Permanent pacemaker implantation after isolated aortic valve replacement: incidence, risk factors and surgical technical aspects

• DOI: 10.2459/jcm.0b013e32832f9fde
• Publication Date: 2010-09-01T12:50:32Z
• Authors: Paolo Nardi; Antonio Pellegrino; Antonio Scafuri; Kyriakos Bellos; Silvia De Propris; Patrizio Polisca; Luigi Chiariello
• Keywords: Permanent pacemaker; Atrioventricular block; Valve replacement

Objectives Conducting system defects are common in patients with aortic valve disease. Aortic replacement may result further conduction abnormalities requiring permanent pacemaker implantation. The aim of our study was to identify the incidence and predictors for postoperative 30-day implantation undergoing isolated replacement, effect an accurate surgical technique order prevent Methods Data from 261 consecutive (mean age 69 ± 12 years, 136 men) January 2004 2008 were analyzed retrospectively. Indications stenosis (n = 156), stenoinsufficiency 63), regurgitation 42). bicuspid present 25% cases 64), redo operation indication 7% 18). Preoperative conducting disease, defined as first-degree atrioventricular block, left or right bundle-branch block anterior hemiblock, 25.6% 67) patients. An debridement calcific material performed. Results In-hospital mortality 0.8% (2 out patients). Postoperatively, 8 (3%) required implantation, second-degree 1) complete 7). Incidence similar either without preoperative disease (25 vs. 25.7%, P NS). Independent greater end-systolic diameter (P 0.026) ventricular septum hypertrophy 0.041). Conclusions Need after seems be related more advanced rather than pre-existing abnormalities. probably helps impairment function early