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Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease

BACKGROUND: Carcinoid heart disease (CaHD) is a rare condition that has a high impact on the morbidity and mortality of its patients. Once heart failure symptoms develop in the patient with CaHD, cardiac valve surgery is often the only effective treatment. Although atrioventricular block (AVB) is a...

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Autores principales: Sunjic, Igor, Shin, Doosup, Sunjic, Katlynd M., Popat, Jesal V., Tran, Thanh, Chae, Sanders H., Caldeira, Christiano C., Strosberg, Jonathan R., Sayad, Dany
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011921/
https://www.ncbi.nlm.nih.gov/pubmed/32095197
http://dx.doi.org/10.14740/cr986
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author Sunjic, Igor
Shin, Doosup
Sunjic, Katlynd M.
Popat, Jesal V.
Tran, Thanh
Chae, Sanders H.
Caldeira, Christiano C.
Strosberg, Jonathan R.
Sayad, Dany
author_facet Sunjic, Igor
Shin, Doosup
Sunjic, Katlynd M.
Popat, Jesal V.
Tran, Thanh
Chae, Sanders H.
Caldeira, Christiano C.
Strosberg, Jonathan R.
Sayad, Dany
author_sort Sunjic, Igor
collection PubMed
description BACKGROUND: Carcinoid heart disease (CaHD) is a rare condition that has a high impact on the morbidity and mortality of its patients. Once heart failure symptoms develop in the patient with CaHD, cardiac valve surgery is often the only effective treatment. Although atrioventricular block (AVB) is a known postoperative complication of the valve surgery, the incidence of AVB in this population has not been well described. METHODS: Comprehensive records were collected retrospectively on consecutive patients with CaHD who underwent a valve surgery at a tertiary medical center from January 2001 to December 2015. We excluded patients with pre-existing permanent pacemaker (PPM). RESULTS: Nineteen consecutive patients were included in this study and 18 of them underwent at least dual valve (tricuspid and pulmonary valve) replacement surgery. Our 30-day post-surgical mortality was 0%. During the 6-month observation period following the surgery, 31.5% (n = 6) required PPM implantation due to complete AVB. There was no statistical difference in baseline characteristics and electrocardiographic and echocardiographic parameters between the patients who did or did not require PPM placement. CONCLUSIONS: Our study revealed that almost one-third of CaHD patients who underwent a valve replacement surgery developed AVB requiring PPM implantation. Due to high incidence of PPM requirement, we believe that prophylactic placement of an epicardial lead during the valve surgery can be helpful in these patients to reduce serious complication from placement of pacemaker lead on a later date through a prosthetic valve.
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spelling pubmed-70119212020-02-24 Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease Sunjic, Igor Shin, Doosup Sunjic, Katlynd M. Popat, Jesal V. Tran, Thanh Chae, Sanders H. Caldeira, Christiano C. Strosberg, Jonathan R. Sayad, Dany Cardiol Res Short Communication BACKGROUND: Carcinoid heart disease (CaHD) is a rare condition that has a high impact on the morbidity and mortality of its patients. Once heart failure symptoms develop in the patient with CaHD, cardiac valve surgery is often the only effective treatment. Although atrioventricular block (AVB) is a known postoperative complication of the valve surgery, the incidence of AVB in this population has not been well described. METHODS: Comprehensive records were collected retrospectively on consecutive patients with CaHD who underwent a valve surgery at a tertiary medical center from January 2001 to December 2015. We excluded patients with pre-existing permanent pacemaker (PPM). RESULTS: Nineteen consecutive patients were included in this study and 18 of them underwent at least dual valve (tricuspid and pulmonary valve) replacement surgery. Our 30-day post-surgical mortality was 0%. During the 6-month observation period following the surgery, 31.5% (n = 6) required PPM implantation due to complete AVB. There was no statistical difference in baseline characteristics and electrocardiographic and echocardiographic parameters between the patients who did or did not require PPM placement. CONCLUSIONS: Our study revealed that almost one-third of CaHD patients who underwent a valve replacement surgery developed AVB requiring PPM implantation. Due to high incidence of PPM requirement, we believe that prophylactic placement of an epicardial lead during the valve surgery can be helpful in these patients to reduce serious complication from placement of pacemaker lead on a later date through a prosthetic valve. Elmer Press 2020-02 2020-01-26 /pmc/articles/PMC7011921/ /pubmed/32095197 http://dx.doi.org/10.14740/cr986 Text en Copyright 2020, Sunjic et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Communication
Sunjic, Igor
Shin, Doosup
Sunjic, Katlynd M.
Popat, Jesal V.
Tran, Thanh
Chae, Sanders H.
Caldeira, Christiano C.
Strosberg, Jonathan R.
Sayad, Dany
Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease
title Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease
title_full Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease
title_fullStr Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease
title_full_unstemmed Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease
title_short Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease
title_sort incidence of atrioventricular block after valve replacement in carcinoid heart disease
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011921/
https://www.ncbi.nlm.nih.gov/pubmed/32095197
http://dx.doi.org/10.14740/cr986
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