Sohn, Suk Ho; Kim, Kyung Hwan; Kang, Yoonjin; Kim, Ji Seong; Choi, Jae Woong
The Annals of thoracic surgery
2021Apr ; 100 ( 13 ) :.
PMID : 33905729
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Sohn, Suk Ho - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Kim, Kyung Hwan - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. Electronic address: kkh726@snu.ac.kr.
Kang, Yoonjin - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Kim, Ji Seong - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Choi, Jae Woong - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
ABSTRACT
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. CI - Copyright ??2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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