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Oversizing Increases Pacemaker Implantation Rate After Sutureless Minimally Invasive Aortic Valve Replacement
Borut Geršak1,2, Mattia Glauber3, Denis Bouchard4
137663 School of Medicine, University of Ljubljana, Slovenia.
Innovations (Philadelphia, Pa.)
|August 8, 2020
Summary
Oversizing sutureless aortic valves increases the risk of permanent pacemaker implantation after surgery. Careful sizing of the Perceval valve is crucial for optimal outcomes and to avoid complications.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
Background:
- Cardiac conduction system disturbances are a common complication after aortic valve replacement, often necessitating permanent pacemaker implantation.
- Minimally invasive aortic valve replacement (MIAVR) with sutureless valves aims to reduce complications and improve patient outcomes.
Purpose of the Study:
- To evaluate the impact of oversizing sutureless prosthetic valves on the rate of permanent pacemaker implantation following minimally invasive aortic valve replacement.
Main Methods:
- A multicenter retrospective study involving 306 patients who underwent MIAVR using the Perceval sutureless valve.
- Valve oversizing was assessed by indexing the implanted valve size to body surface area.
- Multivariable logistic regression analysis was employed to identify risk factors for permanent pacemaker implantation.
Main Results:
- The study reported excellent postoperative results with a 1% mortality rate.
- Eighteen patients (5.9%) required a permanent pacemaker post-procedure.
- Valve oversizing was identified as a significant risk factor (P=0.017) for permanent pacemaker implantation, independent of patient age.
Conclusions:
- Oversizing of sutureless prosthetic aortic valves, specifically the Perceval valve, is a significant risk factor for postoperative permanent pacemaker implantation.
- Precise valve sizing is essential to mitigate complications and ensure optimal performance after aortic valve replacement.
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