. The variability of protocols reflects the lack of standardization, with choices tailored to each patient. The mean duration of cardiopulmonary bypass (107 min) and aortic clamping (86 min) was shorter than that reported by Sahar et al.
[12]
Sahar M, Ibtissam F, Mouhamed C. Atrioventricular block after cardiac surgery: a report of 23 cases. Pan Afr Med J 2014; 19: 297.
. The frequent use of sympathomimetics (76.4%) and transfusions (58.8%) is explained by the hemorrhagic potential of this type of surgery and the hemostasis alterations induced by cardiopulmonary bypass
[15]
Weindling SN, Philip SJ, Gamble WJ, Mayer JE, Wessel D, Walsh EP. Duration of complete atrioventricular block after congenital heart disease surgery. The American journal of cardiology. 1998; 82(4): 525 527.
In the postoperative period, only 9.8% of patients were extubated in the operating room, and the average time to extubation in the intensive care unit was six hours. Although early extubation may reduce mechanical ventilation-related complications
[16]
Sene L, Diagne PA, Ba PS, et al. Prise en charge anesthésique des cardiopathies congénitales opérées sous circulation extra-corporelle au Centre de Chirurgie Cardiaque Pédiatrique Cuomo (Sénégal). Pan Afr Med J. 2020; 37: 362.
. The majority of these blocks were transient: two patients recovered spontaneously, seven with corticosteroid therapy, and only one required a permanent pacemaker. Reversible causes, such as post-surgical edema or inflammation, are well documented
[7]
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
, while direct damage to the conduction tissue more often leads to permanent blocks
[2]
Merin O, Ilan M, Oren A, Fink D, Deeb M, Bitran D. Permanent pacemaker implantation following cardiac surgery: indications and long-term follow-up. Pacing Clin Electrophysiol. 2009 Jan; 32(1): 7-12.
Berdajs D, Schurr UP, Wagner A, Seifert B, Turina MI, Genoni M. Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty. Eur J Cardiothorac Surg. 2008 Jul; 34(1): 55-61.
. The anatomical proximity between the valvular structures and the conduction system explains the occurrence of these disorders, particularly during mitral valve replacement
[17]
Gaudino M, Alessandrini F, Glieca F, Martinelli L, Santarelli P, Bruno P, et al. Conventional left atrial versus superior septal approach for mitral valve replacement. Ann Thorac Surg. 1997; 63(4): 1123-7. 11.
. The optimal timing for pacemaker implantation remains a subject of debate; in our study, it was performed on day 15, whereas Ben Ameur
[19]
Ben Ameur Y. Conduction disorders after valvular cardiac surgery under extracorporeal circulation: a study of 230 operated patients. Annals of Cardiology and Angiology. 2006; 55(3): 140–143.
In multivariate analysis, no significant risk factors were identified, although smoking showed an association (p = 0.035) that was not considered significant due to the small sample size. Contrary to Andres et al.
[7]
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
, who showed that age > 60 years and mitral valve disease were predictive factors, our series did not confirm these links. Similarly, the duration of cardiopulmonary bypass and aortic clamping, although longer in patients with atrioventricular block, was not significantly associated with the occurrence of blocks, contrary to the observations of Andrzej and Beatriz
[8]
Beatriz T, Felipe B, Maria LC, Carlos L, Elisabet B, Carolina GM, Roger V, Axel S, Teresa O, Damià, Xavier R, Antoni BG. Incidence and predictors of new-onset atrioventricular block requiring pacemaker implantation after sutureless aortic valve replacement. Interactive CardioVascular and Thoracic Surgery 23 (2016) 861–868. 22.
Andrzej K, Rafał P, Maciej K, Dariusz J, Maciej B, Jan R. Complete atrioventricular block after isolated aortic valve replacement. Cardiology Polska 2016; 74(9): 985–993.
. These discrepancies may be explained by the small size of our sample and the younger profile of our population.
5. Conclusion
In Senegal, complete atrioventricular block (AVB) complicates nearly 20% of valvular surgeries performed under cardiopulmonary bypass. Although it is mostly transient and resolves with medical treatment, this complication remains serious due to the risk of requiring a permanent pacemaker. Contrary to data in the literature, no significant risk factors were identified in our series, which was characterized by a young and predominantly female population. Prospective multicenter studies are essential to refine the identification of predictive factors and optimize perioperative management protocols.
