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SHR Neuro Cancer Cardio Lipid Metab Microb

Lorusso, R; Ravaux, JM; Pollari, F; Folliguet, TA; Kappert, U; Meuris, B; Shrestha, ML; Roselli, EE; Bonaros, N; Fabre, O; Corbi, P; Troise, G; Andreas, M; Pinaud, F; Pfeiffer, S; Kueri, S; Tan, E; Voisine, P; Girdauskas, E; Rega, F; Garcia-Puente, J; Fischlein, T.
Pacemaker implantation after sutureless or stented valve: results from a controlled randomized trial
EUR J CARDIO-THORAC. 2022; 62(4): Doi: 10.1093/ejcts/ezac164
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Andreas Martin
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Abstract:: OBJECTIVES: Sutureless aortic valves demonstrated non-inferiority to standard stented valves for major cardiovascular and cerebral events at 1 year after aortic valve replacement. We aim to assess the factors correlating with permanent pacemaker implantation (PPI) in both cohorts. METHODS: PERSIST-AVR is a prospective, randomized, open-label trial. Patients undergoing aortic valve replacement were randomized to receive a sutureless aortic valve replacement (Su-AVR) or stented sutured bioprosthesis (SAVR). Multivariable analysis was performed to identify possible independent risk factors associated with PPI. A logistic regression analysis was performed to estimate the risk of PPI associated to different valve size. RESULTS: The 2 groups (Su-AVR; n = 450, SAVR n = 446) were well balanced in terms of preoperative risk factors. Early PPI rates were 10.4% in the Su-AVR group and 3.1% in the SAVR. PPI prevalence correlated with valve size XL (P = 0.0119) and preoperative conduction disturbances (P = 0.0079) in the Su-AVR group. No predictors were found in the SAVR cohort. Logistic regression analysis showed a significantly higher risk for PPI with size XL compared to each individual sutureless valve sizes [odds ratio (OR) 0.272 vs size S (95%confidence interval 0.07-0.95), 0.334 vs size M (95% CI 0,16-0; 68), 0.408 vs size L (95% CI 0,21-0.81)] but equivalent risk of PPI rates for all other combination of valve sizes. CONCLUSIONS: Su-AVR is associated with higher PPI rate as compared to SAVR. However, the increased PPI rate appears to be size-dependent with significant higher rate only for size XL. The combination of preoperative conduction disorder and a size XL can lead to a higher probability of early PPI in Su-AVR.
Find related publications in this database (Keywords): Aortic valve replacement; Pacemaker; Sutureless valves