EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2017
Left bundle branch block after sutureless, transcatheter, and stented biological aortic valve replacement for aortic stenosis.
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Regeer Madelien V, Merkestein Lisanne R, de Weger Arend, Kamperidis Vasileios, van der Kley Frank, van Rosendael Philippe J, Marsan Nina Ajmone, Klautz Robert J M, Schalij Martin J, Bax Jeroen J, Delgado Victoria
Аннотация
AIMS: Conventional aortic valve replacement (AVR), sutureless AVR (su-AVR) and transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) are associated with conduction abnormalities. The aim of the present study was to assess the incidence of left bundle branch block (LBBB) after su-AVR and TAVI, in comparison to conventional AVR.
METHODS AND RESULTS: A total of 501 patients (mean age 74±8 years, 53% male) without preoperative cardiac conduction disturbances who underwent AVR or TAVI were included in the study. Su-AVR patients and TAVI patients had a higher incidence of new-onset LBBB at hospital discharge (23% and 16%, respectively) compared to patients treated with conventional AVR (4%; p<0.001). On multivariate logistic regression analyses, the type of AVR was independently associated with complete LBBB, after correcting for age, preoperative QRS duration and heart rate (su-AVR and TAVI relative to the reference category conventional AVR: odds ratio [OR] 8.5, 95% confidence interval [CI]: 3.7-19.5; p<0.001, and OR 5.8, 95% CI: 2.4-14.1; p<0.001, respectively).
CONCLUSIONS: Su-AVR and TAVI were associated with higher risk of developing postoperative LBBB compared to conventional AVR, after adjusting for age, preoperative heart rate and QRS duration.
METHODS AND RESULTS: A total of 501 patients (mean age 74±8 years, 53% male) without preoperative cardiac conduction disturbances who underwent AVR or TAVI were included in the study. Su-AVR patients and TAVI patients had a higher incidence of new-onset LBBB at hospital discharge (23% and 16%, respectively) compared to patients treated with conventional AVR (4%; p<0.001). On multivariate logistic regression analyses, the type of AVR was independently associated with complete LBBB, after correcting for age, preoperative QRS duration and heart rate (su-AVR and TAVI relative to the reference category conventional AVR: odds ratio [OR] 8.5, 95% confidence interval [CI]: 3.7-19.5; p<0.001, and OR 5.8, 95% CI: 2.4-14.1; p<0.001, respectively).
CONCLUSIONS: Su-AVR and TAVI were associated with higher risk of developing postoperative LBBB compared to conventional AVR, after adjusting for age, preoperative heart rate and QRS duration.