Incidence and risk factors for pacemaker implantation following aortic valve replacement.
Summary of "Incidence and risk factors for pacemaker implantation following aortic valve replacement."
Our aim was to identify the predictive factors for permanent pacemaker (PM) implantation in patients undergoing isolated aortic valve replacement (AVR). A total of 3534 patients received an AVR between January 1990 and December 2003 in our institution. Permanent PM implantation was performed in 234 (6.6%) patients, over median time of three days (range one to 32 days). This patient population was compared to a random sample of 191 patients undergoing AVR without permanent PM implantation. The overall mean age was 63.5 years (+/-14.2) and 261 patients (62%) were male. Univariate and multivariate logistic regression analysis of pre- and perioperative data were performed. Overall the 30 days mortality was 4.2% (10/231) in patients with PM and 1% (2/191) in the control group (P=0.0034). Patients with PMs were older (P<0.001), had more additional coronary artery bypass grafting (CABG) surgery or mitral valve replacement (MVR) (P<0.001), complete right bundle branch block (RBBB) prior to surgery, and more frequently underwent re-operations compared to patients without PMs (P<0.001). The multivariate logistic regression model with PM implantation as the dependent variable demonstrated that older age, and mortality were not independently associated with PM implantation. As a predicted factor concomitant severe mitral valve insufficiency, CABG, subaortic stenosis (SAS) or re-do operations were identified. Keywords: Pacemaker implantation; Aortic valve surgery; Postoperative arrhythmia.
Affiliation
Department of Cardiac Surgery, Triemli Hospital Zurich, Zurich, Switzerland.
Journal Details
This article was published in the following journal.
Name: Interactive cardiovascular and thoracic surgery
ISSN: 1569-9285
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20805253
- DOI: http://dx.doi.org/10.1510/icvts.2010.249904
Medical and Biotech [MESH] Definitions
Aortic Valve Prolapse
The downward displacement of the cuspal or pointed end of the trileaflet AORTIC VALVE causing misalignment of the cusps. Severe valve distortion can cause leakage and allow the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to aortic regurgitation.
Aortic Valve Insufficiency
Pathological condition characterized by the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to regurgitation. It is caused by diseases of the AORTIC VALVE or its surrounding tissue (aortic root).
Discrete Subaortic Stenosis
A type of constriction that is caused by the presence of a fibrous ring (discrete type) below the AORTIC VALVE, anywhere between the aortic valve and the MITRAL VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
Aortic Valve Stenosis
A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
Endocarditis, Bacterial
Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use.
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