Risk Factors for Requirement of Permanent Pacemaker Implantation After Aortic Valve Replacement

Erdoğan, Hasan; Kayalar, Nihan; Ardal, Hasan; Ömeroğlu, Suat Nail; Kırali, Kaan; Güler, Mustafa; Akinci, Esat; Yakut, Cevat

doi:10.1111/j.1540-8191.2006.00216.x

Cited by 99 publications

(89 citation statements)

References 11 publications

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“…Patients with this defect are prone to the development of aortic stenosis or regurgitation. Despite reports on the association between the presence of bileaflet aortic valve and the rate of postoperative complete AV block [1], we were unable to identify such an association in our study.…”

Section: Discussioncontrasting

confidence: 54%

“…This difference was found to be not significant in our study, although an association between annular calcifications and the need for permanent pacemaker implantation was reported by other authors [1].…”

Section: Discussioncontrasting

confidence: 53%

“…The presence of preoperative conduction disturbances including 1 st degree AV block, and right or left bundle branch block, was not found to be associated with the need for permanent pacemaker implantation in our study despite suggested [1,2], obvious association with the occurrence of postoperative complete AV block.…”

Section: -Confidence Intervalmentioning

confidence: 35%

“…Complete or 3 rd degree AV block with a need to implant a permanent cardiac pacemaker is an established and reported complication of aortic valve replacement. The rate of this severe complication has been reported in the literature at 3-6.5% [1,2]. Factors that may predispose to complete AV block following aortic valve replacement have not been well established, and previous studies that evaluated causes of this complication did not arrive at any clear conclusions.…”

Section: Introductionmentioning

confidence: 82%

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Complete atrioventricular block after isolated aortic valve replacement

et al. 2016

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A b s t r a c tBackground: Temporary atrioventricular (AV) conduction disturbances are a common complication following cardiac surgery, especially involving the aortic valve. Permanent complete AV block is a serious and rare complication. Its prevalence has been estimated at 3-6% of all patients undergoing aortic valve replacement. Identification of factors that affect the occurrence of complete AV block requiring permanent pacemaker implantation might help reduce the risk of this problem in the future. Aim:To evaluate clinical, anatomical and surgical factors that might affect occurrence of complete AV, resulting in the need for permanent pacemaker implantation. Methods:In our prospective study, we analysed clinical data of consecutive 159 patients operated due to isolated aortic valve disease between February 2011 and March 2012. Patients with a pacemaker implanted before that time were excluded from the study. The main indication for surgery was aortic stenosis (n = 114, 71.7%). Infectious endocarditis was an indication in 6 (3.8%) cases. Mean patient age was 65.3 ± 11.4 years, and the proportion of males to females was 56.6%/43.4%. Overall, 135 (84.9%) patients had sinus rhythm preoperatively. All operations were performed using median sternotomy, cardiopulmonary bypass, and hypothermia at 30-32°C. A biological prosthesis was implanted in 120 (70.4%) patients. Patients who needed an additional procedure such as another valve surgery, aortic surgery or coronary artery bypass grafting were excluded from the study.Results: Permanent pacemaker implantation was required in 11 (6.9%) patients. The pacemaker was implanted after at least 7 days of complete AV block which was then considered permanent. Univariate analysis showed that permanent pacemaker implantation was associated with prolonged cardiopulmonary bypass time, prolonged aortic cross-clamp time, and the occurrence of electrolyte disturbances. Univariate logistic regression revealed that the need for permanent pacemaker implantation depended on 5 factors including prolonged cardiopulmonary bypass time, prolonged aortic cross-clamp time, larger size of the implanted valve prosthesis, endocarditis as the indication for surgery, and electrolyte disturbances. In both backward and forward stepwise multivariate regression models, two parameters, prolonged aortic cross-clamp time and the presence of electrolyte disturbances, correlated with the occurrence of complete AV block. Conclusions:Permanent complete AV block is a serious complication after aortic valve surgery. Of all analysed clinical, anatomical and surgical factors, prolonged cardiopulmonary bypass time, prolonged aortic cross-clamp time, larger size of the implanted valve prosthesis, endocarditis as the indication for surgery, and electrolyte disturbances were found to be statistically significant predictors of permanent pacemaker implantation.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussioncontrasting

confidence: 53%

Section: -Confidence Intervalmentioning

confidence: 35%

Section: Introductionmentioning

confidence: 82%

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Complete atrioventricular block after isolated aortic valve replacement

et al. 2016

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“…The rate of PPM infection has been out of proportion to that of device placement [2], and this infection is associated with substantial morbidity, mortality, and financial cost [3,[4][5]. The estimated cost of the combined medical and surgical treatment of an infected, pacemakerdefibrillator system in the United States was ∼$35,000 [6].…”

Section: Risk Factor Of Permanentmentioning

confidence: 99%

Pacemaker Patients with High Level of Risk

Sabr¹

2016

International Journal of Innovative Research in Electrical, Ele

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Abstract:In this paper, Cardiac pacing is a safe and effective therapy for multiple bradyarrhythmic conditions [1]. However, incorrect perceptions about the safety of daily activities (SODA) may impair patients' absolute well-being [2]. Chagas' disease (CD) is a chronic protozoan infection caused by Trypanosoma cruzi. Cardiac compromise occurs in up to 30% of CD patients and can manifest as severe bradyarrhythmias. erforated ICD leads were 7F in six of seven ICD patients, whereas only one 9F ICD was represented in our series. The majority of perforated electrodes were active fixation screw in leads.

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Early Postoperative Care

2020

Manual of Perioperative Care in Adult Cardiac Surgery

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Risk Factors for Requirement of Permanent Pacemaker Implantation After Aortic Valve Replacement

Abstract: Irreversible atrioventricular block requiring a permanent pacemaker implantation is an uncommon complication after AVR. Risk factors are annular calcification, bicuspid aorta, female sex, presence of RBBB or LBBB, prolonged total perfusion time, and hypertension.

Cited by 99 publications

References 11 publications

Complete atrioventricular block after isolated aortic valve replacement

Complete atrioventricular block after isolated aortic valve replacement

Pacemaker Patients with High Level of Risk

Early Postoperative Care

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