Permanent Cardiac Pacing After Open‐heart Surgery: Acquired Heart Disease

Abstract

Retrospective review of 5,942 patients who underwent open-heart surgery for acquired heart disease revealed that 123 patients (2.1%) required permanent cardiac pacing postoperatively; 4.6% of these underwent predominantly valvular surgery and 0.6% had coronary bypass. The most important factors appeared to be: 1) preoperative evidence of a conduction disorder; 2) advanced patient age; 3) dense calcium in the aortic annulus; 4) valvular surgery and, especially, tricuspid valve surgery; and 5) poor myocardial protection. Postoperative permanent pacing had a considerable impact on patient morbidity from maintenance operations; most complications were lead-related problems.

Risk factors for pacemaker implantation following aortic valve replacement: a single centre experience

“…[12][13][14][15] Previous studies have already evaluated perioperative risk predictors of PPI after cardiac surgery in large cohorts of patients with different diseases. [12][13][14][15][16][17][18] However, there are only scanty data on the development of irreversible AV block requiring PPI after aortic valve replacement, especially in the presence of isolated aortic regurgitation or in the case of combined aortic stenosis and regurgitation. In our series of 276 patients (39% with isolated aortic stenosis, 29% with isolated aortic regurgitation, and 32% with combined aortic stenosis and regurgitation), we found severe heart block requiring PPI only in 3.2%.…”

“…4 9 12-15 The requirement for permanent pacemaker implantation (PPI) is more frequent after valve surgery (ranging from 3-6%) than after isolated coronary artery bypass grafting (0.8%). [13][14][15][16][17][18] The incidence of conduction disorders requiring permanent pacing in patients operated on for aortic valve replacement has been reported to be 5.7%. 16 However, perioperative risk predictors for PPI after aortic valve replacement are not well characterised.…”

Pacemaker Following Adult Cardiac Surgery

“…This would explain well the different incidences between those who Prevalence differs according to the type of surgery. In a retrospective review of 5,942 patients who underwent open-heart surgery to resolve acquired heart disease, it was observed that 2.1% of patients required PPM postoperatively; 4.6% of them underwent predominantly valve surgery, and 0.6% CABG surgery (Goldman, 1984). In a study of 10,421 patients a PPM prevalence of 0.4% to 1.1% after CABG, and 3.0 to 6.0% after valve operation was found.…”

Conduction disturbances after superior septal approach for mitral valve repair

“…3. An operative view in a case of a left atrial tumor predominantly valvular surgery and 0.6% had coronary bypass (Goldman et al, 1984). They also showed that risk factors of postoperative pacemaker implantation appeared to be: 1) preoperative evidence of a conduction disorder; 2) advanced patient age; 3) dense calcium in the aortic annulus; 4) valvular surgery and, especially, tricuspid valve surgery; and 5) poor myocardial protection.…”