TY  - JOUR
AU  - Berretta, Paolo
AU  - Montecchiani, Luca
AU  - Vagnarelli, Fabio
AU  - Cefarelli, Mariano
AU  - Alfonsi, Jacopo
AU  - Zingaro, Carlo
AU  - Capestro, Filippo
AU  - Pierri, Michele D.
AU  - D’alfonso, Alessandro
AU  - Di Eusanio, Marco
PY  - 2020
TI  - Conduction disorders after aortic valve replacement: what is the real impact of sutureless and rapid deployment valves?
JF  - Annals of Cardiothoracic Surgery; Vol 9, No 5 (September 30, 2020): Sutureless and Rapid Deployment Aortic Valve Replacement II
Y2  - 2020
KW  - 
N2  - Background: Although sutureless and rapid deployment aortic valve replacement (SURD-AVR) has been associated with an increased rate of permanent pacemaker (PPM) implantation compared to conventional AVR (c-AVR), the predictors of new conduction abnormalities remain to be clarified. This study aimed to identify risk factors for conduction disorders in patients undergoing AVR surgery.  Methods: Data from 243 patients receiving minimally invasive AVR were prospectively collected. SURD-AVR was performed in 103 (42.4%) patients and c-AVR in 140 (57.6%). The primary end-point was the occurrence of new-onset conduction disorders, defined as first degree atrioventricular (AV) block, advanced AV block requiring PPM implantation, left anterior fascicular block (LAFB), left bundle branch block (LBBB) and right bundle branch block (RBBB).  Results: The unadjusted comparison revealed that SURD-AVR was associated with a higher rate of advanced AV block requiring PPM when compared with c-AVR (10.5% vs. 2.1%, P=0.01). After adjusting for other measured covariates (OR: 1.6, P=0.58) and for the estimated propensity of SURD-AVR (OR: 5.1, P=0.1), no significant relationship between type of AVR and PPM implantation emerged. On multivariable analysis, preoperative first-degree AV block (OR: 6.9, P=0.04) and RBBB (OR: 6.9, P=0.03) were independent risk factors for PPM. Subgroup analysis of patients with normal preoperative conduction revealed similar incidence of PPM between SURD-AVR and c-AVR (1.3% vs. 1.9%, P=0.6). When compared with c-AVR, SURD-AVR was associated with a greater incidence of postoperative new onset LBBB (18.1% vs. 3.2%, P
UR  - https://www.annalscts.com/article/view/16739