Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution.
Rev Bras Cir Cardiovasc
; 26(3): 364-72, 2011.
Article
em En, Pt
| MEDLINE
| ID: mdl-22086572
ABSTRACT
INTRODUCTION:
Disturbances of the cardiac conduction system are potential complications after cardiac valve surgery.OBJECTIVES:
This study was designed to investigate the association between perioperative factors and atrio-ventricular block, the need for temporary cardiac artificial pacing and, if necessary, permanent pacemaker implantation after cardiac valve surgery.METHODS:
Retrospective analysis of the Cardiac Surgery Database - Hospital São Lucas/PUCRS. The data are collected prospectively and analyzed retrospectively.RESULTS:
Between January 1996 and December 2008 were included 1102 valve surgical procedures 718 aortic valves (65.2%), 407 (36.9%) mitral valve and 190 (17.2%) coronar artery bypass grafting combined with valve repair and 23 (2.1%) aortic and mitral combined surgery. 187 patients (17%) showed clinical and electrocardiographic pattern of atrio-ventricular block requiring artificial temporary pacing. Of these, 14 patients (7.5%) required permanent pacemaker implantation (1.27% of the total valve surgery patients). Multivariate analysis showed association of the incidence of atrio-ventricular block and temporary pacing with mitral valve surgery (OR 1,76; CI 95% 1.08-2.37; P = 0.002), implantation of bioprosthetic devices (OR 1.59; CI 95% 1.02-3.91; P = 0,039), age over 60 years (OR 1.99; CI 95% 1.352.85; P < 0.001), prior use of anti-arrhythmic drugs (OR 1.86; CI 95% 1.04-3.14; P = 0.026) and previous use of b-blocker (OR 1.76; CI 95% 1.25-2.54; P = 0.002). Remarkably the presence of atrio-ventricular block did not significantly show association with increased mortality, but significantly prolonged (P < 0.0001) hospital length-of-stay and, therefore, hospital costs.CONCLUSIONS:
Our study presents a group of predictive factors referring to a specific patient profile by which high risk of atrio-ventricular block and the need of temporary cardiac pacing after cardiac valve surgery it is determined.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
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Estimulação Cardíaca Artificial
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Ponte de Artéria Coronária
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Implante de Prótese de Valva Cardíaca
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Bloqueio Atrioventricular
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Valva Mitral
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Pt
Ano de publicação:
2011
Tipo de documento:
Article