Valvular heart diseaseFrequency of Conduction Disturbances After Transcatheter Implantation of an Edwards Sapien Aortic Valve Prosthesis
Section snippets
Methods
From April 2006 to May 2009, 87 consecutive patients with severe aortic stenosis underwent implantation with an Edwards Sapien prosthesis at Rouen University Hospital (Rouen, France). They were included in 2 prospective European multicenter feasibility studies (Registry of EndoVascular Implantation of Valves in Europe [REVIVE] and Placement of AoRTic TraNscatheter valves trial (EUrope) [PARTNER-EU]) and thereafter in the European SOURCE postmarket registry. Inclusion criteria were an aortic
Results
TAVI was performed using the transfemoral approach in 54 patients (78.2%) and the transapical approach in 15 patients (21.8%). Mean hospital stay was 10.1 ± 6.5 days. Electrocardiograms were analyzed in all 69 patients at day 1 and in 64 of 69 patients at 1 month; 3 patients died within the interval and 2 ECG tracings were not available for interpretation. Clinical evaluation was obtained during follow-up in all cases. Survival at 1 month was 95.6%.
Before the procedure, most patients (79.7%)
Discussion
New-onset AV block is a classic complication of surgical aortic valve replacement, requiring the implantation of a pacemaker in approximately 6% of interventions.17, 18 This is mainly caused by surgical trauma to the very near conduction system,7, 19 which emerges in the ventricles on the crest of the ventricular septum. The left bundle branch exits 2 to 3 mm below the base of the triangle formed by the noncoronary and right coronary cusps of the aortic valve, close to the annulus and left
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Pre-Existing Right Bundle Branch Block Increases Risk for Death After Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve
2016, JACC: Cardiovascular InterventionsA Prospective Analysis of Early Discharge After Transfemoral Transcatheter Aortic Valve Implantation
2016, American Journal of CardiologyShort- and long-term need for permanent pacemaker after transcatheter implantation of the Edwards Sapien aortic valve prosthesis
2015, Revista Portuguesa de CardiologiaThe utility of atrioventricular pacing via pulmonary artery catheter during transcatheter aortic valve replacement
2015, Journal of Cardiothoracic and Vascular AnesthesiaFeasibility and safety of early discharge after transfemoral transcatheter aortic valve implantation with the Edwards SAPIEN-XT prosthesis
2015, American Journal of CardiologyCitation Excerpt :Furthermore, delayed (i.e., >24 hours after the procedure) high-grade atrioventricular block has never been reported using the Edwards SAPIEN-XT prosthesis. In contrast, with the Corevalve, the incidence of complete atrioventricular block requiring permanent pacemaker is higher, occurring in up to 25% of cases and can be delayed, thus requiring prolonged electrocardiographic monitoring after TAVI.15–17 By multivariable analysis, the most powerful predictive factor of early discharge failure was transfusions.
Dr. Cribier is a consultant for Edwards Lifesciences (Irvine, California).