Left ventricular wire pacing technique in transcatheter aortic valve replacement

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter aortic valve replacement (TAVR) is a crucial procedure for aortic stenosis.
• Optimizing TAVR procedural safety and efficacy remains a key focus in cardiac interventions.
• Left ventricular lead pacing offers a potential alternative for procedural management during TAVR.

Purpose of the Study:

• To evaluate the safety and effectiveness of the left ventricular lead pacing technique during TAVR.
• To assess intraoperative pacing success and post-procedural outcomes.
• To determine the impact on complication rates, surgical metrics, and patient recovery.

Main Methods:

• A cohort of 30 patients undergoing TAVR with left ventricular lead pacing was studied.
• Key metrics included intraoperative pacing effectiveness, valve implantation success, complication frequency, procedure duration, radiation dose, and costs.
• Postoperative adverse events (mortality, stroke, myocardial infarction) were monitored for three months.

Main Results:

• Successful TAVR with left ventricular lead pacing was achieved in all patients.
• 29 transfemoral and 1 transcarotid approach cases were completed, with 32 valves implanted, including 2 "valve-in-valve" procedures.
• No significant paravalvular leaks or conduction blocks requiring pacemakers were observed; mild leaks occurred in 25 cases. No major adverse events were reported within 3 months.

Conclusions:

• The left ventricular lead pacing technique is a safe and reliable method for TAVR.
• This approach facilitates successful valve implantation and is associated with favorable short-term outcomes.
• Further research may explore its broader application in TAVR procedures.