Minimizing Permanent Pacemaker Following Repositionable Self-Expanding Transcatheter Aortic Valve Replacement

Jilaihawi, Hasan; Zhang, Zhengang; Du, Rong; Staniloae, Cezar; Sarić, Muhamed; Neuburger, Peter J.; Querijero, Michael; Hisamoto, Kazuhiro; Ibrahim, Homam; Collins, Tara; Clark, Emily; Pushkar, Illya; Bamira, Daniel; Benenstein, Ricardo; Tariq, Afnan; Williams, Mathew

doi:10.1016/j.jcin.2019.05.056

Cited by 222 publications

(239 citation statements)

References 19 publications

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“…Sutureless/rapid-deployment prostheses rely on radial force, and often subannular components to retain the prosthetic valve in its deployed position. Reducing the subannular portion of the valve that is inserted by modifying the deployment height or by using an alternative prosthesis (with anatomical variants such as a short membranous septum) significantly reduces postoperative pacemaker requirement (40)(41)(42). Over 90% of the sutureless valves inserted in this analysis were of the self-expanding variety (Perceval or 3F Enable).…”

Section: Study 5 Study 15mentioning

confidence: 95%

Aortic valve replacement using stented or sutureless/rapid deployment prosthesis via either full-sternotomy or a minimally invasive approach: a network meta-analysis

Woldendorp¹,

Doyle²,

Bannon³

et al. 2020

Ann Cardiothorac Surg

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Background: New technologies such as sutureless or rapid deployment prosthetic valves and access via minimally invasive incisions offer alternatives to traditional full-sternotomy aortic valve replacement (SAVR). However, a comprehensive comparison of these surgical techniques along with alternative valve prosthesis has not been completed. Methods: Electronic databases were searched for studies comparing outcomes for SAVR, minimally invasive AVR (MiAVR), sutureless/rapid-deployment AVR (SuAVR) via full-sternotomy, or minimally invasive SuAVR (MiSuAVR) from their inception until September 2018. Early postoperative outcomes and follow-up data were included in a Bayesian network meta-analysis. Results: Twenty-three studies with 8,718 patients were identified. Compared with standard SAVR, SuAVR had significantly lower incidence of postoperative AF [odds ratio (OR) 0.33, 95% confidence interval (CI): 0.14-0.79, P=0.013] and MiSuAVR greater requirement for postoperative permanent pacemaker (OR 2.27, 95% CI: 1.25-4.14, P=0.008). All sutureless/rapid-deployment procedures had reduced cardiopulmonary bypass and cross-clamp times, by a mean of 25.9 and 25.0 min, respectively. Hospital length of stay (LOS), but not intensive care LOS, was reduced for all groups (MiAVR −1.53 days, MiSuAVR −2.79 days, and SuAVR 3.37 days). A signal towards reduced early mortality, wound infections, and acute kidney injury was noted in both sutureless/rapid-deployment and minimally invasive techniques but did not achieve significance. Sutureless/rapid-deployment procedures had favourable survival and freedom from valve related reoperation, however follow-up times were short and demonstrated significant heterogeneity between intervention groups. Conclusions: Minimally invasive and sutureless techniques demonstrate equivalent early postoperative outcomes to SAVR and may reduce ventilation time, hospital LOS and postoperative atrial fibrillation (POAF) burden.

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Section: Study 5 Study 15mentioning

confidence: 95%

Aortic valve replacement using stented or sutureless/rapid deployment prosthesis via either full-sternotomy or a minimally invasive approach: a network meta-analysis

Woldendorp¹,

Doyle²,

Bannon³

et al. 2020

Ann Cardiothorac Surg

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show abstract

“…4 Lead dislodgement at the time of placement and within 30 days occurs in about 3-4%. 5 Long term complications associated with transvenous leads include fracture (1-4%), moderate to severe tricuspid regurgitation (5%), venous obstruction (8-21%) and infection (1-5%). 5 Surgical site infections usually occur within one year after implantation or later as lead endocarditis.…”

Section: Case Reportmentioning

confidence: 99%

“…5 Long term complications associated with transvenous leads include fracture (1-4%), moderate to severe tricuspid regurgitation (5%), venous obstruction (8-21%) and infection (1-5%). 5 Surgical site infections usually occur within one year after implantation or later as lead endocarditis. Pocket infections involve the subcutaneous pocket that holds the device and the subcutaneous lead segments.…”

Section: Case Reportmentioning

confidence: 99%

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Percutaneous solution for a frequent complication after transcatheter aortic valve replacement: A case of atrioventricular leadless pacemaker implantation after transcatheter aortic valve replacement

Belnavis

Rivner

Colombo

et al. 2021

HeartRhythm Case Reports

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“…Thus, patients with a small body size such as Asians, who may also have a small LV and short MS, may need more careful assessment of MS length by preoperative CT. A recent study by Jilaihawi et al examined the effect of PPM with self-expandable TAVR in relation to MS length, and achieved low and predictable rates of PPM in their Western patients. 26 We are the first to provide data on BEV that accounts for the small body size of the Asian population. Moreover, our results indicate that a low BMI is a risk factor for shorter MS.…”

Section: Incidence Of CD In Bev Patientsmentioning

confidence: 99%

Importance of Preoperative Computed Tomography Assessment of the Membranous Septal Anatomy in Patients Undergoing Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve

Miki

Senoo

Ohkura

et al. 2020

Circ J

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sistent on the association of CD with MS in patients with a balloon-expandable valve (BEV). 9,10 Therefore, we examined whether computed tomography (CT) assessment of the MS anatomy could provide useful information about the risk of CD, PPM implantation or CLBBB, following TAVR with BEV. Methods Study Population The study population comprised 132 consecutive patients with symptomatic severe AS who underwent TAVR at Kyoto Prefectural University of Medicine between February 2016 and July 2019; 26 patients were excluded for the following reasons: 13 did not have sufficient quality of CT T ranscatheter aortic valve replacement (TAVR) has become one of the best treatment options for patients with severe aortic stenosis (AS) and high or extreme surgical risk. 1-3 The periprocedural complication rate for TAVR has markedly decreased, 4 but cardiac conduction disturbance (CD) following TAVR, such as atrioventricular block (AVB) requiring permanent pacemaker (PPM) implantation or complete left-bundle-branch block (CLBBB), is a frequent complication. 5 This is because the atrioventricular node is continuous with the His bundle and pierces the membranous septum (MS), which is just below the left ventricular (LV) outflow tract. 6,7 A previous report showed that short MS length predicted PPM implantation after TAVR with a self-expandable valve (SEV). 8 However, results from 2 studies have been incon

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Minimizing Permanent Pacemaker Following Repositionable Self-Expanding Transcatheter Aortic Valve Replacement

Cited by 222 publications

References 19 publications

Aortic valve replacement using stented or sutureless/rapid deployment prosthesis via either full-sternotomy or a minimally invasive approach: a network meta-analysis

Aortic valve replacement using stented or sutureless/rapid deployment prosthesis via either full-sternotomy or a minimally invasive approach: a network meta-analysis

Percutaneous solution for a frequent complication after transcatheter aortic valve replacement: A case of atrioventricular leadless pacemaker implantation after transcatheter aortic valve replacement

Importance of Preoperative Computed Tomography Assessment of the Membranous Septal Anatomy in Patients Undergoing Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve

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