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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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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 |
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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 |
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