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Conduction disorders after aortic valve replacement with rapid-deployment bioprostheses: early occurrence and
Augusto D'Onofrio1, Chiara Tessari1, Lorenzo Bagozzi1
1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Annals of Cardiothoracic Surgery
|October 26, 2020
Summary
Nearly 40% of patients experience conduction disorders (CDs) after rapid-deployment aortic valve implantation. Bioprosthesis size and patient age are key risk factors for these CDs, with some patients recovering function within a year.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Rapid-deployment bioprostheses are advanced aortic valve substitutes.
- Conduction disorders (CDs) and permanent pacemaker implantation (PPI) are potential complications.
- Evaluating CDs after these implants is crucial for patient outcomes.
Purpose of the Study:
- To assess the incidence of CDs post-rapid-deployment aortic valve implantation.
- To identify risk factors for CDs and PPI at discharge and 1-year follow-up.
- To determine the recovery rate of CDs within one year.
Main Methods:
- Retrospective single-center study of 98 patients undergoing aortic valve replacement (AVR) with rapid-deployment bioprostheses.
- Electrocardiograms (ECGs) recorded pre-procedure, post-ICU, daily, and at 1-year follow-up.
- Analysis of CDs and PPI incidence, with risk factor identification.
Main Results:
- At discharge, 40.8% of patients had CDs, with 33.7% experiencing new CDs and 7.1% requiring PPI.
- Valve size was the sole independent predictor of CDs at discharge.
- At 1-year, 31.3% had CDs or pacemaker-induced rhythm; age and prosthesis size predicted these outcomes.
Conclusions:
- Approximately 40% of patients develop new CDs after rapid-deployment aortic valve implantation.
- One-third of these patients show recovery of conduction by 1-year follow-up.
- Bioprosthesis size and patient age are significant independent risk factors for CDs.
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