Risk of Permanent Pacemaker Implantation Following Bentall Operation.

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology

Background:

• Conduction disorders are common after cardiac surgery, with permanent pacemaker dependency rates up to 5%.
• Long-term data on pacemaker implantation after Bentall operations are limited.

Purpose of the Study:

• To investigate early and late permanent pacemaker implantation rates following Bentall operations.
• To identify risk factors associated with pacemaker dependency after Bentall procedures.
• To analyze the long-term outcomes of patients requiring pacemakers post-Bentall operation.

Main Methods:

• Retrospective analysis of 260 patients undergoing Bentall operations (including endocarditis and aortic dissection) between March 1996 and December 2015.
• Median follow-up duration of 60 months (range: 12-107 months).
• Investigation of early (30-day) and late pacemaker implantation rates and associated risk factors.

Main Results:

• 31.9% of patients received permanent pacemakers postoperatively, with a 30-day incidence of 7.7%.
• After ten years, 21% of patients were pacemaker dependent.
• Risk factors for pacemaker dependency included advanced age (>75 years), preoperative conduction disturbances, aortic valve stenosis, infective endocarditis, tricuspid valve reconstruction, sepsis, and non-cardiac reoperation.
• Pacemaker implantation significantly increased initial hospitalization length (13 vs 8 days).
• No significant difference in long-term mortality between groups.

Conclusions:

• Permanent pacemaker dependency is a frequent short- and long-term complication after Bentall operations.
• Screening for cardiac conduction disturbances is recommended during short- and long-term follow-up.
• Identifying risk factors can aid in patient selection and management strategies.