Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty

Abstract

Data collected in this study showed that, sotalol and amiodarone as well as a prolonged cross-clamp time may slightly influence the 23% incidence of postoperative AVB. The morphological investigation showed that the AV node artery runs in close proximity to the annulus in 23% of cases. We speculate that damage of the AV node artery may play a role in development of AVB.

Bloqueio atrioventricular no pós-operatório de cirurgia cardíaca valvar

“…In our study, incidence of AVB with TCP in 17% (187 cases) of the total of 1102 patients undergoing heart valve surgery during the period. However, most AVBs proved to be transient and reversible: only 1.27% of these patients developed DPM need to implant this hospital stay, incidence similar to the literature (1.3% to 9.7%) this association POCS [1][2][3][7][8][9].…”

“…On the other hand, if there is direct injury of the conduction system (prolonged ischemia, damage by removal of calcium from the valve structures, or deep stitches, etc.) Disorder is expected to drive greater likelihood of permanent and irreversible [1][2][3].…”

“…The incidence of disorders of atrioventricular (AV) in the post-cardiac surgery (POCS) valve is located, according to the literature, 10 to 15% [1]. Most patients have disturbances of a temporary nature and will require temporary cardiac pacing (DPM), but 1% to 3% of patients, given the irreversibility of the framework, will be subject to a definitive pacemaker (DPM) during hospitalization [1][2][3]. In this study, we analyzed the experience of more than 1100 valve surgery procedures in order to verify the relationship between factors pre-, intra-and postoperative (perioperative) associated with atrioventricular block (AVB) and the need for TAC with later implant DPM on POCS.…”

Contemporary Trends in the Use and Outcomes of Surgical Treatment of Tricuspid Regurgitation

“…These findings, nevertheless, are in line with prior single‐center reports showing pacemaker rates of 13% to 28% after TV surgery and higher odds of needing a pacemaker after TVR versus TVr 37, 38. Several anatomical and technical factors have been implicated in these high rates of pacemaker dependency after TV surgery, including intraoperative hypothermia, cardiopulmonary bypass duration, and the proximity of the atrioventricular node and the atrioventricular nodal artery to the tricuspid annulus 39, 40. (2) New dialysis requirements were high after isolated TVR and TVr (5.5% and 4.4%, respectively).…”

Incidence, predictors, and evolution of conduction disorders and atrial arrhythmias after contemporary mitral valve repair

“…The first study included 115 patients and showed an incidence of CDs of 23% and PPI in 2.6% [12]. The second study included 391 patients undergoing mitral valve surgery (147 with MVR) and showed CDs in 23.5% and PPI in 4% [13]. Understanding the risk factors and natural history of CD and AA in patients undergoing MVR may influence both the timing of pacemaker implantation and the strategy to restore sinus rhythm.…”