Oversizing Increases Pacemaker Implantation Rate After Sutureless Minimally Invasive Aortic Valve Replacement
| Autor: | Mattia Glauber, Marco Solinas, Borut Gersak, Denis Bouchard, Jure Jug |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Pacemaker Artificial medicine.medical_specialty 030204 cardiovascular system & hematology Prosthesis Design Pacemaker implantation 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Postoperative results Humans Minimally Invasive Surgical Procedures Medicine Retrospective Studies Heart Valve Prosthesis Implantation Body surface area business.industry Mortality rate Retrospective cohort study Aortic Valve Stenosis General Medicine medicine.disease Sutureless Surgical Procedures Surgery Treatment Outcome 030228 respiratory system Aortic Valve Heart Valve Prosthesis Electrical conduction system of the heart Cardiology and Cardiovascular Medicine business Right anterior Follow-Up Studies |
| Zdroj: | Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 15:449-455 |
| ISSN: | 1559-0879 1556-9845 |
| Popis: | Objective Cardiac conduction system disturbances potentially leading to permanent pacemaker implantation are significant postoperative complications after aortic valve replacement. The aim of this study was to assess the impact of sutureless prosthetic valve oversizing on permanent pacemaker implantation rate. Methods This multicenter retrospective study included 306 patients who underwent minimally invasive aortic valve replacement with the Perceval sutureless valve. Oversizing was determined by the implanted valve size indexed to body surface area. Data were analyzed with a multivariable logistic regression model. Results This study confirmed excellent postoperative results for minimally invasive aortic valve replacement with right anterior minithoracotomy approach and rapid deployment sutureless valves. Mortality rate was 1%. Eighteen (5.9%) patients received a new permanent pacemaker. Multivariable logistic regression model ( P = 0.05) found oversizing as significant risk factor ( P = 0.017) for permanent postoperative pacemaker implantation independent of patient age. There was a significant negative correlation between the indexed implanted valve size and the mean and peak postoperative transvalvular gradients ( P < 0.001). Conclusions Oversizing of sutureless prosthetic aortic valves is a risk factor for postoperative permanent pacemaker implantation. Proper sizing of Perceval is important to avoid complications and ensure optimal valve performance. |
| Databáze: | OpenAIRE |
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