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Permanent pacemaker implantation after transcatheter aortic valve replacement in bicuspid aortic valve patients.
- Source :
- Journal of Interventional Cardiology; Dec2018, Vol. 31 Issue 6, p878-884, 7p
- Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>Studies of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) specifically for bicuspid aortic valve (BAV) patients are lacking. We aim to delineate possible aspects that might affect the incidence of PPI in a retrospective cohort of BAV patients treated with early-generation self-expanding devices.<bold>Methods: </bold>A total of 80 patients with bicuspid morphology who successfully underwent TAVR by self-expanding devices without prior PPI were included. Baseline clinical, echocardiographic, and angiographic characteristics, procedural and post-procedural details were collected.<bold>Results: </bold>The incidence of PPI after early-generation self-expanding valves in this BAV cohort was 26.3%. Baseline characteristics were comparable between patients requiring PPI post-TAVR or not. Perimeter oversizing greater than 20% significantly increased the risk of PPI compared with an oversizing of 10-20% (OR 5.08 [1.22, 21.07], P = 0.03). The proportion of patients with a depth of implantation greater than 6 mm was significantly higher in those who required PPI (82.4% vs 54.3%, P = 0.04). When testing the impact of depth of implantation >6 mm and oversizing in different morphologies, only in type 1 bicuspid patients and by oversizing>20% increased the risk of PPI (OR 12.00 [1.25, 115.36], P = 0.03) compared with an oversizing of 10-20%.<bold>Conclusions: </bold>Excessive perimeter oversizing in relation to aortic annulus and depth of implantation greater than 6 mm should be avoided to improve PPI post-TAVR for BAV patients receiving self-expanding devices, especially for type 1 BAV. [ABSTRACT FROM AUTHOR]
- Subjects :
- AORTIC valve
CARDIAC surgery
CHEMOEMBOLIZATION
AORTIC stenosis
HEART valves
AORTIC valve surgery
AORTIC valve abnormalities
ARRHYTHMIA
CARDIAC pacemakers
PROSTHETIC heart valves
HEART valve diseases
RESEARCH funding
TREATMENT effectiveness
DISEASE incidence
RETROSPECTIVE studies
MULTIDETECTOR computed tomography
Subjects
Details
- Language :
- English
- ISSN :
- 08964327
- Volume :
- 31
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Journal of Interventional Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 133428248
- Full Text :
- https://doi.org/10.1111/joic.12546