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Revista argentina de cardiología
On-line version ISSN 1850-3748
Abstract
SZTEJFMAN, MATÍAS et al. Impact of Cusp-Overlap Technique on Pacemaker Requirement after Transcatheter Aortic Valve Implantation. Rev. argent. cardiol. [online]. 2021, vol.89, n.2, pp.140-144. Epub Apr 01, 2021. ISSN 1850-3748. http://dx.doi.org/10.7775/rac.es.v89.i2.19091.
Background:
Persistent bradyarrhythmias requiring permanent pacemaker implantation are a common complication after transcatheter aortic valve implantation (TAVI), but high implantation with cusp-overlap technique could prevent conduction system disturbances.
Objective:
The aim of this study was to assess the rate of pacemaker use in patients who received TAVI with conventional coplanar technique compared with cusp-overlap technique.
Methods:
A total of 65 consecutive patients from two centers receiving Evolut-R or Evolut-Pro valve implantation, 50 coplanar and 15 cusp-overlap, were analyzed between 2017 and 2019.
Results:
Mean age was 80 years, and there were no differences in risk according to the EuroSCORE. The rate of pacemaker requirement was 0% in cusp-overlap procedures compared with 24.9% in those with conventional implantation; p=0.041). In addition, cusp-overlap implants presented lower rate of major complications (6.67% vs. 42%; OR=0.09; 95% CI 0.01-0.8; p=0.011).
Conclusions:
In this cohort, TAVI procedure with cusp-overlap technique was associated with null pacemaker requirement. Given the potential large-scale impact, external validation of results is needed.
Keywords : Transcatheter aortic valve replacement; Atrioventricular block; Pacemaker, Artificial; Heart Valve Prosthesis Implantation/methods.