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[Atrioventricular conduction disturbances after CoreValve(®) aortic prosthesis implantation. Predictive role of

Carlos Almería Valera1, Alberto de Agustín Loeches, Rosa Ana Hernández-Antolín

  • 1Unidad de Imagen Cardiovascular, Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España.

Revista Espanola De Cardiologia
|October 25, 2011
PubMed

Insights

Improper placement of CoreValve prostheses can cause heart conduction problems. Echocardiography can predict these issues by measuring prosthesis contact with the interventricular septum, guiding better implantation techniques.

Area of Science:

  • Cardiology
  • Medical Devices
  • Echocardiography

Background:

  • Atrioventricular conduction disorders are common after CoreValve implantation, affecting 40-45% of patients needing pacemakers.
  • Predicting these conduction disturbances is crucial for improving patient outcomes and device management.

Purpose of the Study:

  • To identify 2D or 3D echocardiographic predictors of atrioventricular conduction disorders post-CoreValve implantation.
  • To assess the relationship between prosthesis positioning and conduction disturbances.

Main Methods:

  • Retrospective analysis of 26 patients undergoing CoreValve implantation.
  • Evaluation of prosthesis-interventricular septum relationship using echocardiography.
  • Correlation of specific echocardiographic variables with the development of conduction disorders.

Main Results:

  • Twelve patients (46.1%) developed atrioventricular conduction disorders.
  • Prosthetic penetration >12 mm and contact surface >90% with the interventricular septum were associated with conduction disturbances (87.5%, P=.034).
  • Interventricular septum contact percentage in end diastole was the sole independent predictor (OR=1.12, P=.03).

Conclusions:

  • Echocardiographic assessment of prosthesis-interventricular septum interaction can predict conduction issues.
  • Higher implantation and shorter stent length may reduce the incidence of atrioventricular conduction disorders.

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