Atrioventricular conduction abnormalities in patients undergoing isolated aortic or mitral valve replacement

Area of Science:

• Cardiology
• Cardiac Surgery

Background:

• Cardiac conduction defects are frequent in patients with aortic valve disease.
• Calcium deposits in the aortic valve may correlate with spontaneous complete heart block.
• Predictive factors for complete heart block during valve replacement are unknown.

Purpose of the Study:

• To identify predictive factors for complete heart block during isolated aortic or mitral valve replacement.
• To assess the incidence and predictors of transient and late heart block in these patients.

Main Methods:

• Prospective evaluation of 102 patients undergoing isolated aortic valve replacement.
• Comparison with 100 patients undergoing isolated mitral valve replacement.
• Follow-up for over four years to assess late heart block incidence.

Main Results:

• Transient complete heart block occurred in 17.6% of aortic and 13% of mitral valve replacement patients.
• No predictive factors were identified for the occurrence of transient complete heart block.
• Late heart block incidence was very low during the follow-up period.

Conclusions:

• Temporary pacing capability is essential during valve replacement surgery.
• Transient atrioventricular (AV) block in the perioperative period does not predict late AV block recurrence.
• Prophylactic pacemaker implantation is not indicated for transient block during valve replacement.