Cargando…

Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant

OBJECTIVES: Our goal was to compare pacemaker rate usage following two different operating techniques for implanting the Perceval aortic valve replacement. METHODS: In this retrospective, single-centre study, we studied patients with isolated or concomitant Perceval aortic valve replacement operated...

Descripción completa

Detalles Bibliográficos
Autores principales: Fabre, Olivier, Radutoiu, Mihai, Carjaliu, Ionut, Rebet, Olivier, Gautier, Laurence, Hysi, Ilir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295764/
https://www.ncbi.nlm.nih.gov/pubmed/35751610
http://dx.doi.org/10.1093/icvts/ivac182
_version_ 1784750120620785664
author Fabre, Olivier
Radutoiu, Mihai
Carjaliu, Ionut
Rebet, Olivier
Gautier, Laurence
Hysi, Ilir
author_facet Fabre, Olivier
Radutoiu, Mihai
Carjaliu, Ionut
Rebet, Olivier
Gautier, Laurence
Hysi, Ilir
author_sort Fabre, Olivier
collection PubMed
description OBJECTIVES: Our goal was to compare pacemaker rate usage following two different operating techniques for implanting the Perceval aortic valve replacement. METHODS: In this retrospective, single-centre study, we studied patients with isolated or concomitant Perceval aortic valve replacement operated on first between April 2013 and January 2016, following traditional operating techniques, with patients operated on between January 2016 and December 2020, after the adoption of a modified protocol based on different annulus sizing, higher positioning of the valve and no ballooning after valve deployment was adopted. The operations were performed by 2 surgeons, and patients were followed-up for a period of 30 days. RESULTS: A total of 286 patients, with a mean age of 77 (4.9) years, had Perceval valves implanted during the study period, of which 79% were isolated aortic valve procedures. Most patients (66.8%) underwent minimally invasive procedures. Cross-clamp time was 55.1 (17.6) min. The overall postoperative pacemaker insertion rate was 8.4%, which decreased decisively after the 2016 change in the implant protocol (16% vs 5.6%; P = 0.005), adjusted odds ratio of 0.31 (95% confidence interval: 0.13–0.74, P = 0.012). Univariable and multivariable analysis showed that larger valve size (P = 0.01) and ballooning (P = 0.002) were associated with higher risk of implanting a pacemaker. Postoperative 30-day mortality was of 4.5%. CONCLUSIONS: Improvement in the operating techniques for implanting the Perceval valve may decrease the rate of pacemakers implanted postoperatively. Although further studies are needed to confirm these results, such a risk reduction may lead to wider use of Perceval valves in the future, potentially benefiting patients who are suitable candidates for minimally invasive surgery.
format Online
Article
Text
id pubmed-9295764
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-92957642022-07-20 Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant Fabre, Olivier Radutoiu, Mihai Carjaliu, Ionut Rebet, Olivier Gautier, Laurence Hysi, Ilir Interact Cardiovasc Thorac Surg Adult Cardiac OBJECTIVES: Our goal was to compare pacemaker rate usage following two different operating techniques for implanting the Perceval aortic valve replacement. METHODS: In this retrospective, single-centre study, we studied patients with isolated or concomitant Perceval aortic valve replacement operated on first between April 2013 and January 2016, following traditional operating techniques, with patients operated on between January 2016 and December 2020, after the adoption of a modified protocol based on different annulus sizing, higher positioning of the valve and no ballooning after valve deployment was adopted. The operations were performed by 2 surgeons, and patients were followed-up for a period of 30 days. RESULTS: A total of 286 patients, with a mean age of 77 (4.9) years, had Perceval valves implanted during the study period, of which 79% were isolated aortic valve procedures. Most patients (66.8%) underwent minimally invasive procedures. Cross-clamp time was 55.1 (17.6) min. The overall postoperative pacemaker insertion rate was 8.4%, which decreased decisively after the 2016 change in the implant protocol (16% vs 5.6%; P = 0.005), adjusted odds ratio of 0.31 (95% confidence interval: 0.13–0.74, P = 0.012). Univariable and multivariable analysis showed that larger valve size (P = 0.01) and ballooning (P = 0.002) were associated with higher risk of implanting a pacemaker. Postoperative 30-day mortality was of 4.5%. CONCLUSIONS: Improvement in the operating techniques for implanting the Perceval valve may decrease the rate of pacemakers implanted postoperatively. Although further studies are needed to confirm these results, such a risk reduction may lead to wider use of Perceval valves in the future, potentially benefiting patients who are suitable candidates for minimally invasive surgery. Oxford University Press 2022-06-25 /pmc/articles/PMC9295764/ /pubmed/35751610 http://dx.doi.org/10.1093/icvts/ivac182 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Adult Cardiac
Fabre, Olivier
Radutoiu, Mihai
Carjaliu, Ionut
Rebet, Olivier
Gautier, Laurence
Hysi, Ilir
Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant
title Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant
title_full Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant
title_fullStr Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant
title_full_unstemmed Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant
title_short Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant
title_sort recent improvement in operative techniques lead to lower pacemaker rate after perceval implant
topic Adult Cardiac
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295764/
https://www.ncbi.nlm.nih.gov/pubmed/35751610
http://dx.doi.org/10.1093/icvts/ivac182
work_keys_str_mv AT fabreolivier recentimprovementinoperativetechniquesleadtolowerpacemakerrateafterpercevalimplant
AT radutoiumihai recentimprovementinoperativetechniquesleadtolowerpacemakerrateafterpercevalimplant
AT carjaliuionut recentimprovementinoperativetechniquesleadtolowerpacemakerrateafterpercevalimplant
AT rebetolivier recentimprovementinoperativetechniquesleadtolowerpacemakerrateafterpercevalimplant
AT gautierlaurence recentimprovementinoperativetechniquesleadtolowerpacemakerrateafterpercevalimplant
AT hysiilir recentimprovementinoperativetechniquesleadtolowerpacemakerrateafterpercevalimplant