Abbreviations
AVB
Atrioventricular Block
CAB
Complete Atricularoventricular Block
CPB
Cardiopulmonary Bypass
BMI
Body Mass Index
MVR
Mitral Valve Replacement
AVR
Aortic Valve Replacement
TVR
Tricuspid Valve Repair
LVH
Left Ventricular Hypertrophy
LVEF
Left Ventricular Ejection Fraction
PASP
Pulmonary Arterial Systolic Pressure
TAPSE
Tricuspid Annular Plane Systolic Excursion
Author Contributions
Elhadji Boubacar Ba: Conceptualization, Data Curation, Formal Analysis, Methodology, Writing – original draft, Writing – review & editing
Papa Ibrahima Ndiaye: Methodology, Project administration, Supervision, Investigation, Validation, Visualization
Bathie Massamba Fall: Data Curation, Formal Analysis, Software
Cheikh Fall: Investigation, Methodology
Etienne Birane Sene: Data Curation
Ulimata Diop: Data Curation
Marie Victoire Sene: Visualization
Oumar Kane: Validation
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1]
Kim MH, Deeb M, Eagle KA, Bruckman D, Pelosi F, Oral H, et al. Complete atrioventricular block after valvular heart surgery and the timing of pacemaker implantation. Am J Cardiol. 2001; 87(5): 649-51, A10.
Merin O, Ilan M, Oren A, Fink D, Deeb M, Bitran D. Permanent pacemaker implantation following cardiac surgery: indications and long-term follow-up. Pacing Clin Electrophysiol. 2009 Jan; 32(1): 7-12.
Berdajs D, Schurr UP, Wagner A, Seifert B, Turina MI, Genoni M. Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty. Eur J Cardiothorac Surg. 2008 Jul; 34(1): 55-61.
Koplan BA, Stevenson WG, Epstein LM, Aranki SF, Maisel WH, Michaud GF. Development and validation of a simple risk score to predict the need for permanent pacing after cardiac valve surgery. J Am Coll Cardiol. 2003 Mar 5; 41(5): 795-801.
Andres DL, Carolina PS, João CV, Jacqueline CE, Guilherme FG, Débora KF, Luciano CA, Marco AG. Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution. Braz J Cardiovasc Surg. 2011; 26(3): 364-72.
Beatriz T, Felipe B, Maria LC, Carlos L, Elisabet B, Carolina GM, Roger V, Axel S, Teresa O, Damià, Xavier R, Antoni BG. Incidence and predictors of new-onset atrioventricular block requiring pacemaker implantation after sutureless aortic valve replacement. Interactive CardioVascular and Thoracic Surgery 23 (2016) 861–868. 22.
Diagne PA. Results and evaluation of quality of life after heart valve replacement. Medical thesis, Dakar, 2012.
[11]
Florian EM, Helen G, Petra WM, Sebastian S, Christian H and Gerd J. Atrioventricular Block after Tricuspid Valve Surgery Is it a Significant Outcome? Int Heart J 2021; 62: 57-64.
Pierre S, Florence N, Pierre B, Philippe E, Alain B, Pierre S and Lee SN. Frequency of Recovery from Complete Atrioventricular Block After Cardiac Surgery. Am J Cardiol 2017; 120: 1841–1846.
De Hert SG, Van der Linden PJ, Cromheecke S, Meeus R, ten Broecke PW, De Blier IG, et al. Preconditioning with sevoflurane decreases postoperative cardiac troponin I release in patients undergoing coronary artery bypass surgery. Anesthesiology. 2004 Aug; 101(2): 299-310.
Weindling SN, Philip SJ, Gamble WJ, Mayer JE, Wessel D, Walsh EP. Duration of complete atrioventricular block after congenital heart disease surgery. The American journal of cardiology. 1998; 82(4): 525 527.
Sene L, Diagne PA, Ba PS, et al. Prise en charge anesthésique des cardiopathies congénitales opérées sous circulation extra-corporelle au Centre de Chirurgie Cardiaque Pédiatrique Cuomo (Sénégal). Pan Afr Med J. 2020; 37: 362.
Gaudino M, Alessandrini F, Glieca F, Martinelli L, Santarelli P, Bruno P, et al. Conventional left atrial versus superior septal approach for mitral valve replacement. Ann Thorac Surg. 1997; 63(4): 1123-7. 11.
Ben Ameur Y. Conduction disorders after valvular cardiac surgery under extracorporeal circulation: a study of 230 operated patients. Annals of Cardiology and Angiology. 2006; 55(3): 140–143.
Andrzej K, Rafał P, Maciej K, Dariusz J, Maciej B, Jan R. Complete atrioventricular block after isolated aortic valve replacement. Cardiology Polska 2016; 74(9): 985–993.
