Recovery From Conduction Abnormalities After Aortic Valve Replacement Using Edwards Intuity.

PURPOSE: This study investigated the incidences of various conduction abnormalities after rapid-deployment aortic valve replacement using Edwards Intuity (Edwards Lifesciences, Irvine, CA) valve and the temporal changes of these abnormalities during the postoperative course.

DESCRIPTION: We modified the procedure by placing additional anchoring sutures and using a 5-mm videoscope to achieve "complete annulus fitting." Direct visual inspection by videoscopy inside and outside the valve guaranteed complete annulus fitting.

EVALUATION: Overall 167 patients who underwent rapid-deployment aortic valve replacement during the study period were included in the analysis of postoperative conduction abnormalities. After rapid-deployment aortic valve replacement, third-degree atrioventricular block occurred in 18 patients (10.8%), but 15 patients recovered to sinus rhythm at median postoperative 10 days. Left or right bundle branch block occurred in 67 patients (40.1%), but 44 patients returned to their original rhythm at median postoperative 12 days. Delayed-onset conduction abnormalities occurred in 35 patients (21.0%) at median postoperative day 4, and spontaneously regressed in 28 patients.

CONCLUSIONS

The incidence of conduction abnormalities after rapid-deployment aortic valve replacement was high, but most of these abnormalities spontaneously recovered. These good results may be attributed to our implantation technique.