Pacemaker need after sutureless aortic valve replacement: the role of the learning curve.
Aged
Aged, 80 and over
Aortic Valve
/ surgery
Aortic Valve Stenosis
/ complications
Arrhythmias, Cardiac
/ etiology
Female
Heart Valve Prosthesis Implantation
/ methods
Humans
Learning Curve
Male
Pacemaker, Artificial
Postoperative Complications
/ etiology
Prosthesis Design
Retrospective Studies
Sutureless Surgical Procedures
/ methods
Treatment Outcome
Journal
Journal of cardiovascular medicine (Hagerstown, Md.)
ISSN: 1558-2035
Titre abrégé: J Cardiovasc Med (Hagerstown)
Pays: United States
ID NLM: 101259752
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
pubmed:
7
10
2020
medline:
15
12
2021
entrez:
6
10
2020
Statut:
ppublish
Résumé
Aortic valve replacement (AVR) using sutureless prosthesis is a reasonable alternative in those patients with aortic stenosis who would benefit from reduced cross clamp time, such as elderly and high-risk patients. Actually, excellent performances have been demonstrated in hemodynamic outcomes and safety, but some questions remain open regarding long-term durability and the need for postoperative pacemaker implantation. Between January 2014 and August 2019, all 436 patients [male 40.6%, median age 78 years interquartile range (73-82)] treated with sutureless AVR with a Perceval prosthesis were included in our analysis. The univariate logistic regression showed previous aortic valve surgery [P = 0.028; odds ratio (OR) 3.248], dialysis (P = 0.036; OR 6.435), renal insufficiency (P = 0.021; OR 2.75), EuroSCORE II (P = 0.016; OR 1.051) and year of operation (P < 0.01; OR 0.658) as factors associated with the development of atrioventricular type II or type III block or junctional block requiring pacemaker implantation. The overall incidence of pacemaker implantation after sutureless AVR was 7.1% in the current study, but it dropped to 3.8 and 4.7%, respectively, in 2018 and 2019. The Perceval aortic valve is associated with encouraging postoperative results. The incidence of pacemaker implantation is strictly linked to the surgeons' experience, decreasing year by year after an adequate sizing, reaching a percentage comparable with sutured valve.
Identifiants
pubmed: 33021519
pii: 01244665-202102000-00010
doi: 10.2459/JCM.0000000000001095
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
133-138Informations de copyright
Copyright © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.
Références
Iung B, Vahanian A. Epidemiology of acquired valvular heart disease. Can J Cardiol 2014; 30:962–970.
Iung B, Baron G, Butchart EG, et al. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur Heart J 2003; 24:1231–1243. Carabello BA, Paulus WJ. Aortic stenosis. Lancet 2009;373:956–966.
Fujita B, Ensminger S, Bauer T, et al. Trends in practice and outcomes from 2011 to 2015 for surgical aortic valve replacement: an update from German Aortic valve Registry on 42 776 patients. Eur J Cardiothorac Surg 2018; 53:552–559.
Phan K, Xie A, Di Eusanio M, Yan TD. A meta-analysis of minimally invasive versus conventional sternotomy for aortic valve replacement. Ann Thorac Surg 2014; 98:1499–1511.
Berretta P, Andreas M, Carrel TP, et al. Minimally invasive aortic valve replacement with sutureless and rapid deployment valves: a report from an international registry (Sutureless and Rapid Deployment International Registry). Eur J Cardiothorac Surg 2019; 56:793–799.
Mikus E, Calvi S, Campo G, et al. Full sternotomy, hemisternotomy and minithoracotomy for aortic valve surgery: is there a difference? Ann Thorac Surg 2018; 106:1782–1788.
Khwaja A. KDIGO clinical practice guideline for acute kidney injury. Nephron Clin Pract 2012; 120:c179–c184.
Erdogan HB, Kayalar N, Ardal H, et al. Risk factors for requirement of permanent pacemaker implantation after aortic valve replacement. J Card Surg 2006; 21:211–215. discussion 216–217.
Dawkins S, Hobson AR, Kalra PR, Tang AT, Monro JL, Dawkins KD. Permanent pacemaker implantation after isolated aortic valve replacement: incidence, indications, and predictors. Ann Thorac Surg 2008; 85:108–112.
Mazine A, teoh K, Bouhout I, et al. Sutureless aortic valve replacement: a Canadian multicentre study. Can J Cardiol 2015; 31:63–68.
Van Boxtel AG, Houthuizen P, Hamad MA, et al. Postoperative conduction disorders after implantation of self expandable sutureless Perceval S bioprosthesis. J Heart Valve Dis 2014; 23:319–324.
Vogt F, Pfeiffer S, Dell’Aquila AM, Fischlein T, Santarpino G. Sutureless aortic valve replacement with Perceval bioprosthesis: are there predicting factors for postoperative pacemaker implantation? Interact Cardiovasc Thorac Surg 2016; 22:253–258.
Laborde F, Fischlein T, Hakim-Meibodi K, et al. Clinical and haemodynamic outcomes in 658 patients receiving the Perceval sutureless aortic valve: early results from a prospective European multicentre study (the Cavalier Trial). Eur J Cardiothorac Surg 2016; 49:978–986.
Bouhout I, Mazine A, Rivard L, et al. Conduction disorders after sutureless aortic valve replacement. Ann Thorac Surg 2017; 103:1254–1260.
Mugnai G, Moran D, Nijs J, et al. Electrocardiographic and clinical predictors of permanent pacemaker insertion following Perceval sutureless aortic valve implantation. J Electrocardiol 2019; 56:10–14.
Yanagawa B, Cruz J, Boisvert L, Bonneau D. A simple modification to lower incidence of heart block with sutureless valve implantation. Thorac Cardiovasc Surg 2016; 152:630–632.
Vogt F, Moscarelli M, Nicoletti A, et al. Sutureless aortic valve and pacemaker rate: from surgical tricks to clinical outcomes. Ann Thorac Surg 2019; 108:99–105.
Cerillo AG, Amoretti F, Mariani M, et al. Increased gradients after aortic valve replacement with the Perceval valve: the role of oversizing. Ann Thorac Surg 2018; 106:121–128.
Kooistra NHM, van Mourik MS, Rodríguez-Olivares R, et al. Late onset of new conduction disturbances requiring permanent pacemaker implantation following TAVI. Heart 2020; 106:1244–1251.