Ba, E. B., Ndiaye, P. I., Fall, B. M., Fall, C., Sene, E. B., et al. (2026). Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors. International Journal of Cardiovascular and Thoracic Surgery, 12(1), 18-21. https://doi.org/10.11648/j.ijcts.20261201.14
Ba, E. B.; Ndiaye, P. I.; Fall, B. M.; Fall, C.; Sene, E. B., et al. Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors. Int. J. Cardiovasc. Thorac. Surg.2026, 12(1), 18-21. doi: 10.11648/j.ijcts.20261201.14
Ba EB, Ndiaye PI, Fall BM, Fall C, Sene EB, et al. Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors. Int J Cardiovasc Thorac Surg. 2026;12(1):18-21. doi: 10.11648/j.ijcts.20261201.14
@article{10.11648/j.ijcts.20261201.14,
author = {Elhadji Boubacar Ba and Papa Ibrahima Ndiaye and Bathie Massamba Fall and Cheikh Fall and Etienne Birane Sene and Ulimata Diop and Marie Victoire Sene and Oumar Kane},
title = {Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors},
journal = {International Journal of Cardiovascular and Thoracic Surgery},
volume = {12},
number = {1},
pages = {18-21},
doi = {10.11648/j.ijcts.20261201.14},
url = {https://doi.org/10.11648/j.ijcts.20261201.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20261201.14},
abstract = {This single-center retrospective study conducted in Senegal in 2023 aimed to determine the incidence and risk factors of complete atrioventricular block (CAVB) following valve surgery under extracorporeal circulation in adults. Among the 51 included patients, the incidence of postoperative CAVB was high, reaching 19.6%. The study population was young (mean age 36.4 years) and predominantly female, presenting mainly with rheumatic valvulopathies. No statistically significant risk factors were identified, although a trend was observed for prolonged cardiopulmonary bypass and aortic cross-clamp times in patients with CAVB. The majority of blocks (90%) proved to be reversible, recovering either spontaneously or with corticosteroid therapy. Only one patient (10% of CAVB cases) required permanent pacemaker implantation. No deaths were reported. This complication is frequent in this Senegalese context but often transient. The absence of classic risk factors highlights the need for prospective multicenter studies to better identify predictive factors and standardize management protocols in this specific context.},
year = {2026}
}
TY - JOUR
T1 - Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors
AU - Elhadji Boubacar Ba
AU - Papa Ibrahima Ndiaye
AU - Bathie Massamba Fall
AU - Cheikh Fall
AU - Etienne Birane Sene
AU - Ulimata Diop
AU - Marie Victoire Sene
AU - Oumar Kane
Y1 - 2026/02/20
PY - 2026
N1 - https://doi.org/10.11648/j.ijcts.20261201.14
DO - 10.11648/j.ijcts.20261201.14
T2 - International Journal of Cardiovascular and Thoracic Surgery
JF - International Journal of Cardiovascular and Thoracic Surgery
JO - International Journal of Cardiovascular and Thoracic Surgery
SP - 18
EP - 21
PB - Science Publishing Group
SN - 2575-4882
UR - https://doi.org/10.11648/j.ijcts.20261201.14
AB - This single-center retrospective study conducted in Senegal in 2023 aimed to determine the incidence and risk factors of complete atrioventricular block (CAVB) following valve surgery under extracorporeal circulation in adults. Among the 51 included patients, the incidence of postoperative CAVB was high, reaching 19.6%. The study population was young (mean age 36.4 years) and predominantly female, presenting mainly with rheumatic valvulopathies. No statistically significant risk factors were identified, although a trend was observed for prolonged cardiopulmonary bypass and aortic cross-clamp times in patients with CAVB. The majority of blocks (90%) proved to be reversible, recovering either spontaneously or with corticosteroid therapy. Only one patient (10% of CAVB cases) required permanent pacemaker implantation. No deaths were reported. This complication is frequent in this Senegalese context but often transient. The absence of classic risk factors highlights the need for prospective multicenter studies to better identify predictive factors and standardize management protocols in this specific context.
