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Related Concept Videos

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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Conduction Disorders After Sutureless Aortic Valve Replacement.

Ismail Bouhout1, Amine Mazine1, Lena Rivard2

  • 1Division of Cardiac Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.

The Annals of Thoracic Surgery
|October 9, 2016
PubMed
Summary
This summary is machine-generated.

Sutureless aortic valve replacement with the Perceval S prosthesis showed a high rate of conduction disorders, necessitating pacemaker implantation in 23% of patients postoperatively. Further research is needed to reduce this risk.

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Sutureless self-expandable aortic bioprostheses utilize radial forces for stabilization.
  • This mechanism raises concerns about increased risk of postoperative conduction disease.
  • The Perceval S prosthesis is a type of sutureless bioprosthesis.

Purpose of the Study:

  • To determine the incidence of conduction disorders after sutureless aortic valve replacement (AVR) using the Perceval S bioprosthesis.
  • To identify risk factors associated with conduction disorders and pacemaker implantation.

Main Methods:

  • A consecutive cohort of 108 patients undergoing sutureless AVR with the Perceval S prosthesis was studied.
  • Patients with preoperative permanent pacemaker (PPM) implantation were excluded.
  • Electrocardiographic follow-up was conducted for a mean of 14.6 months.

Main Results:

  • Postoperative conduction disorders included first-degree AV block (34%), Mobitz-II AV block (2%), and complete AV block (16%).
  • New-onset bundle branch blocks were observed in 33% (left) and 22% (right).
  • In-hospital PPM implantation was required in 23% of patients, with independent risk factors including age >85 and preoperative right bundle branch block.

Conclusions:

  • The study found a high in-hospital PPM implantation rate of 23% following sutureless AVR with the Perceval S prosthesis.
  • A cumulative incidence of 18% for PPM dependency was noted at 18 months.
  • Further investigation into surgical strategies to mitigate the risk of conduction disorders is warranted.