Prolonged bradyarrhythmias after isolated coronary artery bypass graft surgery

Emlein, Georg; Huang, Shoei K. Stephen; Pires, Luís A.; Rofino, Karen; Okike, O.; Salm, Thomas J. Vander

doi:10.1016/0002-8703(93)90658-v

Cited by 40 publications

(32 citation statements)

References 11 publications

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“…We also found that complete heart block occurred more frequently in patients with PMV. In a study by Chen et al, they identified the presence of a preoperative left bundle branch block (LBBB), and of concomitant left ventricular (LV) aneurysmectomy as reasons of bradycardia or complete heart block that may cause hypoxemia [27]; other studies showed that persistent hypoxemia was the most common cause for PMV [28]. In our patients without PMV the mean ± SD (standard deviation) hours of early intubation was 9.37±0.13 hours (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Predictors and Early Outcome of Prolonged Mechanical Ventilation in Contemporary Heart valve Surgery

Shirzad¹,

Karimi²,

Ahmadi³

et al. 2015

Monaldi Arch Chest Dis

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Predictors and Early Outcome of ProlongedResults: PMV occurred in 6.6% of patients. Initial ventilation hours, atrial fibrillation, cardiac arrest and reintubation were the most prevalent postoperative complications. Preoperative renal failure, postoperative stroke, intra aortic balloon pump insertion, emergent operation, complete heart block, longer perfusion time were independent predictors of PMV in our patients.Conclusion: PMV is associated with significant comorbidities and increased hospital mortality. Strategies to delineate the patients at risk and to modify these risk factors by prophylactic measures should probably lead to a lower incidence of prolonged mechanical ventilation for patients undergoing isolated valve surgery.

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Section: Discussionmentioning

confidence: 99%

Predictors and Early Outcome of Prolonged Mechanical Ventilation in Contemporary Heart valve Surgery

Shirzad¹,

Karimi²,

Ahmadi³

et al. 2015

Monaldi Arch Chest Dis

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“…[1][2][3][4][5][6][7][8][9][10][11] However, the need for a permanent pacemaker is uncommon, though it significantly increases the length of hospital stay and the overall costs. 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%.…”

mentioning

confidence: 99%

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

Limongelli

Ducceschi²,

D’Andrea³

et al. 2003

Heart

137

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Objective: To identify perioperative clinical predictors of permanent pacemaker implantation following aortic valve replacement. Design and patients: Prospective cohort study on 276 patients submitted for aortic valve replacement: 267 patients (mean (SD) age, 57.5 (14) years) with no conduction disturbances, and nine patients (67.7 (5) years) with severe conduction disturbances requiring permanent pacing; 65 perioperative variables (38 preoperative, eight intraoperative, and 19 postoperative) were considered. Results: Nine patients (3.2%) had irreversible second or third degree atrioventricular (AV) block requiring permanent pacing. Risk factors for permanent pacing identified by univariate analysis were: preoperative: additional valvar disease, aortic regurgitation, myocardial infarction, pulmonary hypertension, anaemia, use of digitalis; intraoperative: cardiac arrest; postoperative: cardiac arrest, conduction disturbances, electrolytic imbalance, angiotensin converting enzyme inhibitor use. Multivariate logistic regression analysis identified preoperative aortic regurgitation (p < 0.005; odds ratio (OR) 6.6, 95% confidence interval (CI) 1.6 to 12.2), myocardial infarction (p < 0.0005; OR 15.2, 95% CI 6.3 to 19.9), pulmonary hypertension (p < 0.005; OR 12.5, 95% CI 3.2 to 18.3), and postoperative electrolyte imbalance (p < 0.01; OR 4.5, 95% CI 1.3 to 6.4). Conclusions: Irreversible AV block requiring permanent pacemaker implantation is an uncommon condition following aortic valve replacement. Previous aortic regurgitation, myocardial infarction, pulmonary hypertension, and postoperative electrolyte imbalance should be considered in order to identify patients at increased risk for advanced AV block.

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“…The inci dence of pacemaker implantation after surgical aortic valve replacement is 3-8%. [53][54][55] The rate of pacemaker implant ation with the firstgeneration TAVI devices was higher with the selfexpandable CoreValve® device (26.4% at 30 days and 29.3% at 1 year) 51 than with the balloon expandable SAPIEN® XT (3-12%). [5][6][7][8][9] The rate of rhythm disturbances with the newgeneration devices should be further e valuated outside of formal clinical trials.…”

Section: Discussionmentioning

confidence: 99%

New devices for TAVI: technologies and initial clinical experiences

et al. 2014

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Treatment of aortic stenosis in high-risk surgical patients has been modified in the past 10 years owing to the introduction of transcatheter aortic valve implantation (TAVI). Several issues affecting outcomes with implantation of the first-generation TAVI devices remain unresolved, including haemorrhagic and vascular complications, neurological events, rhythm disturbances, and paravalvular leakage. Further technological improvements are, therefore, required before the indications for TAVI can be extended to young and low-risk patients with aortic stenosis. Many new-generation TAVI devices are currently in the early stages of clinical evaluation. Modifications in the new devices include the ability to reposition the valve before final deployment, features to reduce paravalvular leakage, and the introduction of low-profile delivery systems. The aim of this Review is to provide an overview of the new-generation transcatheter valvular technologies, including initial clinical reports.

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Prolonged bradyarrhythmias after isolated coronary artery bypass graft surgery

Cited by 40 publications

References 11 publications

Predictors and Early Outcome of Prolonged Mechanical Ventilation in Contemporary Heart valve Surgery

Predictors and Early Outcome of Prolonged Mechanical Ventilation in Contemporary Heart valve Surgery

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

New devices for TAVI: technologies and initial clinical experiences

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