PATHOPHYSIOLOGY, SURGICAL STRATEGIES, AND ADVANCEDPERIOPERATIVE MANAGEMENT OF LATE DEVICE EXPLANTATION FORLEFT BUNDLE BRANCH BLOCK AND LEFT VENTRICULAR DYSFUNCTION FOLLOWING TRANSCATHETER VSD CLOSURE
Updated: Sep 26
Transcatheter device closure of ventricular septal defects (VSDs) has emerged as an alternative to surgical repair. However, its proximity to the cardiac conduction system can induce delayed electrical and mechanical complications. This article reviews the anatomical and mechanical pressure causations of late-onset Left Bundle Branch Block (LBBB) and subsequent Left Ventricular (LV) dysfunction following perimembranous VSD device deployment. We examine the biophysical pathways of dyssynchronyinduced cardiomyopathy, present advanced preoperative diagnostic workups, and outline surgical planning and intraoperative dissection protocols for device explantation. Furthermore, we address perioperative mechanical circulatory support (MCS) configurations, such as ExtraCorporeal Membrane Oxygenation (ECMO) and Ventricular Assist Devices (VADs). Finally, we analyze the therapeutic role of Cardiac Resynchronization Therapy (CRT) alongside future trends in biomechanical engineering and electrophysiology https://www.doi.org/10.36106/ijar
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