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Pacemaker dependency after isolated aortic valve replacement: do conductance disorders recover over time?
Hassina Baraki1, Ammar Al Ahmad, Stefan Jeng-Singh
1Department of Cardio-Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. baraki.hassina@mh-hannover.de
Interactive Cardiovascular and Thoracic Surgery
|January 10, 2013
Summary
Most patients needing a permanent pacemaker (PPM) after aortic valve replacement (AVR) do not recover AV conduction. Early PPM implantation is recommended due to high sudden death risk from conduction disorders post-AVR.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Aortic valve replacement (AVR) necessitates permanent pacemaker (PPM) implantation in 3-8% of patients.
- Postoperative atrioventricular (AV) conduction disorders are a significant concern following AVR.
Purpose of the Study:
- To assess long-term pacemaker dependency in patients who received a PPM after AVR.
- To evaluate the recovery of AV conduction in these patients during follow-up.
Main Methods:
- A cohort of 2106 patients undergoing isolated AVR was analyzed.
- 138 patients (6.6%) developed conduction disorders requiring PPM implantation.
- Pacemaker dependency was assessed via ECG and pacemaker checks during follow-up.
Main Results:
- Long-term survival at 1, 5, and 10 years was 88%, 79%, and 59%, respectively.
- Only 10% of survivors (8 out of 84) were no longer pacemaker-dependent.
- The majority (79%) required permanent ventricular stimulation.
Conclusions:
- Recovery from AV conduction disorders after AVR is uncommon.
- High-grade AV blocks post-AVR pose a significant risk of sudden death.
- Early PPM implantation is recommended for patients with conduction disorders after AVR.
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