VL - 12
IS - 1
ER -
Department of Anesthesia-Resuscitation, Cheikh Anta Diop University Faculty of Medicine, Dakar, Senegal;Department of Anesthesia-Resuscitation, Fann Hospital, Dakar, Senegal
Department of Anesthesia-Resuscitation, Cheikh Anta Diop University Faculty of Medicine, Dakar, Senegal;Department of Anesthesia-Resuscitation, Fann Hospital, Dakar, Senegal
Ba, E. B., Ndiaye, P. I., Fall, B. M., Fall, C., Sene, E. B., et al. (2026). Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors. International Journal of Cardiovascular and Thoracic Surgery, 12(1), 18-21. https://doi.org/10.11648/j.ijcts.20261201.14
Ba, E. B.; Ndiaye, P. I.; Fall, B. M.; Fall, C.; Sene, E. B., et al. Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors. Int. J. Cardiovasc. Thorac. Surg.2026, 12(1), 18-21. doi: 10.11648/j.ijcts.20261201.14
Ba EB, Ndiaye PI, Fall BM, Fall C, Sene EB, et al. Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors. Int J Cardiovasc Thorac Surg. 2026;12(1):18-21. doi: 10.11648/j.ijcts.20261201.14
@article{10.11648/j.ijcts.20261201.14,
author = {Elhadji Boubacar Ba and Papa Ibrahima Ndiaye and Bathie Massamba Fall and Cheikh Fall and Etienne Birane Sene and Ulimata Diop and Marie Victoire Sene and Oumar Kane},
title = {Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors},
journal = {International Journal of Cardiovascular and Thoracic Surgery},
volume = {12},
number = {1},
pages = {18-21},
doi = {10.11648/j.ijcts.20261201.14},
url = {https://doi.org/10.11648/j.ijcts.20261201.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20261201.14},
abstract = {This single-center retrospective study conducted in Senegal in 2023 aimed to determine the incidence and risk factors of complete atrioventricular block (CAVB) following valve surgery under extracorporeal circulation in adults. Among the 51 included patients, the incidence of postoperative CAVB was high, reaching 19.6%. The study population was young (mean age 36.4 years) and predominantly female, presenting mainly with rheumatic valvulopathies. No statistically significant risk factors were identified, although a trend was observed for prolonged cardiopulmonary bypass and aortic cross-clamp times in patients with CAVB. The majority of blocks (90%) proved to be reversible, recovering either spontaneously or with corticosteroid therapy. Only one patient (10% of CAVB cases) required permanent pacemaker implantation. No deaths were reported. This complication is frequent in this Senegalese context but often transient. The absence of classic risk factors highlights the need for prospective multicenter studies to better identify predictive factors and standardize management protocols in this specific context.},
year = {2026}
}
TY - JOUR
T1 - Complete Atrioventricular Block Following Valve Surgery Under Extracorporeal Circulation in Adults: Incidence and Risk Factors
AU - Elhadji Boubacar Ba
AU - Papa Ibrahima Ndiaye
AU - Bathie Massamba Fall
AU - Cheikh Fall
AU - Etienne Birane Sene
AU - Ulimata Diop
AU - Marie Victoire Sene
AU - Oumar Kane
Y1 - 2026/02/20
PY - 2026
N1 - https://doi.org/10.11648/j.ijcts.20261201.14
DO - 10.11648/j.ijcts.20261201.14
T2 - International Journal of Cardiovascular and Thoracic Surgery
JF - International Journal of Cardiovascular and Thoracic Surgery
JO - International Journal of Cardiovascular and Thoracic Surgery
SP - 18
EP - 21
PB - Science Publishing Group
SN - 2575-4882
UR - https://doi.org/10.11648/j.ijcts.20261201.14
AB - This single-center retrospective study conducted in Senegal in 2023 aimed to determine the incidence and risk factors of complete atrioventricular block (CAVB) following valve surgery under extracorporeal circulation in adults. Among the 51 included patients, the incidence of postoperative CAVB was high, reaching 19.6%. The study population was young (mean age 36.4 years) and predominantly female, presenting mainly with rheumatic valvulopathies. No statistically significant risk factors were identified, although a trend was observed for prolonged cardiopulmonary bypass and aortic cross-clamp times in patients with CAVB. The majority of blocks (90%) proved to be reversible, recovering either spontaneously or with corticosteroid therapy. Only one patient (10% of CAVB cases) required permanent pacemaker implantation. No deaths were reported. This complication is frequent in this Senegalese context but often transient. The absence of classic risk factors highlights the need for prospective multicenter studies to better identify predictive factors and standardize management protocols in this specific context.
VL - 12
IS - 1
ER -
,
Papa Ibrahima Ndiaye,
Bathie Massamba Fall,
Cheikh Fall,
Etienne Birane Sene,
Ulimata Diop,
Marie Victoire Sene,
Oumar Kane
Share This Article
Twitter
Linked In
Facebook
Copy
Download