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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Clinical impact of persistent left bundle-branch block after transcatheter aortic valve implantation with CoreValve

Luca Testa1, Azeem Latib, Federico De Marco

  • 1Department of Interventional Cardiology, Clinical Institute S. Ambrogio, IRCCS San Donato, 20149 Milan, Italy. luctes@gmail.com

Circulation
|February 28, 2013
PubMed

Insights

New-onset left bundle-branch block (LBBB) after transcatheter aortic valve implantation did not impact long-term mortality. However, LBBB was associated with a higher short-term need for pacemakers.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Conduction disturbances are common after transcatheter aortic valve implantation (TAVI).
  • Persistent left bundle-branch block (LBBB) after surgical aortic valve replacement is linked to adverse outcomes.
  • The prognostic impact of new-onset LBBB following TAVI remains unclear.

Purpose of the Study:

  • To investigate the association between new-onset persistent LBBB and prognosis after TAVI.
  • To evaluate the effect of LBBB on mortality and heart failure hospitalizations post-TAVI.

Main Methods:

  • Analysis of 818 patients undergoing TAVI with the CoreValve Revalving System.
  • Patients were divided into two groups: persistent LBBB (n=224) and no LBBB (n=594).
  • Clinical characteristics, implantation details, and long-term outcomes (mortality, hospitalization) were compared.

Main Results:

  • Persistent LBBB was not associated with increased all-cause mortality, cardiac mortality, or heart failure hospitalization at 30 days or 1 year.
  • A higher rate of pacemaker implantation was observed in the LBBB group at 30 days, but not at 1 year.
  • Low implantation was more frequent in the LBBB group.

Conclusions:

  • Persistent LBBB after TAVI using the CoreValve system does not adversely affect hard clinical endpoints.
  • LBBB is associated with an increased short-term requirement for pacemaker implantation.
  • Further research may explore strategies to mitigate pacemaker dependency in LBBB patients post-TAVI.
Abstract

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