Incidence, predictors and prognostic value of permanent pacemaker implantation following sutureless valve implantation in low-risk aortic stenosis patients.
Eur J Cardiothorac Surg
; 62(2)2022 07 11.
Article
en En
| MEDLINE
| ID: mdl-35639725
ABSTRACT
OBJECTIVES:
Sutureless aortic valve replacement (SU-SAVR) has been associated with higher rates of permanent pacemaker (PPM) compared with conventionally implanted aortic bioprostheses. The purpose of this study was to determine the incidence, predictors and mid-term prognostic impact of PPM after Perceval (Livanova, London, UK) SU-SAVR in low-risk patients.METHODS:
A total of 400 consecutive low-risk (EuroSCORE II < 4%) patients without prior pacemaker who underwent surgical aortic valve replacement with the Perceval prosthesis from 2013 to 2019 in 2 centres were included. Baseline, clinical and electrocardiographic parameters, procedural characteristics and follow-up data were collected.RESULTS:
PPM was required in 36 (9%) patients after SU-SAVR, with a median time between the procedure and PPM implantation of 7.5 (4.5-10.5) days. Older age and prior right bundle branch block (RBBB) were associated with an increased risk of PPM (P < 0.05 for all), but only baseline RBBB was found to be an independent predictor of new PPM requirement (odds ratio 2.60, 95% confidence interval 1.15-5.81; P = 0.022). At a median follow-up of 3.4 (2.3-4.5) years, there were no differences between groups in mortality (PPM 36%, no PPM 22%, P = 0.105) or heart failure rehospitalization (PPM 25%, no PPM 21%, P = 0.839).CONCLUSIONS:
About 1 out of 10 low-risk patients with aortic stenosis undergoing SU-SAVR with the Perceval prosthesis required PPM implantation. Prior RBBB determined an increased risk (close to 3-fold) of PPM following the procedure. PPM was not associated with a higher risk of clinical events at 3-year follow-up.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
/
Marcapaso Artificial
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Prótesis Valvulares Cardíacas
/
Implantación de Prótesis de Válvulas Cardíacas
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Reemplazo de la Válvula Aórtica Transcatéter
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Eur J Cardiothorac Surg
Asunto de la revista:
CARDIOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
España