Incidence, Predictors, and Outcome of Conduction Disorders After Transcatheter Self-Expandable Aortic Valve Implantation

Fraccaro, Chiara; Buja, Gianfranco; Tarantini, Giuseppe; Gasparetto, Valeria; Leoni, Loira; Razzolini, Renato; Corrado, Domenico; Bonato, Raffaele; Basso, Cristina; Thiene, Gaetano; Gerosa, Gino; Isabella, Giambattista; Iliceto, Sabino; Napodano, Massimo

doi:10.1016/j.amjcard.2010.10.054

Cited by 164 publications

(153 citation statements)

References 16 publications

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“…The evolution of conduction disorders took place over a period of 7 days after implantation. In our series, complete atrioventricular block was seen in 13.3%, while 8.9% suffered from type II second-degree atrioventricular block; thus, 22.2% of the patients developed an indication for permanent pacemaker implantation corroborating previous findings (27)(28)(29)(35)(36)(37)(38)(39). Their intracardiac measurements revealed that the occurrence of first-degree atrioventricular block was predominantly due to the prolongation of HV interval, which might be prognostically relevant (40).…”

Section: Conduction Disorderssupporting

confidence: 77%

ECG Abnormalities after Transcatheter Aortic Valve Implantation

Akın¹,

Nienaber²

2014

Arch Cardiovasc Imaging

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Transcatheteraortic valve implantation, first introduced in 2002, has been established as an alternative modality for patients deemed not suitable for open-heart surgery. The anatomical vicinity of the atrioventricular node and the His bundle to the non-coronary and rightcoronary aortic cusps predisposes patients to conduction abnormalities in case of severe calcification or mechanical trauma during valve implantation. However, the two evaluated valves (CoreValve and Edwards SAPIEN valve) have different rates of these complications, mainly driven by their respective geometry. Currently, there is ongoing evaluation of the true rate of conduction disorders and their clinical relevance or durability. The initial experience of fatal outcomes with conduction disorders such as complete atrioventricular block has increased the rate of subsequent pacemaker implantation up to 50%. However, prophylactic pacemaker implantation is associated with several possible complications. Thus, there is a need for further data from large-scale series taking into account the true rate of clinically relevant conduction disorders.Keywords:Heart Valve Prosthesis Implantation; Atrioventricular Block; Bundle-Branch Block; Pacemaker; Artificial; Bundle of His Implication for health policy/practice/research/medical education: The transcatheter aortic valve implantation is an established tool for the treatment of multimorbid patients suffering from severe symptomatic aortic valve stenosis. However, it is much more associated with with pacemaker dependence as compared to classic open aortic valve surgery. Within this review we try to explain the differences between the interventional procedure and the open surgical procedure as well as the difference between different vlave types.

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Section: Conduction Disorderssupporting

confidence: 77%

ECG Abnormalities after Transcatheter Aortic Valve Implantation

Akın¹,

Nienaber²

2014

Arch Cardiovasc Imaging

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“…18 Despite recent evidence of the association between conduction disturbances and baseline ECG and procedural parameters, such as LBBB with left axis deviation and inter-ventricular septum >17 mm, RBBB and paroxysmal AVB episodes during the procedure, preoperative bradycardia, over-sizing prosthesis, a confirmatory multivariate analysis was not performed in the present study due to the limited sample size. [13][14][15][16][17][18][19][20][21] Moreover, the finding that first grade AVB and QRS width increased more in patients approached by CV confirms previous reports that the self-expandable characteristic of this prosthesis may have a greater effect on the nearby electrical structures. 9,13,16,17,18 Compared to its own baseline the ES-TA surprisingly reported higher rate of post-procedural LBBB compared to the other two groups.…”

supporting

confidence: 77%

“…1,2 Following TAVI, electrical conduction abnormalities are known to occur, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] leading to the placement of a permanent pacemaker (PM) in 5-46% of cases [17][18][19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

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One-year follow-up of conduction disturbances following transcatheter aortic valve implantation

Salizzoni

Anselmino

Fornengo

et al. 2015

Journal of Cardiovascular Medicine

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“…The atrioventricular block is a complication often described, and may reach one third of patients, especially with CoreValve [19]. Balloon-expandable prostheses, such as the Edwards Sapien and Inovare, had rates of need for permanent cardiac pacing at about 4.5% [7].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter aortic valve-in-valve implantation: a selection change?

Gaia¹,

Couto²,

Breda³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Objective: Aortic valve replacement for bioprosthesis dysfunction is a procedure involving considerable risk. In some cases, mortality is high and may contraindicate the procedure. Minimally invasive transcatheter aortic "valvein-valve" implant appears to be an alternative, reducing morbidity and mortality. The objective is to evaluate aortic valve-in-valve procedure using Braile Inovare prosthesis.Methods: The Braile Inovare prosthesis, transcatheter, expandable balloon, was used in 14 cases. Average EuroSCORE was 42.9%. All patients had double aortic bioprosthesis dysfunction. Procedures were performed in a surgical hybrid environment under echocardiographic and fluoroscopic guidance. Using left minithoracotomy prostheses were implanted through the ventricular apex under high-frequency ventricular pacing. Serial clinical and echocardiographic controls were performed. Follow-up ranged 1-30 months.Results: Correct prosthetic deployment was obtained in all cases. There was no conversion. There was no operative mortality. The 30-day mortality was 14.3% (two cases). Ejection fraction increased significantly after the 7 th postoperative day. Aortic gradient significantly reduced. The residual aortic regurgitation was not present. There were no vascular complications or complete atrioventricular block. Conclusion:The transcatheter "valve-in-valve" procedure for bioprosthesis dysfunction is safe with low morbidity. This possibility may change prosthesis choice during the first aortic valve replacement, favoring bioprostheses. Descriptors

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Incidence, Predictors, and Outcome of Conduction Disorders After Transcatheter Self-Expandable Aortic Valve Implantation

Cited by 164 publications

References 16 publications

ECG Abnormalities after Transcatheter Aortic Valve Implantation

ECG Abnormalities after Transcatheter Aortic Valve Implantation

One-year follow-up of conduction disturbances following transcatheter aortic valve implantation

Transcatheter aortic valve-in-valve implantation: a selection change?

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