A novel technique to avoid perforation of the right ventricle by the temporary pacing lead during transcatheter aortic valve implantation.
Aortic stenosis
Cardiac tamponade
Rapid pacing
TAVI
Temporary pacemaker
Journal
Cardiovascular intervention and therapeutics
ISSN: 1868-4297
Titre abrégé: Cardiovasc Interv Ther
Pays: Japan
ID NLM: 101522043
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
20
11
2019
accepted:
20
05
2020
pubmed:
1
6
2020
medline:
20
7
2021
entrez:
1
6
2020
Statut:
ppublish
Résumé
Cardiac tamponade is a life-threatening complication during transcatheter aortic valve implantation (TAVI), often caused by perforation of the right ventricle (RV) by the temporary pacemaker used for rapid pacing during valve deployment. We aimed to assess the feasibility of performing rapid pacing while maintaining inflation of the pacing lead balloon in the RV during TAVI. Among 749 consecutive patients who underwent TAVI with SAPIEN XT valves between October 2013 and July 2015, 726 treated using rapid pacing with a transvenous balloon-tip lead were enrolled in our study, and were stratified into three groups according to the extent of balloon inflation in the RV as follows: full inflation (n = 100), partial inflation (n = 196), and deflation (n = 430). We compared the following clinical outcomes: pacing lead-related RV perforation, rapid pacing failure, valve malpositioning due to rapid pacing failure, device success, and 30-day mortality. Pacing lead-related RV perforation occurred only in patients in the deflation group (6 cases, 1.4%), but the differences among the groups were not statistically significant (p = 0.13). Rapid pacing failure, but no valve malpositioning, occurred most frequently in patients in the full inflation group (4.0% vs. 0.5% in the other groups, p = 0.004). The rate of device success (> 94%) and the 30-day mortality (2.0%) were similar among the three groups. Partial inflation of the balloon of the pacing lead may reduce the risk of RV perforation without increasing the risk of pacing failure or valve malpositioning.
Identifiants
pubmed: 32474841
doi: 10.1007/s12928-020-00676-0
pii: 10.1007/s12928-020-00676-0
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
347-354Références
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