Journal of cardiothoracic surgery · 2026
Early reversal of cardiac remodeling in patients with new-onset persistent left bundle branch block after transcatheter aortic valve replacement.
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Wang Shuzhen, Tan Kunyue, Gao Xiaoqiang, Zhang Lijuan, Liu Chunxia, Huang Xiaofeng, Yan Shuangshuang, Guo Jing, Xiong Feng
Аннотация
OBJECTIVE: New-onset persistent left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR) is an independent predictor of long-term cardiovascular mortality in patients. The aim of this study is to evaluate the impact of new-onset LBBB on early cardiac reverse remodeling and clinical outcomes after TAVR.
METHODS: A retrospective analysis was performed on 101 patients who underwent successful TAVR for severe aortic stenosis between March 2021 and October 2024 at our institution. Echocardiographic variables indicative of cardiac remodeling were analysed preoperatively and at one and six months after TAVR. Furthermore, the clinical outcomes of the patients were monitored during the follow-up period.
RESULT: Of the 101 patients who underwent TAVR, 28 (27.7%) had new-onset LBBB. Transcatheter heart valve(THV) implantation depth was an influential factor for new LBBB, which was more prevalent in patients with thinner interventricular septal thickness preoperatively. At the six-month follow-up, the new-LBBB group showed an increase in left ventricular diameter and left ventricular mass index and a reduction in left ventricular ejection fraction compared with the preoperative period. Mitral regurgitation in the no-LBBB group was significantly reduced at 1 month postoperatively. In contrast, mitral regurgitation in new-LBBB group was reduced at one month postoperatively, but worsened at six months.There was no significant difference in rehospitalization rates within 6 months postoperatively between patients with or without LBBB.
CONCLUSIONS: New-onset persistent LBBB after TAVR did not affect short-term rehospitalization, but may adversely affect early postoperative reversal of cardiac remodeling.
METHODS: A retrospective analysis was performed on 101 patients who underwent successful TAVR for severe aortic stenosis between March 2021 and October 2024 at our institution. Echocardiographic variables indicative of cardiac remodeling were analysed preoperatively and at one and six months after TAVR. Furthermore, the clinical outcomes of the patients were monitored during the follow-up period.
RESULT: Of the 101 patients who underwent TAVR, 28 (27.7%) had new-onset LBBB. Transcatheter heart valve(THV) implantation depth was an influential factor for new LBBB, which was more prevalent in patients with thinner interventricular septal thickness preoperatively. At the six-month follow-up, the new-LBBB group showed an increase in left ventricular diameter and left ventricular mass index and a reduction in left ventricular ejection fraction compared with the preoperative period. Mitral regurgitation in the no-LBBB group was significantly reduced at 1 month postoperatively. In contrast, mitral regurgitation in new-LBBB group was reduced at one month postoperatively, but worsened at six months.There was no significant difference in rehospitalization rates within 6 months postoperatively between patients with or without LBBB.
CONCLUSIONS: New-onset persistent LBBB after TAVR did not affect short-term rehospitalization, but may adversely affect early postoperative reversal of cardiac remodeling.